• 제목/요약/키워드: Somatic disorder

검색결과 101건 처리시간 0.029초

다면적 인성검사 II 재구성판(MMPI-2-RF) 척도의 진단적 유용성: 사회불안장애, 공황장애, 주요우울장애 비교 (Diagnostic Utility of Minnesota Multiphasic Personality Inventory-2-Restructured Form Scales: Distinguishing Social Anxiety Disorder, Panic Disorder, and Major Depressive Disorder)

  • 민해원;이정애;오강섭
    • 대한불안의학회지
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    • 제19권2호
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    • pp.69-76
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    • 2023
  • Objective : This study aimed to find out whether the Minnesota Multiphasic Personality Inventory-2-Restructured Form (MMPI-2-RF) scales are useful in distinguishing social anxiety disorder, panic disorder, and major depressive disorder. Methods : The study sample included 118 patients: 33 with social anxiety disorder, 53 with major depressive disorder, and 32 with panic disorder. Participants were classified according to the diagnosis indicated on their medical records. MMPI-2-RF scores were derived from MMPI-2 protocols. Results : The results of multivariate analysis of variance showed that the elevated scales were consistent with the diagnostic and clinical characteristics of each diafnostic group. Logistic regression analyses identified several scales that were useful in differentiating the diagnostic groups. The higher Cognitive Complaints (COG) scale significantly differentiated major depressive disorder from the other groups. The higher Self-Doubt (SFD) scale and Somatic Complaints (RC1) scale were useful in differentiating social anxiety disorder and panic disorder respectively. The lower Cynicism (RC3) scale was also useful in differentiating social anxiety disorder. Other scales that were useful in distinguishing between pairs of groups were also identified. Conclusion : The results of this study suggest that the MMPI-2-RF scales can be useful for discriminating anxiety disorders.

신체증상장애와 관련된 분노정서특질과 아동기 역경 경험 (Anger-Related Characteristics and Childhood Adversity in Somatic Symptom Disorder)

  • 강성혁;박천일;김혜원;김세주;강지인
    • 대한불안의학회지
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    • 제16권2호
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    • pp.49-56
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    • 2020
  • Objective : The present study aims to investigate differences in anger-related features in patients with somatic symptom disorder (SSD) compared to healthy controls, and to examine whether anger trait and anger regulation strategy are associated with clinical characteristics in patients with SSD. In addition, we examined the relationship between childhood adversity and SSD. Methods : 26 patients with SSD and 28 healthy controls were included. Anger-related features were assessed with State-Trait Anger Expression Inventory (STAXI). Clinical somatic symptoms were assessed using the somatization subscale of the Symptom Checklist-90-Revised and the Somatosensory Amplification Scale. Childhood adversity was assessed by the Childhood Traumatic Events Scale. Multivariate analysis of covariance was performed. Results : Disease status of SSD had a significant overall effect on anger-related features (Wilks λ=0.725, F(5, 44)=3.332, p=0.012). Patients with SSD showed a significantly high Trait-Anger (p=0.017) and they had a high score in both Anger-Out (p=0.013) and Anger-In (p=0.001) of anger expression styles. In particular, a directed inward style of anger expression was significantly associated with somatization symptom severity (p=0.003). Regarding childhood adversity, more childhood extreme illness was experienced by the SSD group than the control group (p=0.012). Within the SSD group, childhood extreme illness was associated with higher Trait-Anger (p=0.027) and Anger-Out (p=0.001). Conclusion : The present findings suggest that trait anger, anger expression styles, and childhood adversity of extreme illness may be involved in SSD. Further studies are needed to explore the role of anger-related features and its relationship with childhood adversity in the pathophysiology of SSD.

