• Title/Summary/Keyword: somatic symptom

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Globus Pharyngeus : The Psychiatric Perspective (인후두 이물감의 정신과적 접근)

  • Joo, Young-Hoon
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.27 no.2
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    • pp.84-86
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    • 2016
  • Globus pharyngeus or globus sensation is the painless sensation of a lump in the throat and may be described as a foreign body sensation, a tightening or choking feeling. It is often associated with persistent clearing of the throat, chronic cough, hoarseness, and catarrh. Its etiology remains unclear ; however, laryngopharyngeal reflux may play a role in a subset of patients. Psychogenic problems have often been thought to cause or trigger the globus sensation. Personality studies have found higher levels of alexithymia, neuroticism, and psychological distress (including anxiety, low mood, and somatic concerns) and lower levels of extraversion in patients presenting with globus. Globus patients with laryngopharyngeal reflux exhibited weaker psychological symptoms than non- laryngopharyngeal reflux globus patients, and globus patients who did not respond to proton pump inhibitor had significantly higher anxiety scores. In cases with negative clinical investigations and consistent globus symptom, other treatment strategies, including speech therapy, antidepressants, and cognitive-behavioral therapy, should be considered.

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Use of Hypnosis in the Treatment of Pain

  • Lee, Jin-Seong;Pyun, Young-Don
    • The Korean Journal of Pain
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    • v.25 no.2
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    • pp.75-80
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    • 2012
  • Hypnosis is an altered state of consciousness that comprises of heightened absorption in focal attention, dissociation of peripheral awareness, and enhanced responsiveness to social cues. Hypnosis has a long tradition of effectiveness in controlling somatic symptoms, such as pain. Pain, the most common symptom in clinical practice, is a multi-dimensional experience, which includes sensory-discriminative, affective-emotional, cognitive and behavioral components. There is a growing recognition for hypnosis and related techniques in pain management. Psychological approaches to pain control, such as hypnosis, can be highly effective analgesics, but are underused in Korea. In this article, we would like to review the basic concepts of hypnosis, the mechanism, and the outcome data of the analgesic effects of hypnosis, and also, its limitations.

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.

The Comparison of Perceived Stress and Coping Strategy between Patients with Gastric Ulcer and Those with Chronic Gastritis (위궤양환자들과 만성위염환자들간의 스트레스지각 및 대응전략의 비교)

  • Oh, Seung-Jun;Koh, Kyung-Bong
    • Korean Journal of Psychosomatic Medicine
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    • v.8 no.1
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    • pp.11-19
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    • 2000
  • Objectives : The object of this study was to make a comparison regarding perceived stressor, perceived stress responses, and coping strategies between patients with gastric ulcer and patients with chronic gastritis. Subject and Methods : Subjects consisted of 40 patients with gastric ulcer and 100 patients with chronic superficial gastritis. Global assessment of recent stress(GARS) scale and perceived stress response inventory(PSRI) were used to measure perception for stressors and stress responses. Coping scale was used to measure coping strategies. Results : Scores of perceived stress related to work or job, changes in relationship on GARS scale were significantly higher in patients with gastric ulcer than those with chronic gastritis. Scores of perceived stress responses related to general somatic symptom, specific somatic symptom, passive-responsive and careless behavior on PSRI were significantly higher in patients with chronic gastritis than those with gastric ulcer. Scores of seeking social support, escape-avoidance on coping scale were significantly higher in patients with gastric ulcer than those with chronic gastritis. Conclusion : The above results suggest that perception for stressors were likely to be higher in patients with gastric ulcer than those with gastritis, whereas perception for stress responses were likely to be higher in the latter than the former. It is also suggested that patients with gastric ulcer were likely to use more dependent and passive coping strategies than patients with gastritis.

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Comparison of the Bupropion versus Aripiprazole Adjunctive Therapy for the Treatment of Female Depression : Post-Hoc Analyses from a Randomized Prospective Open-Label Multi-Center Study (여성 우울증 환자에서 Aripiprazole과 Bupropion 부가요법의 우울증상 및 안전성에 대한 효과 비교 : 사후분석연구)

