• Korean Journal of Psychosomatic Medicine
• /
• v.2 no.1
• /
• pp.107-112
• /
• 1994

The authors tried to look into the process of the individual psychotherapeutic experience of a 18-year-old male diagnosed as somatoform pain disorder or chronic pain syndrome. The patient had showed strong resistance to acceptance of his psychological problems. Some issues such as indications of psychotherapy for chronic pain, changing the mode of the treatment some problems around changing the therapist secondary gain and parents' attitude were discussed considering their relatedness to the outcome. The psychotherapy had lasted about 2 years and the result was estimated as fair.

• Korean Journal of Psychosomatic Medicine
• /
• v.6 no.2
• /
• pp.193-209
• /
• 1998

The author conducted a literature review to better characterize the current state of knowledge regarding the relationship between psychological and behavioral factors and cardiovascular disease. This review focus on several problems : Hypertension, coronary artery disease such as myocardial infarction and angina pectoris. We describe model for understanding the relation-ship of psychological factors to the disease, review the results of relevant research studies and provide recommendation for further research.

• Korean Journal of Psychosomatic Medicine
• /
• v.1 no.1
• /
• pp.25-34
• /
• 1993

The author reviewed the general principle in the use of psychotropics for patients with renal diseases. who have psychiatric problems. Durgs which are dialyzable and metabolized or eliminated by kidney should not be used for patients with renal failure. However, lithium can be effectively used in a single dose$(300{\sim}600 mg/day)$ after each dialysis. though lithium has the double negative components. It is recommended that serum lithium level should be frequently monitored and the dose of lithium should be gradually increased to minimize its side effect Most of other psychotropics such as benzodiazepine anxiolytics tricyclic or tetracyclic antidepressants, and neuroleptics are metabolized in the liver, and they can be used in renal patients. The dose of these drugs should be reduced in two-thirds of the standard dose. In addition. it is necessary for liaison psychiatrists and other physicians to understand the interactions between psychotropics and drugs often used for treatment of renal diseases in order to prescribe psychotropics safely and effectively in renal patients.

• Korean Journal of Psychosomatic Medicine
• /
• v.4 no.1
• /
• pp.124-137
• /
• 1996

As the society becomes more industrialized and modernized, we have more chances to experience a serious traumatic event. Post-traumatic stress disorder (PTSD) has 3 major categories of symptoms such as memory disturbance, hyperarousal and avoidance or numbness. I reviewed the psychobiological evidences in 3 main categories of symptoms and the biological treatment after a brief review of the epidemiology, psychosocial etiology and diagnosis of PTSD. The memory disturbance of PTSD might be developed by the potentiation of the memory pathway mediated by norepinephrine. PTSD induces HPA axis abnormality, it might also develop hippocampal dysfunction, which might contribute to the memory disturbance. The kindling effect develops desensitization, which might develop reexperiencing of the traumatic events and hyperarousal state. Chronic aroused state of locus ceruleus with resultant chronic maladaptive state of norepinephrine system, might develop hyperarousal state. Social avoidance and physical numbing state in PTSD might be caused by serotnin or opiate system. Stress induced analgesia might be developed by opiate reliesed against the acute stress. The biologic research results would help the selective treatment of PTSD.

• Korean Journal of Psychosomatic Medicine
• /
• v.1 no.1
• /
• pp.101-108
• /
• 1993

A case of a 38 year-old woman with histrionic personality who had chronic epigastric pain, dyspepsia and alternating bowel habit for more than 10 years was presented in detail on its course of two times of admission and follow-up. The diagnosis was thought as psychophy-siological disorder or gastrointestinal motility disorder of undefined etiology rather than hypo-chondriasis or Briquet's syndrome. She was characterized by sustained illness behavior and combined several physical illnesses. i.e. tuberculosis. anemia and hepatic stone. These physical diseases led to a blurring of psychological and physical boundaries regarding symptom formation. The points on consultation from medical part to psychiatric department were discussed and the supposed causal mechanisms in non-organic functional gastrointestinal disturbances were also reviewed. Physical and psychological modalities for the treatment and the abnormal illness behavior were mainly emphasized in this case.

