• Korean Journal of Psychosomatic Medicine
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• v.7 no.2
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• pp.226-232
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• 1999

Background : Various type of psychological and stressful events in life have been reported to have much effect in the onset, progress and exacerbation of psychosomatic disorders such as hypertension, bronchial asthma, peptic ulcer, tension headache, alopecia areata, and atopic dermatitis. However, the nature of the association between stress and psychosomatic disorders remains unclear. Objective : The purpose of this study is to determine the relation of stress and the progress of dermatologic disorder. Method : We examined 30 patients with atopic dermatitis and 30 control subjects with tinea pedis and onychomycosis who visited to Dept. of Dermatology, Chung-Ang University Hospital. To evaluate the stress, we used 'Scale of Life Events' and 'Multidemensional Coping Scale'. Result : 1) The score of life events stress in atopic dermatitis group was significantly higher than that of control group. 2) In the result of coping strategies, the atopic dermatitis group was significantly higher than control group at the active forgetting, positive comparison, and emotional pacification, while in control group religious seeking and accomodation tended to be higher with no statistical significance. Conclusion : These findings suggest that psychosocial stress may play a role in life pattern of atopic dermatitis. But further studies are needed to clarity the exact relationship between stress and psychosomatic disorder.

• Korean Journal of Psychosomatic Medicine
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• v.6 no.2
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• pp.104-119
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• 1998

This study was conducted to determine the important factors in the illness behavior of panic disorder patients. And then, find the best ways to lead the patients who have recurrent panic attacks to the adequate therapeutic situations. We studied 53 patients diagnosed as panic disorder according to DSM-IV among the outpatients who had been followed up at Bong Seng Memorial Hospital for 6 Ms, from May 1997 to October 1997. To evaluate the illness behaviors, we designed a checklist including socio-demographic data, degree of subjective distress from medical and psychiatric treatment, panic symptoms, life events, places of help-seeking, Anxiety Sensitivity Index. Using the checklist, we had semistructured interviews with the panic disorder patients to elucidate their help-seeking behaviors from first panic attack to diagnosing as panic disorder. The results were as follows ; 1) After first panic attack, the patients initially sought help at 1) Emergency room 40%, 2) Rest &/or Personal emergency care 35%, 3) Pharmacy 10%, 4) Outpatient care at hospital 10%, 5) Oriental medicine 5%. 2) Considering the panic symptoms, derealization, paresthesia and the severity of panic symptoms were the most important factors affecting the patient's help-seeking behaviors who had experienced the first panic attack. 3) Most of all the patients (80%) were apt to visit the hospitals within 15 days after experiencing about 3 panic attacks. 4) Before diagnosed as panic disorder, the patients had visited 3-5 health care centers during about 1 year. 5) Primary care physicaians(for example, emergency care physicians, family doctors and internists) had the most important roles in treating or guiding the patients to the adequate therapeutic situations. From the above results, the authors propose that non-psychiatric physicians have to know the panic disorder or attacks exactly. When patients complaint sudden onset physical symptoms e.g. palpitation, dyspnea, dizziness or the cognitive symptoms like the fear of death or insanity, physicians should consider the possibility of panic attack and encourage the patients to be evaluated for psychiatric illness.

• Journal of Oriental Neuropsychiatry
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• v.13 no.2
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• pp.41-56
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• 2002

The Analysis of MMPI and Clinical Study was carried out the 28 patients with somatoform disorder and depressive disorder who were treated in Daejeon University Oriental Hospital from 19 June 2001 to 17 April 2002. The results were summarized as follows. 1. The ratio of female was higher, especially in the depressive disorder, the ratio of female was higher and in the age distribution, the 40 aged were higher frequence. 2. In the somatoform disorder, symptoms appeared to be busy in physical symptoms, and they were in descending order the digestive organs system, head and face portion and musculoskeletal system symptoms, in the depressive disorder, appeared to be busy in psychosomatic system symptoms and in the prescription drugs, soyosan(逍遙散), punsimkiyyin(分心氣飮) were used to be busy. 3. In the scales of L, F, K, somatoform disorder showed ${\wedge}$ typed graph, and depressive disorder showed ${\vee}$ typed graph. 4. In the somatoform disorder, scales of Hs, Hy, D, Pa were higher, and in the depressive disorder, scales of Hy, Hs, Pd, D were higher. 5. In the scales of Hs, D, Hy, somatoform disorder showed ${\vee}$ typed graph, and depressive disorder showed/typed graph. 6. the average of T-scores and the ratio over 65 score and 70 score showed common distribution.

