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

• Journal of Oriental Neuropsychiatry
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• v.10 no.1
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• pp.205-216
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• 1999

Hwabyung is an illness due to stagnated emotion accumulated for a long time and is not rare in the area of neuropsyhchiatric clinics in Korea. It has been widely used among Korean people, and was introduced as culture bound syndrome in DSM-IV. The purpose of this study was to investigate the origin of Hwabyung, and concepts using at past. Hwabyung is described in 'Choson Wangjo Silok' in 1603 (Sonjo 37th year) at first. The explanation about Hwabyung in 'Choson Wangjo Silok' contain etiology, pathology, symptoms and treatment, is closely related with the meaning through Korean Traditional Medicine.

• Journal of Oriental Neuropsychiatry
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• v.12 no.2
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• pp.193-202
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• 2001

Purpose: Hwabyung is a culture-bound syndrome in Korea, characterized by emotional stress such as anger, depression, and anxiety. The purpose of the present study was to explore the characteristics of Hwabyung patients, based on constitutional medicine, for their symptoms, duration, and coping styles. Method: Participants were 57 Hwabyung patients selected by Hwabyung criteria. They were also diagnosed for their constitution by doctors specialized in constitutional medicine. Each participant was asked to respond to a variety of items such as cause and duration of stress, symptoms of hwabyung, anger and depression, and coping styles. Eight patients were excluded from the total sample; two male patients and six patients unable to be diagnosed for any particular type of constitution. Thus, final sample was 49 female hwabyung patients, which will be reported in what follow. Result: To begin with, constitutional type revealed significant differences in such coping styles as 'perseverance,' 'positive interpretation,' 'positive comparison,' and 'emotional pacification.' More specifically, post-hoc comparison revealed that Taeeumin(person who have taeeum characteristics) was higher in 'perseverance' compared-to other two types of constitution. Taeumin also revealed higher score than Soeumin(person who have soeum characteristics) in 'positive comparison.' With respect to the marital status, the married compared to the unmarried showed higher score in 'anger-control,' and lower score in 'anger-in.' The married compared to the unmarried, regarding coping styles, also showed higher score in 'accommodation,' but lower score in 'emotional expression.' The duration of hwabyung revealed that the longer duration of hwabyung, the more frequent utilization of 'positive interpretation' and 'emotional pacification. Conclusion: The main purpose, the exploration of hwabyung based on four types of constitution, was not supported, as a whole in the present study. However, marital status and duration of hwabyung appear to influence on emotional stress (e.g., anger) as well as coping styles, suggesting that these variables should be dealt with in future studies on hwabyung.

• Journal of Korean Academy of Nursing
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• v.25 no.4
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• pp.825-836
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• 1995

This ethnogrphic exploratory study sought to de-fine the meaning of Sanhubyung, as consequence from the perspective of the women who experienced it. A convenience sample of 9 elderly women in San Francisco. and 20 postpartal women and their 20 non-professional helpers during postpartum in Seoul, Korea were observed and interviewed for 23 months from January 1991 to December 1992 at the Human Development Center in San Francisco and at the hospital and their homes in Seoul, Korea. Sanhubyung was regarded as the consequence of "Doing a Sanhujori Wrongly," as a group of symptoms or sequelae which have two types of characteristics of symptoms . chronic and acute. It can be called a culture bound syndrome in the cultural context re-lated to childbearing phenomenon in Korea. If women violate the principles of Sanhujori, such symptoms can appear at various times : during the period of postpartum itself, at any time, periodically, especially at the anniversary of the child's birth, late forties, and in old age. Acute symptoms that can be classified into immediate and late types include painful and edematous gingiva, sensitive teeth, strange sensation and pain in the knees or backache. Besides, there is a localized sense of soreness and pain ; sense of being in a draft and cold, stomach upset, GI irritation, chilling, shivering, and tiredness, pain and dazzling in the eyes. Chronic symptoms occur in the head, neck, teeth, back, hands, knees, hands and feet, arms and legs, eyes, sinews and joints, bones, and in the body or as a whole. Generally these symptoms are pain, often accompanying a feeling of being cold and in a draft, regardless of actual weather conditions. In conclusion, this findings reflect the Oriental way of thought of causal relationship of women's health and illness based on the wholistic paradigm of harmony and balance of two forces, Yin(cold) -Yang(hot). It provides a challenge to the professional sector to rethink the effect of culture on health and illness. Finally, it suggests care providers use cultural assessment for the appropriateness of the intervention and quality of care for desirable health outcomes.

• Journal of Korean Academy of Nursing
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• v.35 no.2
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• pp.225-238
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• 2005

Hwa-Byung(HB) has been categorized as a Korean culture-bound syndrome that is prevalent in married women of low socioeconomic status. Purpose: The Purpose of the study was to search for the essence of HB and a caring-healing process of HB. Then the research result discusses whether the Transpersonal Caring-Healing Model has been congruent with it. Method: Case examples resulted from in-depth telephone counseling over a period of time at the Women's Hot Line with a client who is a housewife with HB. The counseling content was analyzed through Giorgi's method of descriptive phenomenology. Result: The core meaning of the essence of HB was 'injustice'; and essential themes were 'lack of reciprocity', 'infidelity' 'suppressed aggression and powerlessness' and 'need for recognition'. The core meaning of the essence of the caring-healing process was 'caring-healing experience(maintaining a trust relationship)'; and essential themes were 'active listening', 'empathy' and 'forming a therapeutic relationship'. According to Watson, 'active listening', 'empathy' and 'forming a therapeutic relationship' were identified as intentionality, intersubjectivity and transpersonal. Conclusion: Transpersonal caring can release inner power and strength and help the person to gain a sense of inner harmony. Transpersonal caring is as important to healing as are conventional treatment approaches and even more powerful in the long run.

