• 제목/요약/키워드: Pain PTSD

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외상후 스트레스장애 환자의 불안 및 우울 증상과 압통역치 간의 비교 연구 (Anxiety, Depression and Pressure Pain Threshold in Patients with Posttraumatic Stress Disorder)

  • 김은영;나철;남범우;조주연
    • 정신신체의학
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    • 제7권1호
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    • pp.51-60
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    • 1999
  • 본 연구에서는 불안과 우울감과 같은 정서상태가 만성적인 통증 인지와 상관관계가 있는지를 알아보고자 PTSD 환자군의 압통에 대한 역치와 불안증상, 우울증상의 정도를 측정하였고, 불안, 우울증상의 정도와 압통역치의 상관관계를 대조군과 비교하였다. 연구대상 환자군은 1997년 10월부터 1998년 3월까지 중앙대학교 의과대학 부속필동병원 및 용산병원 신경정신과에 입원한 환자와 외래환자들 중에서 PTSD에 진단된, 20-60세에 해당되는 성인 남자환자 23명을 대상으로 하였다. 결과는 다음과 같다. 1) PTSD 환자군에서 통계적으로 의미있게 높은 우울증상과 불안증상을 보였다(p<.05). 2) 압통에 대한 역치는 환자군에서 유의하게 높은 결과를 보였다(p<.05). 이런 결과를 보인 요인으로는, 환자군의 불안증상보다는 만성적인 우울증상이 통증역치의 증가에 부분적으로나마 영향을 주었을 것으로 추정되며 그외에 환자군에서의 opiate system의 이상, 환자군의 질병역할, 환자군이 처한 여러 사회환경적인 상황의 영향 등과 같은 여러 요인이 관련되었을 것이라고 생각한다. 결론적으로 PTSD의 만성 통증은 감정, 특히 우울증과 관련이 있을 것으로 보였으나, 그 인과관계에 대한 결론을 내리기에는 미흡한 점들이 있다. 앞서 언급한 여러 제한점들을 보완한 향후 연구를 통해 정서적 증상과 동통과의 보다 특이적인 연관성을 규명하는 연구가 필요할 것이라 생각한다.

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Severity of Musculoskeletal Pain and Its Effect on Psychosocial Factors in Veterans With Posttraumatic Stress Disorder

  • Kwon, Chun-suk;Kim, Suhn-yeop
    • 대한물리의학회지
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    • 제10권3호
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    • pp.29-37
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    • 2015
  • PURPOSE: The aim of this study is to investigate the relationship between psychosocial factors and the severity of musculoskeletal pain in veterans with posttraumatic stress disorder (PTSD). METHODS: A total of 60 subjects were recruited from among the veterans with musculoskeletal pain at D Veterans Hospital. PTSD was evaluated by using the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition; severity of pain was measured by using the short-form McGill Pain Questionnaire (SF-MPQ); depression and anxiety were measured by using the Symptom Checklist-90-Revision; and the quality of sleep was measured by using the Pittsburgh Sleep Quality Index. All data were analyzed using SPSS 18.0 software for Windows. RESULTS: The averages cores of pain intensity ($7.48{\pm}1.67$), SF-MPQ-sensory ($13.84{\pm}7.52$), SF-MPQ-affective ($4.41{\pm}3.79$), depression ($19.30{\pm}11.37$), anxiety ($13.39{\pm}7.99$), and quality of sleep ($10.05{\pm}5.89$) were obtained in veterans with PTSD. SF-MPQ-sensory measures sleep quality (r=0.346, p<0.01), SF-MPQ-affective measures depression (r=0.318, p<0.01) and anxiety (r=0.404, p<0.01), and these showed a statistically significant positive correlation in veterans with PTSD. Pain levels were observed to be higher in veterans with PTSD. Moreover, in these subjects, physical pain had a significant influence on the anxiety variable among the psychosocial factors. CONCLUSION: These findings suggest that musculoskeletal pain provides meaningful information about depression, anxiety, and sleep disorder in veterans with PTSD. Our data suggest that musculoskeletal pain may need to be addressed as part of the health management process of veterans.

