• Title/Summary/Keyword: Somatic symptom disorder

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Comparison of Effect of SSRIs and SNRIs on Depression, Pain and Somatic Symptoms in Elderly Patients with Major Depressive Disorder (노인 우울증 환자에서 선택적 세로토닌 재흡수 억제제, 세로토닌 노르에피네프린 재흡수 억제제가 우울증상, 통증 그리고 신체증상에 미치는 효과 비교)

  • Han, Eun Hee;Kim, Hyun;Lee, Kang Joon
    • Korean Journal of Psychosomatic Medicine
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    • v.28 no.1
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    • pp.72-80
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    • 2020
  • Objectives : The aim of this study was to compare the effect of Selective Serotonin Reuptake Inhibitor (SSRI) and Serotonin Norepinephrine Reuptake Inhibitor (SNRI) for mood symptoms, pain, and somatic symptoms in elderly depression patients with pain and somatic symptoms. Methods : This study is a prospective open-label study conducted by a single institution. A total of 43 subjects diagnosed with major depressive disorder under the DSM-5 diagnostic criteria participated in this study (average age: 72.53, 58.1% women). The subjects were classified as SSRI and SNRI groups. Depressive symptoms, pain, and somatic symptoms were evaluated by Korean version of the Hamilton Depression Rating Scale (K-HDRS), visual analogue scale (VAS) and Patient Health Questionnare-15 (PHQ-15) respectively at baseline and six weeks later. Two-way repeated-measure ANOVA was performed to analyze changes in the KHDRS, VAS, and PHQ-15 scores. Results : In the SSRI and SNRI groups, K-HDRS, VAS, and PHQ-15 all showed significant improvement after 6 weeks compared to each baseline values. There were no differences in therapeutic effect between the two groups. Conclusions : We found that SSRI and SNRI both improved somatic symptoms and pain in elderly depression patients. The results of this study are thought to help select antidepressants when administering medication to elderly depression patients who complain pain and somatic symptoms. Further research is needed on the longterm effects of the SSRI and SNRI.

A Clinical Study and an analysis of Symptom Check List-90-Revision on Psychiatric Patients Visiting the Emergency Room in an Oriental Medicine Hospital (한방병원 응급실에 내원한 신경정신과 환자의 임상고찰 및 SCL-90-R에 의한 특성)

  • Park, Ji-Un;Jung, In-Chul;Lee, Sang-Ryong;Choi, Bo-Yun
    • Journal of Oriental Neuropsychiatry
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    • v.14 no.2
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    • pp.155-167
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    • 2003
  • Objective : The aims of this study were to show the clinical aspects and to investigate psychiatric traits by SCL-90-R in patients who visited Oriental Medicine Hospital Emergency Room. Method : We studied twenty patients who visited Daejeon University Oriental Medicine Hospital from May, 2003 to September, 2003. Results : 1. The ratio of male to female patients was 1:3 and age distribution was most frequent in 30s&40s. 2. The most frequent cause of illness was stress in occupation and overwork. The greater part of patients came to hospital in 12hours after an attack. 3. In chief problem, somatic symptoms such as headache, dizziness, numbness and chest discomfort were most frequent. In diagnosis, somatization disorder was most frequent. 4. After treatment, most of symptoms were improved. 5. Psychiatric traits by SCL-90-R correlated with somatization and anxiety.

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Disappearance of Hysteria(Conversion Disorder) and the Evolutionary Brain Discord Reaction Theory (히스테리아(전환장애)의 소실과 진화적 뇌신경 부조화 반응 가설)

