• Journal of Oriental Neuropsychiatry
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• v.24 no.spc1
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• pp.23-36
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• 2013

Objectives : The purpose of this guideline is to show the evidence-based guidelines of diagnosis and evaluation of Hwabyung by the synthesis and organization of existing research contents. Methods : We investigated the existing research on the concept of Hwabyung. Further, we investigated the diagnostic tools, self-diagnostic method, symptoms assessment tools, oriental medical diagnostic methods, treatment evaluation tools and other testing methods of Hwabyung. Results : There was a Hwabyung diagnostic interview schedule (HIBDS) in the standardized measure for the diagnosis of Hwabyung. In the symptoms assessment tools of Hwabyung, there was a self-report measurement tool of Hwabyung and measurement tool of Hwabyung to be evaluated by the interviewer. In the oriental medical diagnostic method, there was an instrument of pattern identification for Hwabyung. In the treatment assessment tool, there was an instrument of oriental medical evaluation for Hwabyung. In addition, MMPI, SCL-90R, Zung's self-rating anxiety scale (SAS), Zung's self-rating depression scale (SDS), State-Trait Anger Expression Inventory (STAXI) and etc. can be used for the diagnosis and assessment of Hwabyung. Conclusions : We expect 'Clinical Guidelines for the Treatment of Hwabyung' to be useful for the diagnosis and assessment of Hwabyung.

• Journal of Oriental Neuropsychiatry
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• v.24 no.spc1
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• pp.15-22
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• 2013

Objectives : The Hwabyung Research Center of The Korean Society Of Oriental Neuropsychiatry attempted to produce clinical guidelines for doctors of Korean medicine for the treatment of Hwabyung. Methods : A standard guideline development process was followed. Relevant literature was identified by a review of bibliographies. The operational criteria were used to rate the quality of scientific evidence, and the line of treatment recommendations included a consensus clinical opinion. This section of "the status of Hwabyung in Korea" is 2 out of 5 articles drafted and reviewed by clinicians. Results : Hwabyung is changed depending on the time and have a risk of relapse. Like the previous studies, Female and lower socio-economic and educational level people suffers Hwabyung frequently. But recently number of Male Hwabyung patients increases. Recovery of Hwabyung is involved in depression, anxiety, stress. Hwabyung is related to Major depressive disorder, generalized anxiety disorder, somatoform disorder and diseases of the digestive system. Conclusions : This study was observed for the progression of Hwabyung. Hwabyung is a long-term disease associated with depression, anxiety and stress. Hwabyung is accompanied by physical and psychological symptoms and degrades the quality of life.

• The Journal of Internal Korean Medicine
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• v.19 no.2
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• pp.81-87
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• 1998

BACKGROUND : Hwabyung is a culturally-related syndrome of Korea diagnostically confounded with somatization, depressive and generalized anxiety disorders, representing typical clinical manifestations of wide range in their severity. METHODS : This clinical study was carried out on 200 inward stroke patients who had stable vital signs and had stayed at least for 10 days after admission. The patients were devided into two groups, hwabyung and non hwabyung group after an interview with an oriental neuropychiatrist. Than we compared the two groups with general characteristics, past history, stroke type, clinical manifestations and serum lipid levels. Also we investigated recent stressors in hwabyung group. RESULTS : The results showed that the incidence of hwabyung was about 28.5% in stroke patients. The greater number of subjects with hwabyung were women in lower educational level. Aphagia were observed more frequently in hwabyung group and verbal disturbance in non-hwabyung group. The most recent stressor of male in hwabyung group was finantial difficulties due to dishonor, unemployment, cheated and so on. As to female, the conflicts with husband or his family were the most recent stressor. As a whole, finantial difficulties were highly ranked as a recent stress in hwabyung group.

• Journal of Oriental Neuropsychiatry
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• v.24 no.spc1
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• pp.47-54
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• 2013

Objectives : The Hwabyung Research Center of The Korean Society Of Oriental Neuropsychiatry has attempted to develop the 'Clinical Guidelines for Hwabyung'. Methods : The Hwabyung Research Center constructed a committee of experts and advisory group. Relevant literature was collected and evaluated in order to discover effective oriental psychotherapy as well as the management of Hwabyung. Results : We found some evidences that proved the effectiveness of oriental psychotherapy in the treatment of Hwabyung. The principles of management were also reviewed. Conclusions : Psychotherapy and management for Hwabyung were studies. We hope that the 'Clinical Guidelines for the Treatment of Hwabyung' is helpful for both oriental medical doctors and patients.

• Journal of Oriental Neuropsychiatry
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• v.26 no.4
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• pp.365-382
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• 2015

Objectives: Interpersonal stress is a major cause and aggravating factor of Hwabyung. The purpose of this study was to compare communication type and stress coping style between the Hwabyung patients group and non-Hwabyung patients group. Methods: The total number of study participants was 101. Based on the Hwabyung symptom scale, the study participants were divided into Hwabyung patients group (30 patients) and non-Hwabyung patients group (43 patients; control group), and the others were excluded from the study . All included patients were administered the Virginia Satir’s communication type questionnaire and stress coping scale based on Folkman & Lazarus’s theory. The independent t-test was used to determine the statistical significance between the features of communication types and stress coping styles in each group. In addition, Spearman correlation analysis was used to identify the relationship between communication types and stress coping styles. Results and Conclusions: 1. Communication types differed significantly between the Hwabyung patients group and non-Hwabyung patients group. 2. Hwabyung patients scored significantly higher in each dysfunctional communication type than functional communication type. Scores of placating stance and super-reasonable stance, which were subtypes of dysfunctional communication type, were high in the Hwabyung patients group. The non-Hwabyung patients group scored the highest in Congruent stance, classified as functional communication type. 3. Stress coping style was not significantly different between the two groups.