외상후스트레스장애 환자의 신체증상 지각 특성과 인지적 정서조절전략 (Characteristics of the Perception of the Somatic Symptoms and the Cognitive Emotion Regulation Strategies in Patients With Posttraumatic Stress Disorder)

  • 권주한;박종일;사공정규;양종철
    • 정신신체의학
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    • 제29권2호
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    • pp.102-110
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    • 2021
  • 연구목적 본 연구는 외상후스트레스장애 환자들의 신체증상 지각 특성과 인지적 정서조절전략을 탐색하기 위해 시행하였다. 방 법 본 연구는 2019년 7월 1일부터 2021년 2월 28일까지 48명의 외상후스트레스장애 환자들과 48명의 정상인을 대상으로 시행하였다. 환자군에 대해 임상가용 외상후스트레스장애 척도, 신체감각 증폭 척도, 인지적 정서조절전략 척도, Hamilton 불안 척도를 평가하였고 정상대조군에 대해 신체감각 증폭 척도를 평가하였다. 신체감각 증폭 척도에 대해 집단간 차이를 검증하였고 환자군에서 척도간 상관 관계를 확인하였다. 결 과 신체감각 증폭 정도는 외상후스트레스장애 환자들이 정상인보다 평균적으로 높았으나 유의하지는 않았다. 외상후스트레스장애 환자군에서, 외상후스트레스장애 증상 심각도는 반추, 파국화의 인지적 정서조절전략과 유의한 양의 상관관계를 나타냈고, 신체감각 증폭 정도는 외상후스트레스장애 과각성 증상과 파국화, 타인비난의 부적응적 인지적 정서조절전략과 유의한 양의 상관관계를 보였다. 결 론 외상후스트레스장애 환자들은 반추, 파국화와 같은 부적응적인 인지적 정서조절전략을 가지고 있으며, 신체감각의 증폭은 외상후스트레스 증상 중 과각성 증상 및 파국화, 타인비난의 인지전략과 관련이 있을 것으로 보인다. 또한 반추, 파국화, 타인비난, 신체감각 증폭과 같은 부정적인 인지를 줄여주는 것이 외상후스트레스장애 증상과 신체증상에 도움이 될 수 있을 것이다.

소아신경정신 질환의 한.양방적 접근 방법론 연구 (A study of methods for Oriental.Western medical approach of Child Neuropsychiatric Disorders)

  • 김근우
    • 동의신경정신과학회지
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    • 제14권2호
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    • pp.15-25
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    • 2003
  • Objectives : This study aimed investigation of clinical development to child neuropsychiatry through the oriental western medical approach of child neuropsychiatric disorders Methods : As DSM-IV and ICD-10 set a standard for clinical expression. According to this standard and oriental medical diseases, child neuropsychiatric disorders are divided into six symptoms Results and Conclusion : 1. View point of oriental medicine, Psycho Somatic stroke(inclusive of the spasm) place under the category 'Epilepsy(癎)', 'Children's fit(驚風)' and 'Chi-Kyeung(?痙)'. 2. View point of oriental medicine, Mental Retardation place under the category 'Dementia(?)', 'Amnesia(健忘)' and 'Speech Disorder(語遲)' 3. View point of oriental medicine, Emotional Disorder place under the category 'Adjustment Disorder(客?)', 'Cry with anxiety at night(夜啼症)', 'Gi-Byung(?病)' and 'Child depressive Disorder(小兒癲症)' 4. View point of oriental medicine, Conduct development Disorder place under the category 'Physical frail of five part(五軟)' and 'Physical stiff of five part(五硬)'. 5. View point of oriental medicine, Childhood Psychosis place under the category 'Insanity(癲狂)'. 6. View point of oriental medicine, Somatoform Disorder place under the category 'Palpitation of the heart(驚悸)', 'Vomiting and Diarrhea(吐瀉)', 'Asthma(喘)', 'Headache(頭痛)' and 'Enuresis(遺尿)'

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외상과 턱관절 장애 연관성에 관한 연구 (THE RELATIONSHIP BETWEEN TRAUMA AND TEMPOROMANDIBULAR JOINT DISORDER)

