• Title/Summary/Keyword: Somatoform disorder

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Clinical Study for Tremor in 31 Outpatient Cases (진전(震顫)을 주소로 내원한 환자 31례에 대한 임상고찰 -체질의학(體質醫學)적 치료를 중심으로)

  • Choi, Bo-Yun;Jung, In-Chul;Lee, Sang-Ryong;Choi, Bung-Man
    • Journal of Oriental Neuropsychiatry
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    • v.13 no.2
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    • pp.57-74
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    • 2002
  • The clinical study was carried out the 31 patients with tremor who were treated in Daejeon University Oriental Hospital from 2 March 2002 to 29 June 2002. The results were summarized as follows. 1. In classification of Four Human coporeal constitution the number of patients So-Yang-In(少陽人) was the most, in the ratio of sex, female was higher than man and in the age distribution the aged over 60 were higher frequence. 2. The 31 patients did not have especially past history and inducing factors. 3. Tremor frequently appeared in extremities but in the case of So-Euem-In(少陰人) tremor frequently appeared in the face. Tremor appeared to be accompanied with dizziness, palpitation, especially in So-Euem-In(少陰人) tremor appeared to be accompanied with anorexia, abdomen pain, weight loss e.t.c. 4. In the case of Tae-Eum-In(太陰人) CHUNGSIMYUNJATANG(淸心蓮子湯), CHUNGPESAGANTANG(淸肺寫肝湯) were used to be busy, in the case of So-Yang-In(少陽人) YANGJUKSANHWATANG(凉膈散火湯) were used to be busy but in the most case of So-Eum-In(少陰人) drug was not used. 5. The rate of treatment was collectively improved. The rate of treatment was higher in the female than in the male and the rate of treatment was higher in short period of the clinical history than long period. But in the age the rate of treatment was not worth special mention.

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A review of the Traditional Concept of Psychologic Therapy in Oriental Medicine-specially about Oh-Ji-Sang-Seung(五志相勝療法) Therapy- (오지상승요법(五志相勝療法)에 관한 임상사례(臨床事例) 연구(硏究)와 현대적(現代的) 이해(理解))

  • Jang Hyun-Ho;Lyu Yeoung-Su;Kang Hyung-Won
    • Journal of Oriental Neuropsychiatry
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    • v.12 no.1
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    • pp.11-27
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    • 2001
  • In oriental medicine, from old times, psychological therapy has been regarded as physical therapy that has been inseparable from psychological therapy. The major objects for oriental psychological therapy is human emotions. Human emotions can be put in the seven feelings(七精) that include Joy(善), Anger(怒), Grief(思), Pity(悲), Fear(恐), Surprise(驚). The seven feelings are connected with human physiology. If each of the seven feelings if excessive, human physiology loses its valance. So the seven feelings are major causes of diseases. The specific character of oriental neuropsychiatry is to make use of the seven feelings in clinical treatment. These oriental neuropsychiatry therapies are performed through consultation with the patient. Of these therapies, Oh-Ji-Sang-Seung(五志相勝療法) is based on the theo교 of interrelation in five elements(metal, wood, water, fire, and earth) in oriental medicine. Specially the sequential subjugations of the five emotions are applied. The contents of Oh-Ji-Sang-Seung(五志相勝療法) include five subjugations of five emotions. Anxiety subjugates fear(思勝恐), fear subjugates joy(恐勝喜), joy subjugates pity(喜勝悲), pity subjugates anger(悲勝怒) and anger subjugates anxiety(怒勝思). The psychological therapy of Oh-Ji-Sang-Seung(五志相勝療法) can be applied in all area of neuropsychiatry. These days, many mental diseases such as Panic Disorder, Depression Somatoform disorders, and negative symptoms of Schizophrenia have been improved by Oh-Ji-Sang-Seung(五志相勝療法) therapy. Here, we present the treatment cases applied Oh-Ji-Sang-Seung(五志相勝療法) therapy in oriental medicine quoted from old oriental books and the latest treatment cases. Moreover, we hope that many oriental therapist will treat many different patients with mental disorders by Oh-Ji-Sang-Seung(五志相勝療法) therapy.