• Korean Journal of Psychosomatic Medicine
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• v.9 no.1
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• pp.58-65
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• 2001

Objectives : It is well known that pharmacologic and behavioral therapies of panic disorder show remarkable acute treatment outcome, however the course of panic disorder in clinical settings is often chronic and relapsing. The purpose of this study is to investigate the treatment outcome of panic disorder and the factors related to good treatment outcome by prospective follow-up study after 6 month in clinical settings. Methods : Twenty nine patients were diagnosed to have panic disorder by SCID(Structured Clinical Interview for DSM-III-R), among the patients who had visited the psychiatric out-patients clinic of the Asan Medical Center for the first time. We determined the initial clinical and demoraphic features of each patient and reevaluated them after 6 months, investigating the treatment outcome by anxiety, phobia, impairment scales. We looked into the rate of the patients who showed good treatment outcome and determined the factors that had relation with good treatment outcome among demographic and clinical features. Results : Nineteen out of 29 patients could be followed after 6 months. Among them, 10 patients 52.6%) on the impairment scale and phobia scale each, and 8 patients(42.1 %) on the anxiety scale showed good treatment outcome. 8 patients(42.1 %) showed good treatment outcome on the all three scales. High score in initial phobia scale had significant relation with good treatment outcome. Short duration of illness did not have significant relation with good treatment outcome however there was a trend(p=0.07). Conclusion : About half(42.1 %) of the panic disorder patients showed good treatment outcome on all three scales. Severe initial phobic symptom and short duration of illness were expected to have relation with good treatment outcome.

• Korean Journal of Psychosomatic Medicine
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• v.14 no.1
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• pp.39-46
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• 2006

Objectives: The study was intended to explore the relationships between temperament and premenstrual dysphoric disorder, to understand symptomatology of premenstrual dysphoric disorder and associated personality trait and to suggest therapeutic availability. Method : Twenty eight women, diagnosed as premenstrual dysphoric disorder by DSM-IV, were asked to complete the Korean version of Tridimensional Personality Questionnaire, and Shortened Premenstrual Assessment Form. The correlations between the severity of premenstrual symptoms and the scores of Tridimensional Personality Questionnaire were calculated. Results : The severity of symptoms of premenstrual dysphoric disorder was best explained by the harm-avoidance factor of the four dimensions of temperament. Conclusion : The symptoms of premenstrual dysphoric disorder are well explained by the harmavoidance factor and the reward-dependence factor of four dimensions of the temperament.

• Korean Journal of Psychosomatic Medicine
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• v.3 no.2
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• pp.139-146
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• 1995

Forty patients meeting DSM-III-H criteria for panic disorder and 51 normal controls were assessed with the Personality Diagnostic Questionnaire-Revised(PDQ-R), a self-rating scale designed to assess Axis II personality disorders and traits. Results replicated previous findings of a preponderance of dependent, avoidant, and histrionic features. But our result showed other features such as paranoid, schizotypal, borderline, and antisocial traits also. Patients were divided into two groups according to the severity of their personality traits(high or low). These groups were compared in various panic symptomatology and SCL-90-R. None of the specific symptom dimensions in panic disorder, i.e. panic, anxiety, agoraphobia, social impairment, or chronicity was different between groups. Rather, high personality trait groups were found to have significantly more symptomatology in SCR-90-R than low personality groups. Result indicated that patients exhibiting a greater number of personality traits were also significantly more symptomatic. The results suggested a possible link beteween panic disorder and personality disorder. And, general factors such as depression, social or interpersonal sensitivity might provide a much better explanation of personality disorders in panic patients.

• Korean Journal of Psychosomatic Medicine
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• v.28 no.1
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• pp.89-97
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• 2020