  • 김영균;윤필영;안민석;김재승
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제31권5호
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    • pp.375-380
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    • 2009
  • Objective : Trauma has been a controversial issue although it has been considered to be a major factor for the temporomandibular disorder(TMD). We evaluated the relationship between macrotrauma or microtrauma and TMD. Methods : This study was performed in patients with TMD undergoing treatment at SNUBH from October 2006 to January 2007. Sixty one male patients and 166 female patients(total 227) were included and the average age was 34 years(ranging from 14 to 85 years). We investigated the possible etiologic factors, diagnosis and treatment with the review of medical records and radiography. Chronic pain, depression, somatic score(including pain item), somatic score(excluding pain item) were evaluated on the basis of diagnostic index from the Research Diagnostic Criteria on TMD. Results : Eighteen patients(7.9%) out of 227 patients suffered from TMD as a result of macrotrauma. Ninety four(41.4%) patients had microtrauma and six patients(2.6%) had both macro- and microtrauma(etiologic factor). The main symptoms included pain. joint noise and mouth opening limitation while the other symptoms were headache and tinnitus. The patients had suffered from TMD for average 41 weeks (ranging from 1 to 480 weeks). 116 patients took splint as a major treatment. As a prognosis, 19 patients(8.4%) recovered completely. 26(11.0%) had improvement and 181(80%) had persistent symptoms. 1 patient(0.4%) underwent an arthroplasty. Diagnostic index from RDC chart showed that macrotrauma was the highest score(except depression score) among the other etiologic factors. Conclusion : This study showed that macro- and microtrauma can be considered to be the major etiologic factors of TMD, which also affect the chronic, depression and somatic discomfort.

신체화의 생물학적 기전 : 신체화의 신경심리학적 모델을 중심으로 (Biological Mechanism of Somatization : Mainly Focused on the Neuropsychological Model of Somatization)

  • 이영호
    • 정신신체의학
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    • 제8권1호
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    • pp.122-140
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    • 2000
  • 신체화 장애란 명백한 기질적 병리가 없이 다양한 신체 증상을 호소하는 만성 장애를 말한다. 그런데 신체화 장애는 역사적으로 기질적인 이상이 없이 신체적인 증상이 나타나는 히스테리와 연관이 있다고 알려져 왔다. 따라서 신체화와 관련된 대부분의 이론들은 주로 정신역동이나 사회적인 관점에 초점이 맞추어져 왔다. 그러나 감정적인 문제나 정신질환이 신체화로 나타나는 기전에서 신경생물학적인 관점에 대한 관심 또한 적지 않았었다. 이런 신경생물학적인 관점에서 히스테리아의 원형으로 알려져 있는 Anna O 증례조차도 신경심리학적인 관점에서 재조명되기도 하였다. 몇몇 신경생리학적 및 신경심리학적 연구결과들, 히스테리 환자에서 신체화증상 표현의 좌우 반구차이에 대한 연구결과들이 신체화의 생물학적 근거를 뒷받침해 주고 있다. 최근 들어 신체화 장애의 신경영상검사는 신체화 장애에서 뇌의 기능 이상이 존재함을 보여 주고 있다. 이에 저자는 생물학적 관점에서 신체화의 과정을 설명해 줄 수 있는 몇몇 가설들을 고찰하고 이를 바탕으로 신체화에 대한 새로운 신경심리학적 가설을 제시하고자 한다. 이와 함께 이 가설을 신체화 장애의 치료에 어떻게 적용시킬 수 있을까도 논의하고 이 가설의 제한정과 이 영역에 있어 앞으로의 발전 방향에 대해서도 논의하려고 한다.

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부모자녀놀이치료 프로그램이 부모자녀 상호작용에서의 공감 및 문제행동에 미치는 효과 - 분리불안아동을 대상으로 - (The Effectiveness of Filial Therapy on Empathy in Parent-child Interaction and Problem Behavior of Children with Separation Anxiety Disorder)

  • 백지은;이정숙
    • 아동학회지
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    • 제30권4호
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    • pp.99-117
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    • 2009
  • This study examined the effectiveness of the Filial Therapy program for children with Separation Anxiety Disorder (SAD). Subjects were 8 mother-child dyads each in the experimental and comparison groups. Mann-Whitney U-test and the Wilcoxon Matched-Pairs Signed-Ranks Test were performed following the therapeutic program. After application of the Filial Therapy program, results showed that, compared to the control group, (1) parents of SAD children in the experimental group significantly increased their level of empathic interactions with their children. AND (2) the experimental group children significantly reduced level of somatic complaints, anxious/depressed, and social problems. Conclusions were that Filial Therapy is an effective program for improvement of parent-child relationship of SAD children but not for changing problem behavior of SAD children.