  • Keum, Mu-sung;Cheon, Eun-Jin;Lee, Kwang-Hun;Koo, Bon-Hoon;Lee, Young-Ji;Park, Young-Woo;Lee, Jong-hun;Lee, Seung-Jae;Sung, Hyung-Mo
    • Mood & Emotion
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    • v.16 no.3
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    • pp.140-151
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    • 2018
  • Objectives : The purpose of this study was to examine effects of adjunctive aripiprazole versus bupropion, on depressive symptoms of female depression. Methods : Sixty six female patients with major depressive disorders were enrolled from a six-week, randomized prospective open-label multi-center study. Participants were randomized to receive aripiprazole (2.5-10 mg/day) or bupropion (150-300 mg/day). Montgomery Asberg Depression Rating Scale, 17-item Hamilton Depression Rating scale (HAM-D17), Iowa Fatigue Scale, Drug-Induced Extrapyramidal Symptoms Scale, Psychotropic-Related Sexual Dysfunction Questionnaire scores, and Clinical Global Impression-Severity (CGI-S) were obtained at baseline and after one, two, four, and six weeks. Changes on individual items of HAM-D17 were assessed as well as on composite scales (anxiety, insomnia and drive), and on four core subscales that capture core depression symptoms. Results : Overall, both treatments improved depressive symptoms, without causing serious adverse events. There were significant differences in the HAM-D17 total score (p=0.046) and CGI-S (p=0.004), between aripiprazole and bupropion augmentation, favoring aripiprazole over bupropion. Aripiprazole revealed significantly greater effect size in depressed mood (p=0.006), retardation (p=0.005), anxiety psychic (p=0.032), and general somatic symptom (p=0.01). Conclusion : While both treatments were effective, results of this study suggested that aripiprazole may be preferable, in treating general and core symptoms of female depression.

Development of the Perceived Stress Response Inventory (스트레스반응 지각척도의 개발)

  • Koh, Kyung-Bong;Park, Joong-Kyu;Kim, Chan-Hyung
    • Korean Journal of Psychosomatic Medicine
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    • v.7 no.1
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    • pp.26-41
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    • 1999
  • The perceived stress response inventory(PSRI) was developed to measure 4 types of current stress responses : emotional, somatic, cognitive, and behavioral responses. 242 patients with psychiatric disorders(71 patients with anxiety disorders, 73 patients with depressive disorders, 47 patients with somatoform disorders, 51 patients with psychosomatic disorders) and 215 healthy subjects completed the questionnaire including the PSRI. Global assessment of recent stress(GARS) scale, perceived stress questionnaire(PSQ) and symptom checklist-90-revised(SCL-90-R) were also administered at the same time. Factor analysis for each of 4 types of stress responses yielded 8 factors : negative emotional responses, general somatic symptoms, specific somatic symptoms, lowered cognitive function and general negative thinking, self-depreciative thinking, impulsive-aggressive thinking, passive-responsive and careless behavior, and impulsive-aggressive behavior. Both test-restest reliability(r= .83 -.93) and internal consistency(Cronbach's alpha : .79 -.96 for each of 8 subscales and .98 for total items of the scale) were all at statistically significant levels. Total scores of the PSRI significantly correlated with total scores of GARS scale, PSQ, and global indicies of SCL-90-R, respectively. The patient group had significantly higher scores than healthy subjects in each of all the subscales except impulsive-aggressive behavior subscale. These results suggest that the PSRI is a reliable and valid tool stable over time which may be effectively used for the research in stress-related field including psychosomatic medicine.

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Development of the Somatization Rating Scale (신체화 평가 척도의 개발)

  • Koh, Kyung-Bong;Park, Joong-Kyu
    • Korean Journal of Psychosomatic Medicine
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    • v.10 no.2
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    • pp.78-91
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    • 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.

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PSYCHOLOGICAL ASPECT OF PATIENT SATISFACTION AND ACCEPTANCE OF COMPLETE DENTURES (총의치 환자 만족도에 대한 정신의학적 측면)

  • Chung, Moon-Kyu;Lee, Suk-Won
    • The Journal of Korean Academy of Prosthodontics
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    • v.37 no.4
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    • pp.494-505
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    • 1999
  • In spite of the progress in techniques and materials of the prosthodontic rehabilitation of patients with complete edentulous arches, prosthodontists still face patients' complaints about dissatisfaction and discomfort from their dentures. In the past several decades, prosthodontists tried to find the factors that influence the patient's satisfaction with dentures. However the results are contraversial especially with the psychological factor. In this study using 'patient denture satisfaction questionnaire' and Hopkins Symptom Checklist, we tried to find the correlation between the patient's denture satisfaction and the patient's psychological aspects. 23 complete edentulous patients who have visited the Department of Prosthodontics, Yonsei University Dental Hospital from September 1998 to June 1999 for complete denture treatment were asked to complete the questionnaires 4 to 6 weeks after the upper and lower complete delivery. After the measurement of validity of the questionnaires, correlations between the patient's general satisfaction with their new upper and lower complete dentures and the other satisfaction questions including the satisfactions with esthetics, retention, mastication, speech, comfort and other people's opinion and between the patient's general satisfaction with their new upper and lower complete dentures and the 5 symptoms of Hopkins Symptoms Checklist including somatic, obsessive-compulsive, interpersonal sensitivity, depression and anxiety were analyzed. Among the several satisfaction questionnaire items, comfort with the lower denture showed highest relation to the patient's general satisfaction with dentures. However, only the anxiety scale of Hopkins Symptoms Checklist among the other symptom scales was related to the patient's general satisfaction with dentures. The two questionaires used in this study turned out to be valid means of analyzing patient's denture satisfaction and psychological status before and after the complete denture treatment.