• 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.

• Research in Community and Public Health Nursing
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• v.12 no.3
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• pp.705-715
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• 2001

This study examined 19 papers published from 1977 to 2000 based on the objective frame evaluation. This purpose of this study was to examine the trend of Hwabyung research and to serve as a guide for the future 'Hwabyung' study. The results of studies were as follow. In the design of research, clinical studies are definitely dominant. As for the fields of research, the concept of Hwabyung was studied more frequently than the others. As for the authorship. psychiatrists prevailed but nursing professionals are on the increase. Research subject in clinical and survey study, patient was definitely dominant and the place of study was almost always a hospital (75%), data collection was higher on interview (58.3%). Hwabyung was considered unique culture bounded syndrome related to Korean culture. Frequent etiologic factor of Hwabyung were a husband's extra-marital affair, conflicts between houses wives and mothers-in-laws, and financial loss and suffering. From the incidence of Hwabyung, a greater number of patients with Hwabyung were middle aged women in the low economic and educational classes, and these were connected with the culture and the family system. The symptoms of Hwabyung included psychological and physical symptom, neurological disorder and disease behavior. Defense mechanisms and coping strategies for Hwabyung were somatization, suppression, orality, withdrawal, isolation, regression, help-seeking, complaining, and wreaking anger. Treatment of Hwabyung were medication, effort by herself, communication with families, consultation with psychologist, acupuncture, negative therapy, moxa, and Qi-kong. Psychiatric therapy, behavior therapy, nursing intervention on multi-interdisciplinary approach and psychiatric nursing approach were recommended for the nursing care of a Hwabyung patient.

• Journal of Oriental Neuropsychiatry
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• v.24 no.spc1
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• pp.37-46
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• 2013

Objectives : The Hwabyung Research Center of The Korean Society Of Oriental Neuropsychiatry has attempted to develop the 'Clinical Guidelines for Hwabyung'. Methods : The Hwabyung Research Center constructed a committee of experts and advisory group. Relevant literature was collected and evaluated in order to find out effective Pharmacotherapy (Herbal medicine), acupuncture and moxibustion, and cupping of Hwabyung. Results : We found some evidences that proved the effectiveness of Pharmacotherapy (Herbal medicine), acupuncture and moxibustion, and cupping in the treatment of Hwabyung. 1) We recommend Pharmacotherapy (Herbal medicine), acupuncture and moxibustion, cupping, psychotherapy and management, other therapeutic approaches and education for Hwabyung. 2) Pharmacotherapy (Herbal medicine) should be determined according to the pattern identification of Korean medicine. Further, the prescription should be cost-effective, safe and have no side effects. Also, the interaction between Herbal and Western drugs should be considered carefully. 3) There are general acupuncture, scalp acupuncture, Pharmacopuncture, Sa-am acupuncture as well as acupuncture treatments for Hwabyung. 4) Moxibustion and cupping are useful, relieving various somatic symptoms of Hwabyung. Conclusions : Pharmacotherapy (Herbal medicine), Acupuncture and Moxibustion, Cupping for Hwabyung were studied. We hope that the 'Clinical Guidelines for the Treatment of Hwabyung' are helpful for oriental medical doctors and patients.

• Journal of Oriental Neuropsychiatry
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• v.8 no.1
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• pp.141-150
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• 1997

A clinic study was carried out on 83 neuropsychiatric outpatients who visited 'Hwabyung Clinic' in Oriental Hospital of Kyung Hee University from July 1 in 1996, in order to study clinical research and the aspect of 'Hwa'. 1. Onset of stress that causes of Hwabyung was 14.23 years ago and onset of symptoms were 6.39 years ago. Hwabyung patients were maintaining their marital state and were under the same stress that was thought to be the chief causes of the Hwabyung..3. Familiar troubles including their spouse were the main cause of the Hwabyung, which suggested that prolonged trobles were more important rather than sudden emotional shock, and it was obvious that the patients were recognizing the predisposing factors of Hwabyung.5. The emotional state which led to Hwabyung and the present state caused by Heabyung were complicated very much. Feeling being mortified, anger and resentment were gradually changed into anxiety, irritability, depression and loss of interest.6. The somatic symptoms of Hwabyung were flushing, insomnia, hradache, dizziness, and oppressed.7. The feeling of flushing were whole body, front of the body and upper of the body.

• Journal of Oriental Neuropsychiatry
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• v.30 no.3
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• pp.129-140
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• 2019

Objectives: The purpose of this paper is to report the results of applying philosophical counseling to Hwabyung. Methods: At the time of the medical examination, 15 minutes or more of philosophical counselling method based on self-identity was conducted if possible. Additionally, We applied Hwabyung treatment guidelines (acupuncture, herbal medicine, etc.) to the patient If diagnosed as necessary. We evaluated visual Analogue Scale (VAS), Hwabyung scale, and Symptom Checklist 90-Revision (SCL 90-R) at baseline, and reassessed VAS and Hwabyung scale after about two weeks of treatments. Results: After about two weeks of treatment and philosophical counselling, VAS was between 10 to 1-2 and Hwabyung scale from 59 to 48. Also, the problem of fragmentation in the patient's life process was insighted, and the viewpoint was changed. Conclusions: It is useful to combine Korean traditional medical treatment with philosophical counselling method based on self identity for patients suffering from the Hwabyung. To Hwabyung patient, the view of philosophical counselling of feminism which understands women in political and cultural contexts is helpful.