• Korean Journal of Psychosomatic Medicine
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• v.4 no.2
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• pp.262-268
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• 1996

It is important not only understanding the underlying psychodynamic mechanism of the somatization but also understanding the somatization as a process where biological and sociocultural factors are acting as maintaining and exaggerating the primary vague somatic symptoms. Recently, among mechanisms of the somatization biological and cognitive aspect became more important than psychodynamics. When the doctors see patients complain physical discomforts without organic foundation, they should give attention to the mechanism of symptom amplification, misinterpretation, individual cognitive characteristics and learned behavior. Psychiatric disorders which show somatic symptoms should be also evaluated. Autonomic dysfunctions linked with stress would give some clues of the mystery of the mind-body relationship.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.21 no.10
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• pp.274-282
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• 2020

This study examined the effect of job stress and mental health factors on the oral symptoms of caring service workers in Seoul. For the research method, a survey was conducted from July 24 to August 6, targeting 150 caring service workers. The survey items were job stress, mental health (physical symptoms, anxiety, and insomnia), and self-diagnosed oral symptoms. The results of the study were as follows. Job stress (p=0.001) had a significant effect on the oral symptoms. In addition, physical symptoms (p<0.001), anxiety symptoms (p<0.001), and insomnia symptoms (p<0.001) all had significant effects on the oral symptoms. Among the risk factors, physical symptoms had the greatest influence on oral symptoms. In addition, according to the correlation result of job stress, anxiety symptoms, insomnia symptoms, oral symptoms, as job stress increases, physical symptoms (p<0.001), anxiety symptoms (p<0.001), insomnia symptoms (p<0.001), oral symptoms (p<0.01) showed an increasing positive correlation and a statistically significant difference. Physical and psychological labor power is greatly exhausted by care service workers performing tasks that require physical and mental care for those who are being cared for. Therefore, there is a need for systematic expansion measures for the mental health of workers and the introduction of customized oral health education programs to improve oral health because improved health and oral health conditions can increase work performance.

• Korean Journal of Psychosomatic Medicine
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• v.8 no.2
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• pp.172-180
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• 2000

Objectives : We investigated the characteristics of perceived stress response and relationship between some variables of gastrointestinal symptoms(esp., dyspepsia) and subscales of perceived stress response inventory(PSRI) in patients with upper gastointestinal disorder when they perceived stress. Methods : 84 patients with upper gastrointestinal disorder(gastritis, gastric ulcer, duodenal ulcer etc.) and 94 normal controls completed the PSRI developed by Korean psychiatrists. The patient group performed the questionnaire including some variables of gastrointestinal symptoms. Results : Internal consistency was statistically significant in all subscales of PSRI. The patient group was significantly higher at total score of PSRI, general somatic symptom subscale score, specific somatic symptom score than control group. As the result of stepwise regression analysis for relationship between some variables of gastrointestinal symptoms ans subscales of PSRI, specific somatic symptom subsclae closely related with illness duration, past illness history and severity of symptom, and the lowered cognitive function & general negative thinking subscale related with the existence of emotional distress. Conclusion : Patients with upper gastrointestinal disorder showed stronger perceived stress response than control group and they experiences somatic symptoms related to autonomic nervous system and/or gastrointestinal symtoms rather than emotional, cognitive, behavioral symtoms when they perceived stress. They also responded to stress as they expeirenced specific somatic symtom when they had long illness duration, past illness history, and high severity of symptom and the existence of emotional distress could develop lowered congnitive function and general negative thinking.

• Korean Journal of Psychosomatic Medicine
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• v.31 no.2
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• pp.108-117
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• 2023