• Journal of Oriental Neuropsychiatry
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• v.18 no.3
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• pp.299-308
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• 2007

Hwabyung is an culture-bound anger syndrome in Korea. It consists of as one or more of a wide range of physical symptoms, in response to emotional stress. In this case, a 51-years woman complained neck pain and foreign body sensation in throat. We diagnosed her Hwabyung because her chief complaint occurred from stress in process of traffic accident. We classified her Soeumin in Sasang Constitutional Medicine, and used Hwanggigyeji-tang. And we encouraged her think positive and don't worry about little matters because Soeumin tend to think negative and wony about little matters. After treatment, her condition got improved. This report suggest that treatment method of Sasang Constitutional Medicine such as herb medicine and way of thinking is effective in treatment of Hwabyung patient.

• Journal of Oriental Neuropsychiatry
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• v.15 no.2
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• pp.221-228
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• 2004

Many literature-based researches have been thus far reported of Hwa-Byung in oriental medicine and Hwa-Byung is considered as culture-bound syndrome of Korea. It is showed practically middle-aged women and connected with emotion of Han(恨)and its progress generally chronic. But this case described a 36-year old man who diagnosed as Hwa-Byung by HBDIS. He complained chiefly headache and suffered from chest discomfort and sleep disorder. After acupuncture teatment, herbal medication and oriental psychotherapy, his condition got improved. This report is for better understanding of this disease, that Hwa-byung can be seen in male according to changes of social environment.

• Journal of Physiology & Pathology in Korean Medicine
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• v.22 no.5
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• pp.1071-1077
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• 2008

Hwa-byung is a form of psychogenic illness among people in Korea and is listed as a culture-bound syndrome of Korea in the DSM-IV. Despite increased clinical researches for Hwa-byung in the oriental medicine of Korea, there has been no agreement of pattern identification for Hwa-byung. The purpose of this study is to develop a standard instrument of pattern identification for Hwa-byung which will be applied to clinical research. The items and structure of the instrument were based on review of published literature. The advisor committee on this study was organized by 15 neuropsychiatry professors of 11 oriental medical colleges nationwide. The experts attended 2 consultation meetings and discussed developing the instrument. and we also took professional advices by e-mail. The results were as follows; First, we divided the symptoms and signs of Hwa-byung into five pattern identification - stagnation of liver Qi, flare-up of the liver fire, disharmony between heart and kidney, deficiency of both Qi and blood, malfunction of gallbladder due to phlegm stagnation. Second, we got the mean weights to each symptom of five pattern identification which had been scored on a 5-point scale - ranging from 0 to 4 by the 15 experts. Third, we made out the Korean instrument of the pattern identification for Hwa-byung. It was composed of 34 questions and decided on question-and-answer form. Though there are some limits in this study, the instrument of pattern identification for Hwa-byung is meaningful and expected to be applied to the subsequent research. And also, we hope to improve the instrument and make up for this study through various research and discussion.

• The Journal of Korean Medicine
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• v.32 no.5
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• pp.139-146
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• 2011

Hwabyung is a culture-bound anger syndrome in Korea. It manifests as one or more of a wide range of physical symptoms, in response to emotional stress. This case describes a 26-year old woman diagnosed as Hwabyung by HBDIS. She complained chiefly of binge eating and sleep disorder. She also complained of chest discomfort, abdominal discomfort, foreign body sensation in the throat, burning sensation and so on. We treated the patient with herbal medication, acupuncture, cupping, and moxa. After treatment, her condition improved. Standardized patients (SP) were used in teaching and practicing interviewing and physical examination skills for This report suggests that traditional Korean treatment such as herbal medication, acupuncture, cupping, moxa is effective for the treatment of Hwabyung patients.

• The Journal of Korean Obstetrics and Gynecology
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• v.34 no.2
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• pp.16-30
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• 2021

Objectives: The aim of this study was to establish a clear diagnostic definition of Sanhupung using the Delphi method. Methods: This study used the Delphi technique. A panel consisting of 21 experts of Korean medicine, particularly in of gynecologic medicine, participated in the Delphi examination that included answering the 4th round survey. The Delphi examination was carried out through evaluating and correcting the questionnaire by e-mail. Results: Through the Delphi survey, we have reached on an agreement regarding the basic concepts, time, cause, essential symptoms, and accessory symptoms of Sanhupung. They are as follows: 1) Sanhupung is a culture bound syndrome reflecting Korea's cultural specificity. 2) Sanhupung can be diagnosed even after the miscarriage. 3) For the diagnosis of Sanhupung, the main cause of symptoms should not be classified as other disease. 4) Sanhupung can be diagnosed based on essential symptoms and accessory symptoms. 5) Essential symptoms include local symptoms such as joint pain at specific areas, partial sensory impairment and general symptoms including pain of all the joints, whole body sensory impairment, increased sweating, feeling of wind coming into the body, worsened symptoms with the cold, intolerance to cold, and pain of all the muscles. Conclusions: The basic concepts and diagnostic definition of Sanhupung were suggested based on the Delphi survey among experts in the field. Further research is necessary to improve reliability and validity of diagnostic definition of Sanhupung in clinical trials.