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Diagnosis and successful visual biofeedback therapy using fiberoptic endoscopic evaluation of swallowing in a young adult patient with psychogenic dysphagia: a case report

  • Youngmo Kim;Sang Hun Han;Yong Beom Shin;Jin A Yoon;Sang Hun Kim
    • Journal of Yeungnam Medical Science
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    • v.40 no.1
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    • pp.91-95
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    • 2023
  • Psychogenic dysphagia is a deglutition disorder characterized by a fear of swallowing, with no structural or functional causes. This report presents the case of a young male patient who had severe malnutrition due to psychogenic dysphagia and was provided visual biofeedback using fiberoptic endoscopic evaluation of swallowing (FEES). A healthy 25-year-old man presented to our clinic with a complaint of throat discomfort when swallowing that had started 6 months prior. As the symptoms worsened, he became fearful of food spreading to his lungs after swallowing and the development of respiratory difficulties. His food intake gradually decreased, resulting in a weight loss of 20 kg within 2 months. Evaluation of organic and other functional causes of dysphagia was performed, but no abnormalities were detected. The sensation of a lump in his throat, fear of swallowing, and anxiety were transformed into somatic symptoms. The patient was diagnosed with psychogenic dysphagia. After visual biofeedback by a physician who performed FEES, the patient resumed eating normally and increased his food intake. If routine tests do not reveal structural or functional causes of dysphagia, assessment of a psychogenic swallowing disorder should be considered. FEES can help in the diagnosis and management of psychogenic dysphagia.

Validity of Korean Version of the Mini-International Neuropsychiatric Interview (한국판 Mini International Neuropsychiatric Interview 타당도 연구)

  • Yoo, Sang-Woo;Kim, Young-Shin;Noh, Joo-Sun;Oh, Kang-Seob;Kim, Chan-Hyung;NamKoong, Kee;Chae, Jeong-Ho;Lee, Gi-Chul;Jeon, Seong-Ill;Min, Kyung-Jun;Oh, Dong-Jae;Joo, Eun-Jung;Park, Hyun-Ju;Choi, Young-Hee;Kim, Se-Joo
    • Anxiety and mood
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    • v.2 no.1
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    • pp.50-55
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    • 2006
  • Objectives : In the psychiatry, structured interview is very important tool to be used in epidemiological or psychopharmacological studies. However, investigators often find that the administration of comprehensive diagnostic interviews is time-consuming and expensive to be used in clinical or research settings. Considering these points, Sheehan and his colleagues developed MINI (Mini International Neuropsychiatric Interview) to meet the need for a brief, reliable, and valid structured diagnostic interview for psychiatric disorders. The MINI has been translated into many languages and used in many countries. Therefore, we translated the MINI into Korean and determined its validity in this study. Methods : Twohundred seventy patients and normal subjects participated in the validation of the MINI versus an expert's professional opinion. Schizophrenia and other psychotic disorders, mood disorders including major depressive disorder and bipolar disorder, anxiety disorders including panic and other phobic disorders, and alcohol dependence were included in this study. The validity was obtained by examination whether MINI based diagnoses were compatible with diagnoses by expert psychiatrists. Results : The range of Kappa values was 0.22 (somatoform disorder) to 0.93 (bipolar disorder - past). Overall agreement between MINI and expert's diagnoses were good. The Kappa values for anxiety disorders seemed to be higher than those for other disorders. Conclusion : The MINI Korean version has the good validity. It also has potential applications as a diagnostic tool for psychiatric disorders.

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Validity and Reliability of the Korean Version of the Global Assessment of Recent Stress Scale (전반적인 스트레스평가 척도 한국판의 타당도 및 신뢰도)

  • Koh, Kyung-Bong;Park, Joong-Kyu
    • Korean Journal of Psychosomatic Medicine
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    • v.8 no.2
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    • pp.201-211
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    • 2000
  • Objectives : The purpose of this study was to determine the validity and reliablity of the Korean version of the Global Assessment of Recent Stress(GARS) Scale developed for assessing the severity of current perceived stressors, and then to use the scale in clinical practice. Methods : The questionnaire was completed by 215 healthy subjects. A comparison was made regarding the perception of stressors among 242 patients(71 with anxiety disorder, 73 with depressive disorder, 47 with somatoform disorder, and 51 with psychosomatic disorder) and 215 healthy subjects. Factor analysis was done using oblique rotation after maximum-likelihood factor analysis. Results : Factor analysis yielded 1 subscale. Reliability was computed by administering the GARS Scale to 69 healthy subjects during a 2-week interval. Test-retest reliability for 8 items and the total score was significantly high, ranging between 0.85-.95. Internal consistency was significant(Cronbach's a for 7 items : .86). Convergent validity was computed by correlating the 8 items and the total score with the total score of the stress response inventory(SRI), the perceived stress questionnaire(PSQ), and the somatization, anxiety, depression, hostility subscales and general indices of the symptom checklist-90-revised(SCL-90-R). The correlations were all at significant levels. Discriminant validity was computed by comparing the 8 item scores of the patient and control groups. Significant differences were found in area relevant to sickness or illness and the overill global area. The patients with anxiety disorder were significantly higher in area relevant to sickness or illness than the healthy group, whereas the patients with depressive disorder was significantly higher in the overall global score than healthy group. The depressive disorder group was the highest in overall global score of the GARS scale among 4 patient groups, and showed a significant higher scores in interpersonal relationship and overall global area than the psychosomatic disorder group. Conclusions : These results indicate that the Korean version of the GARS scale is highly reliable and valid, and that it can be utilized as an effective measure of perceived stressors for research in stress-related fields. It is suggested that depressive disorder patients are more likely to perceive recent stressors than psychosomatic disorder patients.