• Korean Journal of Psychosomatic Medicine
• /
• v.4 no.1
• /
• pp.98-108
• /
• 1996

Korean women are now living almost 1/3 of their life after menopause. Sex-steroid hormone deficiency adversely affect various fields of physical & mental activity and quality of life during this period. Therefore, replacement of deficient hormone is thought to be natural therapeutic modality. Postmenopausal syndrome is recently redefined as an endocrinopathy with both short-and long-term sequelae, as a result of cessation of ovarian function. Hormone replacement therapy taken at or near time of menopause alleviates shot-term acute menopausal symptoms such as vasomotor disturbances and psychological problems. HRT also beneficially affects some of intermediate symptoms such as urogenital atrophy and cutaneous problems. The major benefits of long-term use were reductions in risk of long-term sequelae, that is, total fracture by 50-60%, cardiovascular disease by 50% and cerebrovascular disease by 30-40%, respectively. In addition, HRT may also positively influence Alzheimer's disease, reduce the colorectal cancer risk and increase longevity of the life. In conclusion, all postmenopausal women should consider preventive HRT when there are no contraindications.

• Korean Journal of Psychosomatic Medicine
• /
• v.1 no.1
• /
• pp.92-97
• /
• 1993

Successful management of mental symptoms requires proper diagnostic tools and comprehensive treatment including psychotherapy, physical therapy and psychopharmacotherapy. For this purpose. valid and reliable diagnostic instruments need to be developed. and the data regarding various treatment methods in medical and psychiatric comorbid conditions should be available. Because mental symptoms originate from various aspects of biological, psychological and social factors. each aspect may have slightly different therapeutic goal. Alterations in pharmacokinetics and pharmacodynamics of medically ill and/or old patients may complicate the treatment outcomes. Best psychopharmacological treatment needs to be elaborated in various states. Mental symptoms of the medically ill patients may be treated more effectively with an eclectic approach.

• Korean Journal of Psychosomatic Medicine
• /
• v.1 no.1
• /
• pp.98-100
• /
• 1993

To become an effective and successful consultation-liasion psychiatrist the psychiatrist should consider two aspects of consultation before he/she meets his/her patients. First the psychiatrist should understand the internal need and psychological state of patients who visited their physician before being refered to a psychiatrist So psychiatrists should be careful in the evaluation of the patient's intention whether they are willing to accept the psychiatric treatment approach or not Second the psychiatrist should understand the situation and the physician's internal need in the consultation. Psychiatrists should recognize whether there are any factors which interfere with the mutual understanding and cooperation between physicians and psychiatrist.

• Korean Journal of Psychosomatic Medicine
• /
• v.4 no.1
• /
• pp.120-123
• /
• 1996

Regarding menopause as a turning point in woman's lift, the author reviewed the psychosocial aspects of menopause. Seeing menstruation as the symbolic meaning of female sexuality, psychoanalysts argue that menopause, the loss of symbolic meaning of female sexuality, may bring a mourning reaction to woman. It is reported that the high ratio of depression does not have a serious relationship with the menopause syndrome, and that depression cannot be viewed as a different symptoms. It is also proved that most women successfully recover themselves from temporary menopause symptom. Research data shows that some women have a negative thought on the meaning of menopause. Others, however, have a positive concept on the meaning of menopause because of the feeling of release and freedom. In sum, the author suggests that psychosocial consideration is very important as much as bilogical consideration in considering the meaning of menopausal syndrome.

• Korean Journal of Psychosomatic Medicine
• /
• v.22 no.2
• /
• pp.130-137
• /
• 2014

Objectives : Obsessive-compulsive(OC) symptoms have yet to be directly studied in neurodegenerative conditions involving behavioral changes. To examine regional abnormalities in the brains of dementia patients with OC symptoms, we assessed the gray matter density using voxel-based morphometry(VBM). Methods : We performed brain magnetic resonance imaging(MRI) with VBM analysis in 106 dementia patients with OC behaviors. In this study, OC behaviors were investigated in patients with neurodegenerative disease using the modified Manchester Behavior Questionnaire. Results : The OC behavior scores were correlated with structural brain volume using VBM. The total OC symptom score correlated negatively with the volume of both putamens, the right middle orbitofrontal gyrus, both anterior cingulate cortices, and the left insula(p<0.001, uncorrected). No gray matter reductions were associated specifically with the OC symptom sub-categories. Conclusions : Our results suggest that abnormalities in these brain regions may play an important role in the pathophysiology of OCD in neurodegenerative disease. This is the first lesion study to investigate the neural basis of OCD behaviors in neurodegenerative disease.