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『상한론(傷寒論)』 변병진단체계(辨病診斷體系)에 근거하여 태음병(太陰病)으로 진단하고 치료한 신경정신과 질환 증례 5례 (5 Neuropsychiatric Disorder Cases Diagnosed and Treated as Greater Yin Disease Based on Disease Pattern Identification Diagnostic System by Shanghanlun Provisions)

  • 조성환;정재원;김민환;허주
    • 대한상한금궤의학회지
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    • 제15권1호
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    • pp.53-84
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    • 2023
  • Objective : The purpose of this study is to explore the therapeutic potential of Shanghanlun for neuropsychiatric disorders through a comparative review of five neuropsychiatric disorder cases diagnosed with Greater yin disease pattern/syndrome (太陰病). Methods : We collected and compared five neuropsychiatric cases diagnosed and treated with Greater yin disease pattern/syndrome (太陰病) from four korean medicine clinics. Clinical symptoms common to the five cases were analyzed by connecting them with Shanghanlun provision 273 and 279. Results : In all five cases, the improvement of chief complaints and decrease in general anxiety were observed after administration of Gyejigajakyak-tang (桂枝加芍薬湯) and Gyejigadaehwang-tang (圭支加大黃湯). In addition, neuropsychiatric symptoms and physical symptoms that are mentioned in Shanghanlun provision 273 and 279 were confirmed in all five cases. Conclusions : We not only reconfirmed that the core features of Greater yin disease pattern/syndrome(太陰病) proposed in previous studies; zi-tong (自痛), yin-er (因爾), jie-ying (結硬), but also that the physical symptoms associated with fu-man (腹満), tu (吐) and zi-li (自利) were common in the presenting symptoms and past histories of the five patients.

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식욕억제제 Phentermine, Phendimetrazine으로 유발된 정신병적 장애 증례군 연구 (Psychotic Disorder Induced by Appetite Suppressants, Phentermine or Phendimetrazine : A Case Series Study)

  • 곽숙영;윤탁;이남영;정인원;김세현
    • 생물정신의학
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    • 제24권3호
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    • pp.134-141
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    • 2017
  • Objectives A retrospective case series study was conducted to investigate the clinical characteristics of psychotic disorders induced by appetite suppressants, phentermine and phendimetrazine. Methods A retrospective electronic medical record review identified 5 admitted patients who had psychotic symptoms after taking phentermine or phendimetrazine. Clinical information was reviewed and summarized in each case. Results Hallucinations were reported in all cases, including auditory, visual, olfactory and somatic hallucinations. After discontinuation of phentermine or phendimetrazine, the symptoms rapidly improved with low dose of antipsychotics. Patients tended to have less prominent negative symptoms and higher insight into illness, and often showed depressive mood. These clinical characteristics were similar to psychosis induced by amphetamines. Two patients developed stimulant use disorder while using phentermine. Conclusions These findings call for awareness of the risks associated with use of appetite suppressants. Prescription of phentermine or phendimetrazine should be accompanied by close monitoring of mental status, and suspicion for substance/medication-induced psychotic disorder.

불안 장애에서 벡우울척도의 요인구조 (Factor Structure of the Beck Depression Inventory in Anxiety Disorder)

  • 양현주;김대호;장은영;한창우;박용천
    • 대한불안의학회지
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    • 제7권1호
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    • pp.16-21
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    • 2011
  • Objective : Depressive symptoms often coexist with other anxiety disorder symptoms. Furthermore, an anxiety disorder that is comorbid with a depressive disorder results in more severe symptoms and a poorer outcome prognosis. To understand the construct of depressive symptoms in anxiety disorder, this study investigated the factor structure of the Beck Depression Inventory among outpatients with anxiety disorders. Methods : All data were from psychiatric department outpatients at a university-affiliated hospital. We conducted a principal component analysis using data from 194 outpatients with DSM-IV anxiety disorders and calculated goodness-of-fit-indices. Results : Exploratory factor analysis revealed a four factor structure--Cognitive-affective symptoms (Factor 1), Somatic symptoms (Factor 2), Self-reproach (Factor 3), and Hypochondriasis/indecisiveness (Factor 4)--and a 57% total variance. This four-factor model demonstrated an acceptable level of model fit, and it fit better than did a three-factor solution from the literature on depressive disorder. Conclusion : This study's results suggest a difference in the construct of self-reported depressive symptoms in anxiety disorders. These findings also support a dimensional approach to studying anxiety and depression. Further studies may benefit from including comorbid depressive disorder and its influence on anxiety disorders.