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THE COMORBIDITY AND EMOTIONAL STATE OF THE ENURETIC CHILDREN (유뇨증 소아의 공존질병 및 정서상태)

  • Lee, Kyu-Kwang;Shin, Yun-O;Lee, Tae-Yong
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.8 no.1
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    • pp.34-42
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    • 1997
  • Enuresis is repeated involuntary or intentional voiding of urine into bed or clothes over age 5. Though it would be a self-remitting disorder, it could be serious problem in emotional and socio-adaptational aspects. The author reviewed the enuretic patients of Child & Adolescence psychiatric section in Chungnam National University Hospital during past 3 years. 46(4.9%) of 936 patients were diagnosed as enuresis in DSM-Ⅳ. The author evaluated their comorbidity by the data of diagnostic review made in two psychiatrists, and emotional aspects(self-concept, anxiety, depression) through the self-rating scales (Piers-Harris children’ self concept scales, RCMAS, state-trait anxiety inventory for children, child’s depresson inventory). Thirty(65.2%) of the 46 enuretic patients had additional diagnoses such as attention deficit hyperactive disorder, mental retardation, encopresis, oppositional defiant disorder, depression, anxiety disorder, autism, somatoform disorder, tic disorder, obsessive-compulsive disorder, sleep disorder, etc. Sixteen enuretic patients had at least one comorbid disorder. Eleven patients had two, and three patients had more than three. Fourteen of 46 enuretic patients were evaluated through self-rating scales of self-concept, anxiety and depression. But we couldn’t obtain meaningful results. Maybe it was due to the small sample size(N=14) and the influence of the comorbid disorders. Finally, it was an impressive evidence that there exist many comorbid disorders in enuresis(esp. attention deifict/hyperactive disorder). In emotional aspects, the author thought that further evaluation should be needed for more meaningful results.

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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.

Research Status on Psychotherapy in Korean Medicine (한방정신요법의 연구현황)

  • Sue, Joo-Hee;Ryu, Chun-Gil;Cho, A-Ram;Lee, Go-Eun;Lyu, Yeoung-Su;Kang, Hyung-Won
    • Journal of Oriental Neuropsychiatry
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    • v.24 no.spc1
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    • pp.63-88
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    • 2013
  • Objectives : We attempt to find out the present situation of a study regarding psychotherapy in Korean medicine through research journals in the JON (The Journal of Oriental Neuropsychiatry). Methods : We searched and read every JON from 1990 to 2012 and selected articles relating to Psychotherapy. We then analyzed the data and divided them into 3 categories: literature study, case studies and clinical trials. Results : 1) We found 16 literature articles, in which 6 compared Korean psychotherapy with that of the Western, 4 reinterpreted it focusing on traditional cases in Korean psychotherapy, 3 articles were on Qigong, 1 article was on Buddhism and another on Tao, and 1 article was with regards to dreams. 2) There were a total of 26 case reports about Korean psychotherapy. Among them, JiUnGoRoen had the most at 12; somatoform disorder was the most target disease in 9. 3) There were a total of 13 clinical trials on Korean psychotherapy. There were 4 trials on meditation, 6 on Qigong, each 1 of each for EFT, suggestion and autogenic relaxation. Conclusions : In spite of many resources in Korean psychotherapy, it was limited because it was not able to systematize clinically. Hence, we need to hand down and systematize Korean psychotherapy further.