Objectives : Somatic symptom disorder (SSD) is characterized by the manifestation of a variety of physical symptoms, but little is known about differences in autonomic nervous system activity according to symptom severity, especially within patient groups. In this study, we examined differences in heart rate variability (HRV) across symptom severity in a group of SSD patients to analyze a representative marker of autonomic nervous system changes by symptoms severity. Methods : Medical records were retrospectively reviewed for patients who were diagnosed with SSD based on DSM-5 from September 18, 2020 to October 29, 2021. We applied inverse probability of treatment weighting (IPTW) methods to generate more homogeneous comparisons in HRV parameters by correcting for selection biases due to sociodemographic and clinical characteristic differences between groups. Results : There were statistically significant correlations between the somatic symptom severity and LF (nu), HF (nu), LF/HF, as well as SD1/SD2 and Alpha1/Alpha2. After IPTW estimation, the mild to moderate group was corrected to 27 (53.0%) and the severe group to 24 (47.0%), and homogeneity was achieved as the differences in demographic and clinical characteristics were not significant. The analysis of inverse probability weighted regression adjustment model showed that the severe group was associated with significantly lower RMSSD (β=-0.70, p=0.003) and pNN20 (β=-1.04, p=0.019) in the time domain and higher LF (nu) (β=0.29, p<0.001), lower HF (nu) (β=-0.29, p<0.001), higher LF/HF (β=1.41, p=0.001), and in the nonlinear domain, significant differences were tested for SampEn15 (β=-0.35, p=0.014), SD1/SD2 (β=-0.68, p<0.001), and Alpha1/Alpha2 (ß=0.43, p=0.001). Conclusions : These results suggest that differences in HRV parameters by SSD severity were showed in the time, frequency and nonlinear domains, specific parameters demonstrating significantly higher sympathetic nerve activity and reduced ability of the parasympathetic nervous system in SSD patients with severe symptoms.

• Korean Journal of Psychosomatic Medicine
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• v.12 no.1
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• pp.66-75
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• 2004

Objectives: This study was intended to see the relationship between psychiatric consequences and injury severity following traffic accidents. Methods: We surveyed the 134 patients who were hospitalized from 1994 to 2003 at Chosun University Hospital for psychiatic disability evaluation following traffic accident. We reevaluate demographic factors from admission note. Psychiatric symptoms from mental status exam in medical records. Psychological tests(MMPI, BAI, BDI, K-WAIS) were done. Then we calculate the injury severity score and McBride's rate of disability due to diagnosis from emergency care hospital records. Their relationships were evaluated by statistical methods which were t-test and Pearson correlation analysis using SPSS-10. Results: When physical injury was not severe, suicidal attempt was more frequent and depression, hysteria, psychasthenia, psychopathic deviation subscales were high in MMPI. But when physical injury was severe, they have diffficulty in concentration, impaired orientation, and changed in IQ score. There was no relationship between physical injury severity and faking bad scales(F, Ds-r). Conclusion: We must not assume when physical injury was not severe, the severe sympomts are just faking for their benefit.

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

• Korean Journal of Psychosomatic Medicine
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• v.12 no.1
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• pp.47-55
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• 2004

Objectives: The aim of this study was to investigate alexithymia, depressive symptoms, and stress response of patients with alcohol dependence. The results were taken as a basic data of ameliorating the quality of life. Methods: 94 patients with alcohol dependence completed stress response inventory, Korea depression scale, and toronto alexithymia scale successfully. Results: 55% of variance of alexithymia of patients with alcohol dependence were explained by the stress response and depressive symptoms and score of ADS, and the stress response had the most explanatory power. Conclusions: The alexithymia of patients with alcohol dependence may be influenced by depressive symptoms, education, frequency of drinking, and stress response. The specialists were identifying symptoms of depression and optimizing the management, therefore increasing the compliance and quality of life of patients with alcohol dependence.

• Korean Journal of Psychosomatic Medicine
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• v.17 no.2
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• pp.45-51
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• 2009

Pulmonary diseases distress millions of people worldwide. Numerous studies have shown an association between pulmonary disease and psychiatric disorders. Despite this, little is known about the treatment of psychiatric disorder in patients with pulmonary disease. The three main goals of this article are 1) to discuss the major disorders such as asthma, chronic obstructive pulmonary disease, hyperventilation, tuberculosis, lung cancer that most clinicians see in practice, 2) to provide an information about psychiatric treatment such as anxiety, depression, psychosis in pulmonary disease, and 3) to provide some clinically relevant suggestions about pharmacologic interactions between pulmonary and psychotropic drugs.

• The Science & Technology
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• v.33 no.3 s.370
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• pp.84-85
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• 2000

정신계통의 특이한 현대병 '공황장애'는 갑자기 가슴이 조여들고 숨이 막히면서 손발이 저리고 어지러워져 곧 쓰러질 것 같은 느낌이 20~30분간 계속되며 이 증상이 주기적으로 나타나는 정신계통의 질환이다. 정신과 질환임에도 불구하고 여러 가지 급성 신체증상들을 동반해 심장질환 등 내과 계통의 질환으로 오진하기 쉬운 질병이다. 대개의 경우 약물치료후 2~3개월이면 호전되고 1년반 정도 장기 약물복용이 필요하다.

• 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.