Daily Functioning in Chronic Pain: Study of Structural Relations with Posttraumatic Stress Disorder Symptoms, Pain Intensity, and Pain Avoidance

  • Cho, Sung-Kun;Heiby, Elaine M.;McCracken, Lance M.;Moon, Dong-Eon;Lee, Jang-Han
    • The Korean Journal of Pain
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    • 제24권1호
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    • pp.13-21
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    • 2011
  • Background: This study aimed to evaluate processes from the mutual maintenance model in relation to daily functioning in patients with both chronic pain and a history of a traumatic experience. The mechanism illustrated the structural relations for daily functioning among pain intensity, hyperarousal, re-experiencing, trauma avoidance, and pain avoidance. Methods: Archival data (N = 214) was used for this study and data were analyzed for 142 chronic pain patients reporting a traumatic experience and seeking treatment at a tertiary pain clinic in Korea. Results: The results indicated that pain intensity, hyperarousal, and pain avoidance had significant direct effects on daily functioning. Also, pain intensity showed significant indirect effects on daily functioning through hyperarousal and pain avoidance; and hyperarousal through pain avoidance. Conclusions: Results suggest a direct contribution of high levels of pain, hyperarousal symptoms of PTSD, and pain avoidance behaviors to reduced daily functioning. Also, elevated pain as reminders of the trauma may trigger high levels of hyperarousal symptoms of PTSD. Subsequently, avoidant coping strategies may be used to minimize pain so that the trauma would not be re-experienced, thus inhibiting the activation of hyperarousal symptoms of PTSD. However, prolonged use of such strategies may contribute to decline in daily functioning.

외상후 스트레스 장애를 가진 만성요통 환자에게 도수치료가 외상후 스트레스와 수면 장애 및 통증에 미치는 영향-사례 연구 (A Case Study of the Effect of the Manual Therapy on Patient with Posttraumatic Stress Disorder, Sleep Disturbance and CLBP)

  • 유성훈;강용주;김태원
    • 대한정형도수물리치료학회지
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    • 제20권1호
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    • pp.47-52
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    • 2014
  • Background: This case study is to describe the manual therapy for the patient with posttraumatic stress (PTSD), sleep disturbance, and pain such as chronic low back pain (CLBP). Methods: The patient who participated in this study was a 60 year-old male PTSD patient with CLBP. His CLBP is not from any genetic or family history but a sequelae of torture that he had gone through about 30 years ago. Prior to the intervention, it was assessed that the PDS-K score was 16, PQSI-K was 12, SLR-90-R was low, VAS score was 10, and KODI socre was 25. The intervention was conducted through manual therapy (myofascial release, muscle energy technique, lumbar stabilization) twice a week for eight weeks in total. Results: After eight week-intervention, the PDS-K, SLR-90-R, VAS, and KODI score were improved whereas PQSI-K was not sufficiently fast improved. Conclusions: The manual therapy is substantially effective in dealing with PTSD and CLBP.

자살 및 관련 질환과 침치료 및 혈위지압에 대한 대중과 연구자의 관심도 분석: Google Trends와 주요 전자 데이터베이스를 이용하여 (Analysis of Public and Researcher Interests in Suicide and Related Illnesses, and Acupuncture and Acupressure: Utilizing Google Trends and Major Electronic Database)

  • 강성현;이정경;권찬영
    • 동의신경정신과학회지
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    • 제34권3호
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    • pp.235-245
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    • 2023
  • Objectives: The aim of this study was to analyze public and researcher interests in suicide and related illnesses and acupuncture and acupressure treatment using Google Trends and some electronic databases. Methods: Search results for keywords "suicide," "acupuncture," "acupressure," and several illnesses related to suicide were analyzed in Google Trends from January 2004 to June 2023. Illnesses included anxiety, depression (including major depressive disorder), schizophrenia, bipolar disorder, post- traumatic stress disorder (PTSD), eating disorder (including anorexia nervosa and bulimia nervosa), substance use disorder, autism spectrum disorder, personality disorder (including borderline person- ality disorder), and chronic pain. Search results were extracted using relative search volume (RSV) scores between 0 and 100. Search terms were also searched in online databases, including PubMed, CNKI, and OASIS, to estimate the number of related studies, and descriptive analysis was conducted. Results: Google Trends analysis showed a strong positive correlation between the RSVs of "suicide and depression," "acupuncture and chronic pain," and "acupressure and PTSD." The electronic database search results produced numerous studies published on "suicide and depression," "acupuncture and depression," and "acupressure and anxiety." High interest in "suicide and depression," "acupuncture and chronic pain," and "acupressure and anxiety" was seen among the public and researchers. Interest in "suicide and chronic pain," "acupuncture and eating disorder," and "acupressure and PTSD" was higher in the public than among researchers, while "anxiety and suicide" and "anxiety and acu- puncture" showed opposite trends. Conclusions: The results of this research enable an understanding of public and researcher interest in suicide, acupuncture, acupressure, and suicide-related illnesses. The results also provide a basis for fu- ture research and examining public health implications in Korean medicine.

