• Korean Journal of Psychosomatic Medicine
• /
• v.7 no.1
• /
• pp.116-123
• /
• 1999

Objectives : The authors attempted to assess how much the mechanism of dissociation affects somatization disorder patients psychopathologically, and explore the relationship between sexual or physical abuse and somatic symptoms in somatization disorder patients. Methods : The authors administered the Dissociative Experiences Scales-Korean version(DESK) and Dissociative Disorders Interview Schedule to 25 patients with somatization disorder and 51 normal subjects. Results : There were no significant demographic differences between patient and control groups. The mean score of DES-K for patient group was 18.2, and 10.0 for the control group. The percentage of the individuals with high scores(20 and over) was 36.0 in the patient group and 7.8 in the control group, respectively. The percentage of the individuals with sexual and/or physical abuse was 16.0 in the patient group and zero in the control group. Our results showed that DES-K scores were not influenced by the factor of age or religion in either group, but the scores of the patients with somatization disorder were significantly higher than those in the normal subjects. Conclusion : There was an implication that the mechanism of dissociation affects issues of psychopathogenesis and psychopathology in Korean patients with somatization disorder, even though they have different sociocultural backgrounds in comparison to Western patients. The authors suggest it is useful to focus attention on childhood abuse and dissociation in the evaluation and dynamic psychotherapy of patients with somatization disorder.

• Korean Journal of Psychosomatic Medicine
• /
• v.10 no.2
• /
• pp.78-91
• /
• 2002

Objective : The purpose of this study was to develop the somatization rating scale (SRS), and then to use the scale in clinical pracitice. Methods: First, a preliminary survey was conducted for 109 healthy adults to obtain 40 response items. Second, a preliminary questionnaire was completed by 215 healthy subjects. Third, a comparison was made regarding somatization responses among 242 patients (71 with anxiety disorder. 73 with depressive disorder, 47 with somatoform disorder, and 51 with psychosomatic disorder) and 215 healthy subjects. Results : Factor analysis yielded 5 subscales : cardiorespiratory and nervous responses, somatic sensitivity, gastrointestinal responses, general somatic responses, genitourinary, eye and muscular responses. Reliability was computed by administering the SRS to 62 healthy subjects during a 2-week interval. Test-retest reliability for 5 subscales and the total score was significantly high, ranging between .86-.94. Internal consistency was computed, and Cronbach's ${\alpha}$ for 5 subscales ranged between .72-.92, and .95 for the total score. Convergent validity was computed by correlating the 5 subscales and the total score with the total score of the global assessment of recent stress (GARS) scale, the perceived stress questionnaire (PSQ), and the symptom checklist-90-revised (SCL-90-R). The correlations were all at significant levels. Discriminant validity was computed by comparing the total score and the 5 subscale scores of the patient and control groups. Significant differences were found for 5 subscales and the total score. Only the depressive disorder group was siginificantly higher than control group in all the subscale scores and total scores of SRS among 4 patient groups. In somatic sensitivity, only depressive disorder patients were significantly higher than the normal controls, whereas in general somatic subscale, depressive disorder and somatoform disorder groups were significantly higher than the normal controls. In total scores of the SRS, female subjects were significantly higher than males. Conclusion : These results indicate that the SRS is highly reliable and valid, and that it can be utilized as an effective measure for research in stress- and somatization-related fields. The depressive disorder and somatoform disorder groups showed more widespread somatization than the anxiety and psychosomatic disorder groups.

• Korean Journal of Adult Nursing
• /
• v.21 no.6
• /
• pp.639-651
• /
• 2009

Purpose: This study examined relationships among stress, stress coping strategies, and somatization in mothers-in-law from multi-cultural families in a rural area. Methods: Elderly mothers-in-law (n=227) living with foreign daughters-in-law completed a self-reporting questionnaire. Data were collected from April to August 2009. Questions related to stress (Visual Analog Scale, VAS), coping strategies (Coping Strategy Scale) for stress, and somatization (Symptom Check List 90, Revised). SPSS/WIN 12.0 program was used for descriptive analysis, t-test, one-way ANOVA, Pearson correlation, and multiple regression analyses. Results: Subjects had a moderate level of stress (5.03). There were significant differences in stress level according to age, educational level, religion, chronic disease, health status, number of children, agreement of an international marriage of her sons, satisfaction in living with a foreign daughter-in-law, and family conflict. Stress showed a significant positive correlation with offensive coping strategy, passive strategy, and somatization. Stress, offensive coping strategy, and passive coping strategy affected the level of somatization. Conclusion: In a family situation involving co-habitation of mother- and foreign daughter-in-law, increased stress experienced by the mother-in-law can lead to increased offensive and passive coping strategies, and increased somatization. More effective means of stress reduction are needed for mothers-in-law from multi-cultural families.