Measuring Symptom Exaggeration in Posttraumatic Stress Disorder using the MMPI-2 and the Personality Assessment Inventory Symptom Validity Scales (MMPI-2와 Personality Assessment Inventory 타당도 척도를 이용한 외상후 스트레스 장애 환자의 증상과장 평가)

  • Kong, Sung-Whoi;Chae, Jeong-Ho;Lee, Jong-Hun;Hahn, Sang-Woo;Park, Eun-Jin;Choi, Kyeong-Sook
    • Anxiety and mood
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    • v.8 no.1
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    • pp.22-30
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    • 2012
  • Objective : We investigated whether Posttraumatic stress disorder patients have a higher tendency to exaggerate the extent of their psychological symptoms compared to other psychiatric patients. Methods : Medical records of patients, who had received psychiatric treatment at four university hospitals in Korea between January 2009 and December 2010, were retrospectively reviewed. We compared a group of 37 patients diagnosed with PTSD, and another group of 41 patients diagnosed with neurotic, stress-related and somatoform disorders according to the ICD-10. To compare the extent of malingering in the two groups, we compared the validity scales of MMPI-2 and Personality Assessment Inventory. We determined the number of participants in both groups feigning their responses by using various cutoff scores of the validity indicators. Results : The PTSD group showed significantly higher scores on the F (p=0.001), F (B)(p=0.000), F (P)(p=0.030), F-K (p=0.003) scale of the MMPI-2 compared to the other group of psychiatric patients. The PTSD group had a significantly higher NIM score (p=0.001) but a lower PIM score (p=0.020) of the PAI compared to the other group of psychiatric patients. Using the cutoff scores, the PTSD group showed a significantly higher number of patients who feigned responses compared to the other group ($Fb{\geq}75$ (p=0.010), $F-K{\geq}1$ (p=0.005), $F-K{\geq}10$ (p=0.011) from the MMPI-2, and $NIM{\geq}80$ (p=0.001) from the PAI). Conclusion : These results suggest that PTSD patients have a tendency to exaggerate their symptom. This group of patients overreported the severity of their condition during standardized personality assessment that included the MMPI-2 or PAI compared to patients diagnosed with other psychiatric disorders. Additional research is required to determine the factors influencing symptom exaggeration in PTSD.

Usefulness of video-EEG monitoring in paroxysmal nonepileptic events of children and adolescents (소아와 청소년의 돌발적 비간질 발작의 진단에 있어 비디오-뇌파 모니터링의 유용성)

  • Lee, Jee Yeon;Lee, Hee Sun;Choi, Wook Sun;Eun, So Hee;Lee, Ki Hyung;Enu, Baik Lin;Lee, Joo Won
    • Clinical and Experimental Pediatrics
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    • v.51 no.1
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    • pp.62-66
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    • 2008
  • Purpose : In addition to epileptic seizures (ES), a variety of physiologic, organic and psychogenic disorders can manifest as paroxysmal behavioral events. Paroxysmal nonepileptic events (PNEs) are quite encountered in infants, young children, and adolescents. In a substantial proportion of cases, a careful history and examination will elucidate their nature. However, in other cases, it is necessary to differentiate PNEs from ES by video-electroencephalographic (EEG) monitoring. We report our experiences with PNEs in a group of children and adolescents who underwent video-EEG monitoring. Methods : From September, 2004 to June, 2006, one hundred thirty patients were monitored in the Pediatric Epilepsy Monitoring Units of Korea University Guro and Ansan hospitals. Their hospital charts were reviewed and video records of these events were analyzed. We observed all patients after video-EEG monitoring for more than 3 months. Results : Typical spells occurred during monitoring in 33 patients, not associated with a seizure pattern on EEG recordings. Two patients were diagnosed as frontal lobe epilepsy on basis of typical semiology and clinical characteristics, so 31 patients were documented to have PNEs finally. The mean age of patients was $7.2{\pm}5.8\;years$. The male to female ratio was 15 (48.4%) to 16 (51.6%). Among 31 patients, fifteen patients had associated disorders such as epilepsy, developmental delay, cerebral palsy, gastric ulcer, attention deficit hyperactivity disorder or depressive disorder. Somatoform disorder and factitious disorder was frequently seen in children more than 5 years old (P<0.05). Psychogenic disorder was more frequent in female (n=6) than in male (n=2) but there was no statistical significance (P>0.05). Conclusion : Our study suggests that video-EEG monitoring is an important diagnostic tool in the evaluation of paroxysmal behavioral events. With correct diagnosis of the PNEs, several unnecessary treatment could be avoided.