담정격(膽正格) 병행치료와 일반한방치료가 교통사고 후 PTSD환자의 심리상태와 통증에 미치는 영향에 대한 비교 (Comparative Study of General Oriental Medical Treatment and Damjeonggyeok Acupuncture on Pain and Post-Traumatic Stress Disorder due to Trafiic Accident)

  • 이지은;천혜선;류충열;조명래;류미선
    • Journal of Acupuncture Research
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    • 제26권6호
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    • pp.151-159
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    • 2009
  • Objectives : The purpose of this study was designed to estimate the effect of Damjeonggyeok acupuncture on Post-Traumatic Stress Disorder patient due to a series of traffic accidents by using Symptoms Check List-90-Rivision(SCL-90-R). Methods : This report have been observed among 30 patients who admitted our department for whiplash injury associated disorders during 04-01-2009 to 09-31-2009. The PTSD patients was divided into 2 groups. One group was treated general oriental medical treatment(Group A) and the other group was treated Damjeonggyeok acupuncture with general oriental medical treatment(Group B). SCL-90-R and visual analogue scale(VAS) were checked before and after treatment for evaluating the improvement of whiplash injury associated disorders with PTSD. Results : 1. Both Group A and Group B showed good effect on decreasing of VAS and improving of psychological symptoms after traffic accident. 2. Group B symptoms about SCL-90-R Conclusions : Damjeonggyeok acupuncture with general oriental medical treatment can be recommended as a useful therapy to treat patients who have PTSD. Further study is needed to confirm the effectiveness of Damjeonggyeok acupuncture on whiplash injury associated disorders with PTSD.

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외상후 스트레스장애 치료에 대한 한의학 임상연구 동향 (A Review on Clinical Research Trends in the Treatment of Post Traumatic Stress Disorder (PTSD) in Korean Medicine)

  • 주성준;권정은;권찬영;이보람;김상호
    • 동의신경정신과학회지
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    • 제30권3호
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    • pp.251-263
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    • 2019
  • Objectives: The purpose of this study was to review the clinical research trends in the treatment of post traumatic stress disorder (PTSD) in Korean medicine (KM). Methods: We searched MEDLINE, CENTRAL, EMBASE, Google Scholar and five Korean databases through May 2019, for studies on KM to treat PTSD. Clinical research that conducted KM treatment of PTSD patients were included. Two researchers independently conducted study selection and data extraction process. Results: Totally, eight studies were included in this review. Types of traumatic events that patients experienced included physical violence/threatening, traffic accidents, sexual violence and personal tragic events. KM interventions performed included acupuncture, moxibustion, herbal medicine, physical therapy, and KM-based psychotherapy. Treatment duration varied from two days to more than five months. Follow-up began at least one week to three months after the end of treatments. It was reported that the major psychological and/or somatic symptoms of PTSD, such as anxiety, depression, insomnia, and musculoskeletal pain, subjectively improved, as well as other objective outcomes: Impact Event Scale-Revised Korean version (IES-R-K), Beck's Depression Inventory (BDI), State-Trait Anxiety Inventory, Hwabyung Symptoms/characters, Electroencephalography (EEG) change, etc. Statistical studies were conducted in three studies only. Outcomes such as Visual Analogue Scale (VAS), BDI, and IES-R-K showed statistically significant improvement after KM treatments. There was no study reporting adverse events during or after the interventions. Conclusions: According to this review, diverse types of KM treatments have been used among PTSD patients in eight studies. The KM treatments effectively improved psychological and somatic symptoms of PTSD patients. However, the lack of high quality research as well as the lack of standardization of KM treatments for PTSD are limitations. Further methodologically robust clinical trials should be performed, and the standardization of KM treatments for PTSD should be sought.