• Sleep Medicine and Psychophysiology
• /
• v.19 no.2
• /
• pp.84-88
• /
• 2012

Introduction: The objective of the present study was to investigate the independent effects of major depressive disorder (MDD) and insomnia on somatization, respectively. Methods: A total of 181 participants (73 males and 108 females ; mean age $41.59{\pm}8.92$) without serious medical problem were recruited from a community and a psychiatric clinic in Republic of Korea. Subjects were divided into 4 groups based on the Structured Clinical Interview for DSM-IV axis I disorder (SCID-IV) and sleep questionnaire : 1) normal controls (n=127), 2) primary insomnia (n=11), 3) MDD without insomnia (n=14), and 4) MDD with insomnia (n=29). All participants were requested to complete the somatization subscores of the Symptom Checklist-90-Revised (SCL-90-R). Results: There were significant between-group differences in somatization score (F=25.30, p<0.001). Subjects with both MDD and insomnia showed higher somatization score compared to normal control (p<0.001), subjects with primary insomnia (p=0.01), or MDD subjects without insomnia (p<0.001). Subjects with primary insomnia had higher somatization score than normal controls (p<0.01), while there was no significant difference between MDD subjects without insomnia and normal controls. In multiple regression, presence of insomnia predicted higher somatization score (beta=0.44, p<0.001), while there was only non-significant association between MDD and somatization (beta=0.14, p=0.08). Conclusion: In the current study, insomnia was associated with somatization independently from major depression. Subjects with primary insomnia showed higher somatization. Within MDD patients, presence of insomnia was related to higher somatization. Our finding suggests that insomnia may partly mediate the relationship between depression and somatization.

• Korean Journal of Occupational Health Nursing
• /
• v.24 no.3
• /
• pp.224-234
• /
• 2015

Purpose: The purpose of this study was to identify family stress, somatization, social support, depression and its influencing factor among middle-aged workers. Methods: The research was cross-sectional descriptive study. The subjects were 212 middle-aged workers living in Seoul and Gyeonggi-do. Data collection was done from May 21 to 31, 2015 using self-reported structured questionnaires asking about general characteristics, family stress, somatization, social support and depression. Data were analyzed using descriptive statistics, independent sample t-test, one way ANOVA, Pearson's correlation coefficient, stepwise multiple regression with SPSS/WIN 19.0 program. Results: Mean score of family stress was 41.67 (range: 25~125), somatization 17.42 (range: 12~60), social support 69.79 (range: 12~84) and depression 13.01 (range: 0~60) and reported as depression in 34.0%. Social support (${\beta}=-.36$, p<.001), somatization (${\beta}=.28$, p<.001), family stress (${\beta}=.15$, p=.014) had significant association with depression and the most important variable was social support. Conclusion: It is suggested to check social support system in middle aged workers and needed to reinforce social support of community based on the relation of occupational category. Also, it is necessary to legalize the institutional devices to prevent and control depression to ensure industrial safety and disaster prevention.

• Anxiety and mood
• /
• v.5 no.2
• /
• pp.80-88
• /
• 2009

Disorder of Extreme Stress, Not Otherwise Specified (DESNOS) is the proposed diagnosis that meets the severe, complex, and prolonged psychological sequela of victims with chronic traumatization (e.g., family violence, incest, and childhood sexual or physical abuse). The hallmarks of DESNOS are a multiplicity of symptoms (e.g., somatization, dissociation, and depression), pathological changes in relationships, identity disturbances, and a propensity to experience repeated harm and injury at the hands of oneself and others. DESNOS can be directly assessed by Structured Interview of Disorder of Extreme Stress (SIDES) and Self- Report Inventory of Disorder of Extreme Stress (SIDES-SR). The treatment of DESNOS should be phaseoriented and involve movement back and forth among three basic stages : 1) stabilization ; 2) trauma processing ; 3) reintegration.

• Journal of Oriental Neuropsychiatry
• /
• v.14 no.2
• /
• pp.155-167
• /
• 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.

• The Journal of Korean Obstetrics and Gynecology
• /
• v.22 no.2
• /
• pp.172-188
• /
• 2009

Purpose: For mothers just delivered of a child, sanhupung(産後風) is a critical disease which can threaten their health. The symptoms of sanhupung were diverse and divided into pain symptoms, general symptoms, and neuropsychiatric symptoms. We tried to search for the relationship between sanhupung and somatization of postpartum depression. Methods: Analysis was carried out with materials concerning the postpartum depression and sanhupung. For the analysis, materials related with the issue of this study were searched at the Korea Education & Research Information Service, and Oriental medicine advanced searching. Results: 1. The range of period and symptoms of sanhupung has been broaden. The symptoms of sanhupung were divided into pain syndrome, general symptoms, and neuropsychiatric symptoms. 2. As the symptoms of postpartum depression might indicate not only physical symptoms but also mental disorder, more attention should be placed on wether the symptoms were involved in somatization of postpartum depression. Conclusion: The authors conclude that obstinate sanhupung that do not healed up and improve in symptoms have a relation to somatization of postpartum depression.