Objectives : We investigated heart rate variability (HRV) patterns in patients with somatic symptom disorder (SSD) and the relationships of these patterns with alexithymia. Methods : In total, 42 patients with SSD and 33 healthy controls were enrolled in this study. Demographic, psychological, and HRV data were assessed at baseline, and 24 patients with SSD were reassessed after 6 months of treatment. The psychological data included somatic symptoms and levels of depression, anxiety, and alexithymia as indicated by the somatic symptom subscale of the Symptom Checklist 90-Revision (SCL-12), Beck Depression Inventory-II (BDI-II), Beck Anxiety Inventory (BAI), and the Toronto Alexithymia Scale 20 (TAS-20), respectively. Results : Patients with SSD had a lower standard deviation of normal-to-normal R-R intervals (SDNN) and lower proportions of adjacent R-R intervals greater than 50 milliseconds (pNN50) compared with controls. These HRV parameters were negatively correlated with alexithymia severity. After treatment, patients exhibited significantly decreased levels of somatic symptoms and reduced anxiety and depression, but there were no significant differences in the HRV parameters. In patients with alexithymia, a high baseline SDNN and pNN50 were associated with a decrease in somatic symptoms. Conclusions : Patients with SSD have different HRV patterns, and several HRV parameters are associated with alexithymia severity. These findings suggest that ANS regulation is involved in the pathophysiology of SSD, mediated by alexithymia. Furthermore, these results suggest that certain HRV parameters may be associated with clinical outcomes of SSD.

• Korean Journal of Psychosomatic Medicine
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• v.10 no.2
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• pp.166-175
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• 2002

Recently many researches support the use of traditional psychiatric treatments in the management of chronic pain. Chronic pain is a significant public health problem and frustrating to everyone affected by it. Psychiatrists offer skills with treatments now recognized as effective in the management of chronic pain. In addition to the diagnosis and treatment of psychiatric co-morbidity, the application of psychological treatments to chronic pain, and the development of interdisciplinary efforts to provide comprehensive health care to the patient disabled with chronic pain, psychiatrists have particular skill in pharmacological treatment that have proven efficacy for a variety of chronic pain conditions. With their expertise in the use of psychoactive medication plus their interest in the personal and family dynamics of patients, psychiatrists have the capacity to be involved in the treatment of patients with chronic pain. So, the author reported three cases of patient with pain disorder associated with psychological factors, and reviewed to propose that psychiatrists in Korea should take an active role in the care of these patients.

• Korean Journal of Psychosomatic Medicine
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• v.4 no.1
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• pp.13-20
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• 1996

This study was performed to explore the frequency of panic attack induced by sodium lactate in alcohol dependence patients and to compare the extent of blunted growth hormone reponses after clonidine infusion with that of normal controls. The authors investigated 10 alcohol dependence patients receiving inpatient care in Hangang Sacred Heart Hospital from March 2, 1993 to August 31, 1993 and 10 normal controls. The disagnosis of alcohol dependence was based on DSM-III-R. Thirty minutes after the sodium lactate infusions clonidins were administrated. Venous bloods were sampled before the sodium lactate infusions, and 30, 45, 60, 90 minutes after the administrations of clonidine. Plasma growth hormone levels were measured by RIA method. The results were as follows : 1) In the questionaires of Hamilton Anxiety Rating Scale, Hamilton Depression Raing Scale, CAGE, Korean MAST, the scores of alcohol dependent patients were higher than those of normal controls. 2) Sixty percent of alcohol dependence patients and twenty percent of normal controls had panic attacks induced by sodium lactate. 3) All panic attacks induced by sodium lactate were relieved after clonidine infusions. 4) There were blunted growth hormone responses after clonidine infusions in alcohol dependence patients who had sodium lactate induced panic attacks like panic disorder patients. These results suggest that alcohol dependence patients may have noradrenergic abnormality same as panic disorder patients and two disorder may have high biological correlations each other.

• Korean Journal of Psychosomatic Medicine
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• v.7 no.2
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• pp.256-262
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• 1999

Because chronic pain disorder may has multiple causes or contributing factors, including physical, psychological, and socio-environmental variables, the treatment of patients with the disorder requires biopsychosocial approaches in a multidisciplinary setting. In treating chronic pain, it is important to address functioning as well as pain, and treatment should be to increase functional capacity and manage the pain as opposed to curing it. Therefore treatment goal should be adaptation to pain or minimizing pain with corresponding greater functioning. Treatment begins with the initial assessment, which includes evaluation of psychophysiologic mechanisms, operant mechanisms, and overt psychiatric comorbidity. Psychiatric treatment of the patients requires adherence to sound pharmacologic and behavioral principles. There are four categories of drugs useful to psychiatrist in the management of chronic pain patients : 1) narcotic analgesics, 2) nonsteroidal antiinflammatory drugs, 3) psychotropic medications, and 4) anticonvulsants, but antidepressants are the most valuable drugs in pharmnacotherpy for them. Psychological treatments tend to emphasize behavioral and cognitive-behavioral modalities, which are divided into self-management techniques and operant techniques. Psychodynamic and insight-oriented therapies are indicated to some patients with long-standing interpersonal dysfunction or a history of childhood abuse.