  • Song, Ji Young
    • Korean Journal of Psychosomatic Medicine
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    • v.24 no.1
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    • pp.28-42
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    • 2016
  • Objectives : The author tried to find out reasons why and how hysteria(and conversion disorder) patient numbers, which were so prevalent even a few decades ago, have decreased and the phenotype of symptoms have changed. Methods : The number of visiting patients diagnosed with conversion disorder and their phenotype of symptoms were investigated through chart reviews in a psychiatric department of a University hospital for the last 12 years. Additionally, the characteristics of conversion disorder patients visiting the emergency room for last 2 years were also reviewed. Those results were compared with previous research results even if it seemed to be an indirect comparisons. The research relied on Briquet P. and Charcot JM's established factors of the vicissitudes of hysteria(and conversion disorder) which has been the framework for more than one hundred and fifty years since hysteria has been investigated. Results : The author found decreased numbers and changes of the phenotype of the hysteria patients(and conversion disorder) over the last several decades. The decreased numbers and changes of the symptoms of those seemed to be partly due to several issues. These issues include the development of the diagnostic techniques to identify organic causes of hysteria, repeated changes to the symptom descriptions and diagnostic classification, changes of the brain nervous functions in response to negative emotions, and the influence of human evolution. Conclusions : The author proposed that the evolutionary brain discord reaction theory explains the causes of disappearance of and changes to symptoms of hysteria(conversion disorder). Most patients with hysteria(conversion disorder) have been diagnosed in the neurological department. For providing more appropriate treatment and minimizing physical disabilities to those patients, psychiatrists should have a major role in cooperating not only with primary care physicians but with neurologists. The term 'hysteria' which had been used long ago should be revived and used as a term to describe diseases such as somatic symptom disorder, functional neurological symptoms, somatization, and somatoform disorders, all of which represent almost the same vague concept as hysteria.

CLINICAL CHARACTERISTICS OF CHILD AND ADOLESCENT PSYCHIATRIC INPATIENTS WITH MOOD DISORDER (입원한 기분장애 소아청소년의 임상특성 - 주요 우울증과 양극성장애의 우울삽화 비교를 중심으로 -)

  • Cho, Su-Chul;Paik, Ki-Chung;Lee, Kyung-Kyu;Kim, Hyun-Woo;Hong, Kang-E;Lim, Myung-Ho
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.11 no.2
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    • pp.209-220
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    • 2000
  • The purpose of this study is to find out the characteristics of depressive episode about major depression and bipolar disorder in child and adolescent. The subjects of this study were 34 major depression patients and 17 bipolar disorder patients hospitalized at child and adolescent psychiatry in OO university children's hospital from 1st March 1993 to 31st October 1999. The method of this study is to review socio-demographic characteristics, diagnostic classification, chief problems and symptoms at admission, frequency of symptoms, maternal pregnancy problem history, childhood developmental history, coexisting psychiatric disorders, family psychopathology and family history and therapeutic response through their chart. 1) The ratio of male was higher than that of female in major depressive disorder while they are similar in manic episode, bipolar disorder. 2) Average onset age of bipolar disorder was 14 years 1 month and it was 12 years 8 months in the case of major depression As a result, average onset age of major depression is lower than that of bipolar disorder. 3) The patients complained of vegetative symptoms than somatic symptoms in both bipolar disorder and depressive disorder. Also, the cases of major depression developed more suicide idea symptom while the case of bipolar disorder developed more aggressive symptoms. In the respect of psychotic symptoms, delusion was more frequently shown in major depression, but halucination was more often shown in bipolar disorder. 4) Anxiety disorder coexisted most frequently in two groups. And there coexisted symptoms such as somartoform disorder, mental retardation and personality disorder in both cases. 5) The influence of family loading was remarkable in both cases. Above all, the development of major depression had to do with child abuse history and inappropriate care of family. It is apparent that there are distinctive differences between major depression and bipolar disorder in child and adolescent through the study, just as in adult cases. Therefore the differences of clinical characteristics between two disorders is founded in coexisting disorders and clinical symptoms including onset age, somatic symptoms and vegetative symptoms.