• Journal of Oriental Neuropsychiatry
• /
• v.15 no.2
• /
• pp.45-51
• /
• 2004

Hwabyung is a Korean culture bound syndrome and translated as anger syndrome at DSM-IV. And it is caused by the suppression of anger and has characteristics of chest discomfort, burning up as physical symptoms, and mortification, chagrin as psychological symptoms. It is very common in the field of psychiatry in Korea with Major Depressive Disorder (MDD). * Objective : 95 patients with MDD or Hwabyung, who visited the department of psychiatry in Korea University Medical Center or oriental medical hospital of Kyunghee Medical Center from May 2003 to August 2003, were selected for the study to compare between Major Depressive Disorder and Hwabyung. * Methods : The Structured Clinical Interview Schedule for DSM-IV (SCID) and Hwa-Byung Diagnostic Interview Schedule (HBDIS) were conducted for diagnosis. And Symptom Check List-90-Revised (SCL-90-R) was carried out for comparison between MDD and Hwabyung. * Result : Among the 95 patients, MDD group was 23 persons, Hwabyung group was 36 persons, and MDD plus Hwabyung group was 36 persons and it occupied 37.9%. MDD plus Hwabyung group had higher scores than any other groups in the whole dimensions of SCL-90-R. Hwabyung group had higher scores than MDD group in somatization, anxiety, hostility, Global Severity Index(GSI) and positive symptom total (p<.05) of SCL-90-R, but two groups had no difference in obsessive-compulsive, interpersonal-sensitivity, depression, phobic anxiety, paranoid ideation, psychoticism, positive symptom distress index of SCL-90-R. * Conclusion : These result showed that Hwabyung is similar to MDD at the point of depression and psychoticism but more severe at somatization, anxiety and anger than MDD.

• Korean Journal of Psychosomatic Medicine
• /
• v.4 no.2
• /
• pp.269-276
• /
• 1996

A theroretical study was made on the psychodynamism of somatoform disorder. Somatoform disorder is caused by a defense mechanism of somatization. Somatization is the tendency to react to stimuli(drives, defenses, and conflict between them) physically rather than psychically(Moore, 1990). Ford(1983) said it is a way of life, and Dunbar(1954) said it is the shift of psychic energy toward expression in somatic symptoms. As used by Max Shur(1955), somatization links symptom formation to the regression that may occur in response to acute and chronic conflict. In the neurotic individual psychic conflict often provokes regressive phenomena that may include somatic manifestations characteristic of an earlier developmental phase. Schur calls this resomatization. Pain is the most common example of a somatization reaction to conflict. The pain has an unconscious significance derived from childhood experiences. It is used to win love, to punish misdeeds, as well as a means to amend. Among all pains, chest pain has a special meaning. Generally speaking, 'I have pain in my chest' is about the same as 'I have pain in my mind'. The chest represent the mind, and the mind reminds us about the heart. So we have a high tendency to recognize mental pain as cardiac pain. Kellner(1990) said rage and hostility, especially repressed hostility, are important factors in somatization. In 'Psychoanalytic Observation on Cardiac Pain', psychoanalyst Bacon(1953) presented clinical cases of patients who complained of cardiac pain in a psychoanalytic session that spread from the left side of their chests down their left arms. The pain was from rage and fear which came after their desire to be loved was frustrated by the analyet. She said desires related to cardiac pain were dependency needs and aggressions. Empatic relationship and therapeutic alliances are indispensable to psychotherapy in somatoform disorder. The beginning of therapy is to discover a precipitating event from the time their symptoms have started and to help the patient understand a relation between the symptom and precipitating event. Its remedial process is to find and interpret a intrapsychic conflict shown through the symptoms of the patient. Three cases of somatoform disorder patients treated based on this therapeutic method were introduced. The firt patient, Mr. H, had been suffering from hysterical aphasia with repressed rage as ie psychodynamic cause. An interpretation related to the precipitating event was given by written communication, and he recovered from his aphasia after 3 days of the session. The second patient was a dentist in a cardiac neurosis with agitation and hypochondriasis, whose psychodynamism was caused by a fear that he might lose his father's love. His symptom was also interpreted in relation to the precipitating event. It showed the patient a child-within afraid of losing his father's love. His condition improved after getting a didactic interpretation which told him, to be master of himself, The third patient was a lady transferred from the deparment of internal medicine. She had a frequent and violent fit of chest pains, whose psychodynamic cause was separation anxiety and a rage due to the frustration of dependency needs. Her symptom vanished dramatically when she wore a holler EKG monitor and did not occur during monitoring. By this experience she found her symptom was a psychogenic one, and a therapeutic alliance was formed. later in reguar psychotherapy sessions, she was told the relaton between symptoms and precipitating events. Through this she understood that her separation anxiety was connected to the symptom and she became less terrifide when it occurred. Now she can travel abroad and take well part in social activities.