외상 후 스트레스 장애에 대한 한방정신요법 기반 심리치료 개발 및 예비적 임상시험 (Development of Korean Medical Psychotherapy and Preliminary Clinical Trial for Post Traumatic Stress Disorder)

  • 김진형;서주희;이고은;김남권;최성열;유영수;강형원
    • 동의신경정신과학회지
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    • 제26권1호
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    • pp.49-61
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    • 2015
  • Post traumatic stress disorder (PTSD) is an anxiety disorder that usually occurs after suffering from a psychological trauma that can not threatening events, which is one of the individual's subjective pain and their families and the larger society due to the chronic disease burden results. Treatment with a medication, as well as cognitive behavioral therapy (CBT), exposure therapy, prolonged exposure therapy (PE), eye-movement desensitizing, and reprocessing (EMDR) are preferentially performed, including psychotherapy. Korean medical psychotherapy consists of a wide range of manual therapy, but it does not have systematically screening limits. This study was developed by Korean medical psychotherapy program for PTSD, and it was carried out as a preliminary clinical trial for validity. The Korean medical psychotherapy program for PTSD consists of four stages as follows: building chapter of safety, flow and send, accept, and integration. Based on this preliminary clinical study of PTSD, seven patients were treated for 2 hours per week for 5 weeks. We report the meaningful results gained by observing the changes in IES-RK points, questionnaire on five-faceted mindfulness, quality of life, anxiety, depression, insomnia, hwabyung scale, HRV, and EEG, before and after the Korean medical psychotherapy program.

경부운동훈련이 외상 후 스트레스 장애 환자의 경부통증 수준, 우울 요인에 미치는 영향 (The Impact of The Cervical Exercise Training on Post-traumatic Stress Disorder Patient's Cervical Pain Levels and Depression Factor)

  • 박성두;신영일;김명준
    • 대한정형도수물리치료학회지
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    • 제21권1호
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    • pp.37-42
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    • 2015
  • Background: This study investigates the impact of the cervical musculoskeletal intervention on post-traumatic stress disorder patient's cervical pain levels and depression factor. Methods: Thrty neck pain patients diagnosed with post-traumatic stress disorder were enrolled. Neck exercise training using a sling system was applied to the experimental group and self-neck movement exercise, modification of the McKenzie exercise, was applied to the control group. Both groups were checked every week whether they performed or not. Both groups performed their exercise for 35 minutes for a time and 3 times per week. Total period of the intervention was 6 weeks. To compare the effects of interventions, threshold of cervical tenderness and depression level were measured before and after the each intervention and also measured at follow-up. Results: Painthreshold of left trapezius showed a significant difference between two groups at three points. It increased 19.71% in the experimental group after the intervention compared to before the intervention. At follow-up it also increased 20.06% in the experimental group. Pain threshold of right trapezius showed a significant difference at three points. It increased 18.35% in the experimental group after the intervention compared to before the intervention. At follow-up it also increased 15.93% in the experimental group. According to the result interaction between groups and measurement time in both side of trapezius was valid. Depression level showed significant difference in the experimental group between three points. It decreased 18.07% after the intervention compared to before the intervention and decreased 15.21% at follow-up. According to the result interaction between groups and measurement time in depression level was valid. Conclusions: This study has important implications as the therapeutic strategy, high potent of improving symptoms, shows effect to a subject who has psychological problem such as posttraumatic stress disorder (PTSD).

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신체화를 동반한 외상후 스트레스 장애 환자의 근막이완술 적용이 신체화, 우울증 및 통증에 미치는 영향 : 사례 연구 (The Effects the Application of MyoFascial Release of Depression, Anxiety, Sleep Disturbance, and Headache in Post Traumatic Stress Disorder Patients with Somatization: Case Study)

  • 유성훈;박재명;홍현표
    • 대한정형도수물리치료학회지
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    • 제23권2호
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    • pp.75-81
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    • 2017
  • Background: The purpose of this study is to examine the effects of myofascial release technique (MFR) on psychological and physical symptom in somatization with post traumatic stress disorder (PTSD). Based on this, proceed to present an effective physical treatments. Methods: In this study, three subjects were applied ABA design for a total of 12 weeks. Intervention was performed three times per week, and only MFR for 6 weeks was applied to the patient for 60 minutes. General physical therapy consisted of a total of 60 minutes including hot pack, electric therapy, and ultrasound. In this study, we measured three times in the second baseline stage at the initial evaluation before the commencement of intervention, somatization, depression, anxiety, sleep disorder, and pain after 6 weeks and 12 weeks. Results: In this study, the application of MFR showed significant differences in somatization symptoms, sleep disturbance, and headache. There was no significant difference in depression and anxiety. Conclusions: As a result, the application of MFR in PTSD patients with somatization can be suggested as a useful intervention to resolve the psychosomatic problem.

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