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The Investigation Regarding the Psychiatric Consultation of the Inpatient from General Hospital (일 종합병원 입원 환자의 정신과 자문 의뢰의 최근 3년간의 특성에 대한 연구)

  • Lee, Soo-Jin;Lee, Joong-Kwaun;Wang, Kwuan-Shu;Kim, Jung-Gee;Cho, Dong-Hwan;Kim, Hyun-Jin
    • Korean Journal of Psychosomatic Medicine
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    • v.13 no.1
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    • pp.49-59
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    • 2005
  • Objectives: This clinical study investigates the status of psychiatric consultation from 2001 to 2003 at Maryknoll General Hospital, located in Busan to evaluate the characteristic patterns of current psychiatric consultation and to contribute for further data of consultation study. Methods : The subjects of this study were hospitalized at Maryknoll General Hospital from 1 January, 2001 to 31 December, 2003, who were referred for psychiatric consultation during hospitalization. This study was analysed demographic data, reason for referral, psychiatric diagnosis by patient's chart and psychiatrist's report retrospectively. Results : 1) The psychiatric consultation rates was 1.72%. 2) There was 47.8% in referral among the age group over 60 years, especially the age group over 70 years was 20.3%. 3) The most frequent referral source was department of internal medicine(72.5%). 4) The frequency of psychiatric consultation was the highest at March and the lowest at December. 5) The reasons of psychiatric consultation, according to frequency, were affective change, somatic symptom without abnormal finding. And drug intoxication. alcohol problem were increased. 6) Somatoform disorder was the most common psychiatric diagnosis followed by depressive disorder, organic mental disorder. The diagnosis of somatoform disorder, depressive disorder, alcohol dependence were increased, but anxiety disorder, organic mental disorder were decreased. 7) Pharmacotherapy was the most recommendation, and diagnostic procedure and psychotherapy were increased. Conclusion : In review of consultation referral subjects, the referral rate was 1.72%. The consultation referral of the old(over 60 years) was 42.8%, and annually increased. The most frequent request source was from department of internal medicine. The reasons of consultation referral was the most due to affect change. The recommendation of pharmacotherapy was the most numerous. and psychotherapy was increased annually. Further studies warranted on geriatric psychiatric consultation, pattern change of consultation.

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THE CLASSIFICATION OF ADOLESCENTS IN RUNAWAY SHELTERS BY THE EVALUATION OF THEIR PSYCHOPATHOLOGY (보호시설 가출청소년의 정신병리에 대한 평가와 분류)

  • Lee, Jong-Sung;Kwack, Young-Sook
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.12 no.2
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    • pp.192-217
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    • 2001
  • Object:This study was carried out to classify adolescents in runaway shelters by evaluating their psychopathology. And the ultimate purpose is to offer basic data for preventing adolescents‘ runaway and for diversifying runaway shelters suitable for the problem of individual adolescent. Method:128 adolescents who stay in the runaway shelters were asked to complete self-report qeustionnaires including basic sociodemographic data, Child Behavior Check List(CBCL), Minnesota Multiphasic Personality Inventory(MMPI), and Symptom Check List-90-Revised(SCL-90-R). Korean Wechsler Adult Intelligence Scale(K-WAIS)[or Korean Educational Developmental Institute-Wechsler Intelligence Scale for Children(KEDI-WISC)] and Bender-Gestalt test(BGT) were also done by clinical psychologists. Results:The most common age of the subjects were 15-year-old, and they dropped out their schools in the middle school most commonly. Mostly they were from middle class family and their parents' educational level were high school graduates. The first runaway episode was most common in the middleschool period, and their runaways were repeated. The most common frequency of runaways were more than 10 times. About 10% of them abused drugs and about 80% of them abused alcohol. One third of them had experiences of illegal problems and 10% of them engaged in sexual activity for money. 95 adolescents(83%) in CBCL, 42 adolescents(36%) in SCL-90-R, and 70 adolescents(69.3%) in MMPI showed clinical significance. In intelligence test, 22 adolescents(22%) were mentally retarded. In BGT, 35 adolescents(39.4%) manifested brain dysfunction signs. Conclusion:Runaway adolescents in the shelters have variable and severe psychopathology. Their psychopathology is classified as follows;The behavior disorder group, the mood disorder group with anxiety/depression, the somatic disorder group with somatic symptoms, and the psychosis group with possibility of severe psychopathology. Therefore it is very important to evaluate psychiatric problems of runaway adolescents, and specific therapeutic interventions according to their problems are required.

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