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Stress, Anxiety, and Depression of the Patients Who Complained of Functional upper Gut Symptoms (기능성 상부 위장관 증상을 호소하는 환자의 스트레스, 불안 및 우울)

  • Lee, Sang-Yeol;Shean, Sung-Hun;Choi, Suk-Chei
    • Korean Journal of Psychosomatic Medicine
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    • v.6 no.1
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    • pp.3-12
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    • 1998
  • Objective : The sensation of dysphagia, heartburn, globus hystericus, and functional dyspepsia are common symptoms of the functional upper gut disorders. This study was designed to investigate quantity of perceived stress, depression, and anxiety in the patients with functional upper gut symptoms whose esopahgeal manometry(EM) and gatroesophageal reflux (GERT) test were normal. Methods : A total of 38 patients who complained of the symptoms had been tested with 24-hour ambulatory EM and conventional GERT in our gastrointestinal clinic. Thirty patients whose tests had been normal(patients group) were assessed with Symptom Checklist-90-Revision(SCL-90-R), Beck Depression Inventory(BDI), and Spielberger Stait-Trait Anxiety Inventory(STAI) and compared with 30 patients(control group) without functional upper gut symtpoms in the hepatobiliary clinic. The two groups were also assessed by quantity of perceived stress during the last year through self-report. Results: 1) These patients tended to be predominently female, older, and possessed a lower education than control group. 79% of 38 patients who had been tested were normal. 2) Compared to the control group, the patients had significantly higher mean scores on four subscales(somatization, depression, anxiety, and positive symptom distress index). 3) The patient group had significantly more perceived stress than the control group. 4) The patients group had significantly higher levels of depression than the control gorup, but there was not any significant difference in the STAI. 5) There were significant positive correlations between the BDI score and the STAI-trait, the STAI-stait and the STAI-trait, the quantity of perceived stress and the STAI-trait. Conlusion : The patients with functional upper gut symptoms displayed more, psychological distress, sornatization, anxiety, and deperssion. Among them, patients had higer depression than control group. Functional upper gut symtoms could be more appropriately viewed as somatic symptoms of depression. These findings suggest that such patients need to have psychiatric intervention and treatment.

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Effect of Emotional Labor on Somatization among Dental Hygienists in an Area

  • Kim, Mi-Jeong;Lim, Cha-Young;Son, Ju-Lee
    • Journal of dental hygiene science
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    • v.19 no.2
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    • pp.113-121
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    • 2019
  • Background: We investigated somatization symptoms experienced by dental hygienists due to stress from emotional labor. Our aim was to provide basic research data that could be useful in the development of efficient stress management schemes for this occupational group. Methods: We analyzed data collected from 208 dental hygienists working in Jeollabuk-do Province, Korea. To measure the level and intensity of emotional labor among research participants, we used the Korean Emotional Labor Questionnaire. We used the Somatization Symptom Checklist-90-Revised (SCL-90-R) to measure the level of somatization symptoms among participants. Results: On analyzing the level of emotional labor and somatization symptoms according to general characteristics, participants aged 23~25 years showed high scores for stress due to emotional labor (p<0.05). Working 5 days per week, subjective health status, and organizational support and protection systems were found to correlate with the level of stress due to emotional labor (p<0.05). In the analysis of correlations between emotional labor and somatization symptoms, scoring high across all domains of emotional labor was associated with scoring high for somatization symptoms in the subdomains of emotional labor. When emotional labor and demographical variables were used as independent variables, having higher scores for emotional labor and having poor subjective health status were found to be associated with having higher levels of somatization symptoms (p<0.05). Conclusion: Our results showed that working at night and organizational support and protection systems were correlated with emotional labor and somatization symptoms. Measures must be taken at the organizational level to reduce emotional labor and somatization symptoms.