• Journal of Korean Academy of Nursing
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• v.29 no.6
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• pp.1221-1232
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• 1999

The purpose of this study was to study how nurses interpreted the meaning of Hwa-Byung. It was carried through a review of literature, and the result is expected to explore ways that nursing intervention can promote the understanding of Hwa-Byung. The literature review focused on cultural psychology and psychiatrists' views toward Hwa-Byung. After that, it was reconfirmed concept of Hwa-Byung in nursing devived from historical analysis of the examples of Hwa-Byung from a true record of the Cho-Sun Dynasty(CD ROM, 1997). Characteristics of patients with Hwa-Byung include 'Hwa', an aspect of somatization, and self-diagnosing. It also could find that Hwa-Byung is characterized as 'Hwa', 'somatization' and 'self-diagnosis(subjectiveness)' according to a true record of the Cho-Sun Dynasty(CD ROM, 1997). The conceptual definition of 'Hwa', 'somatization' and 'self-diagnosing (subjectiveness)' are as follows. The core concept of Hwa-Byung, 'Hwa,' has the property of 'fire', and equals the feeling of injustice. Hwa-Byung means congestion of 'Hwa'. Therefore Hwa-Byung is the accumulation of being mistreated and mortified. The feeling of mistreatment comes from subjective experiences, which cannot be in harmony with the values, beliefs and rights of the patients. The situations that they have to endure again and again, though they are the sufferers, connote suppressed aggression and powerlessness endured over time. Suppressed aggression subordinated hostility, hatred and revengeful thoughts; powerlessness subordinates frustration, resignation, and fatalism. Somatization is another form of expressing 'Hwa' through physical symptoms. The somatization of clients with Hwa-Byung plays a role in expressing non-verbalized and suppressed emotions within themselves. The clients who experiences Hwa-Byung think that they know the cause of their illness and self-diagnose their problem as Hwa-Byung. Therefore, the feeling of unfairness which is the premise of Hwa-Byung infers 'subjectiveness' In conclusion, nursing's concept of Hwa-Byung is the accumulation of feelings of being mistreated and mortified. Hwa-Byung is the internalized 'Hwa' from enduring again and again. The feeling of being mistreated comes from subjective judgements about unfairness that cannot be harmonized with the clients' values, beliefs and rights. Those who can express their 'Hwa' only through their bodies imply suppressed aggression and powerlessness.

• Korean Journal of Biological Psychiatry
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• v.8 no.2
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• pp.220-225
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• 2001

As numbers of serotonin's function are so many, studies of serotonin are numerous nowadays. In the beginning, concentration of metabolites such as 5-HIAA was a key issue, but recent studies have been challenged for serotonin receptor genes and their relation to mood disoder. Serotonin transporter(5-HTT) gene is a strong candidate gene of mood disoder for following reason. Serotonin transporter is a key protein in the serotonin pathway as it regulate the concentration of serotonin in the synaptic clept and essential pathophysiology of depression is dysregulation of 5-HTT so that all antidepressants have effect of 5-HTT antagonist. The decrease of 5-HTT in the platelet and in brain of the depressive patients is much consistent results in the studies of the pathophysiology of mood disorder till now. By this, we will be able to develop simple and easy marker for diagnosis, type, and treatment monitoring of depression. Many psychiatrists have sought the independent genes in relation to depression or schizophrenia. Obviously, the hereditary vulnerability contributes to etiology of mood disorders, but it is difficult to discriminate the independent genes because of many environmental factors. Moreover, in the hereditarily complex diseases such as mood disorder, the only vulnerability of gene can not sufficiently explain the etiology. In the future, to exclude the role of the gene-environmental interaction, the methods such as gene transfer can be considered. In the opposite direction, by using the gene destruction method, the role of target genes can be examined. As yet the concept of the gene expression, neural plasticity, neurogenesis and etc, is the elementary stage. The development of this field will help to establish the treatment strategy of chronic and refractory mood disorders.

• Korean Journal of Biological Psychiatry
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• v.21 no.2
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• pp.49-56
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• 2014

Objectives Previous literature on the prescription change among patients with schizophrenia mainly focused on antipsychotics. This study investigated chronological change in the patterns of discharge medication among inpatients with schizophrenia at a psychiatric inpatient unit of a university-affiliated hospital. Methods All admission records at a psychiatric unit of Hanyang University Guri Hospital with discharge diagnosis of schizophrenia during two different five-year time frames (1996-2000 and 2006-2010) were reviewed including the demographic and clinical data and discharge medications. The data were gathered from a total of 207 patients (95 in 1990s and 112 in 2000s). Results The frequency in use of atypical antipsychotics (p < 0.01), antidepressants (p < 0.05), beta-blockers (p < 0.01), and benzodiazepine (p < 0.01) was significantly higher in 2000s. Anticholinergic drugs were less likely used in 2000s (p < 0.01). We did not find significant differences in the equivalent dose of antipsychotic drugs, the use of mood stabilizers and cholinergic drugs between two time frames. Conclusions Increased proportion of atypical antipsychotics and decreased use of anti-parkinsonian drugs are in line with literature. Our results show that more diverse classes of psychotic medications are used for schizophrenia in recent years. It is likely that psychiatrists are becoming more conscious of negative symptoms, anxiety, and depression in the pharmacotherapy of schizophrenia as well as positive symptoms of the illness.

• Korean Journal of Psychosomatic Medicine
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• v.15 no.2
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• pp.93-99
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• 2007

Object : This study aimed to investigate the characteristics of delirium in liver transplanted patients in a hospital in Korea. Method : We reviewed the medical records of 29 liver transplanted patients who were confirmed as delirium by psychiatrists with DSM-IV-TR diagnostic criteria. We estimated the correlation between delirium and clinical conditions of liver transplantations. Result : Post-operative delirium duration was significantly correlated with frequency of hepatic encephalopathy, pre-operative mental status, and stay of intensive care unit. Conclusion : Although there were many limitations of this study, it seemed that pre-operative hepatic encephalopathy affected post liver transplantation delirium.

• Korean Journal of Psychosomatic Medicine
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• v.21 no.2
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• pp.81-92
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• 2013

Newer antidepressants are commonly used in clinical practice to treat psychiatric disorder and psychosomatic disorder including chronic pain syndrome, fibromyalgia, headache. However there are many unexpected adverse effects of these drugs such as nausea and vomiting, weight gain, sexual dysfunction. These are 3 most well-recognized common adverse effects of newer antidepressant and are most common causes of treatment failure. I reviewed mechanisms, epidemiology, and pharmacological management of these adverse effects of newer antidepressants. In this paper, newer antidepressants include selective serotonin reuptake inhibitor(fluoxetine, fluvoxamine, citalopram, escitalopram, sertraline, paroxetine), serotonin norepinephrine reuptake inhibitor(venlafaxine, duloxetine), norepinephrine and dopamine reuptake inhibitor(bupropion), noradrenergic and specific serotonergic antidepressant(mirtazapine), and reversible inhibitor of MAO-A(moclobemide). I suggest that psychiatrists and clinicians in the psychosomatic field should know mechanisms, epidemiology, and management of these common and well-recognized adverse effects of newer antidepressants. Therefore it will be helpful to recognize easily and treat well for patients with psychiatric disorder and psychosomatic disorder using newer antidepressants.

• The Journal of Internal Korean Medicine
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• v.28 no.2
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• pp.363-376
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• 2007

Objectives : This study was undertaken to learn what should be considered in a good clinical trial investigating a herbal medicine as an antidepressant. Methods : Five well-designed clinical trials published from 2000 to 2006 investigating SJWE in depressive disorder were selected. The trials were reviewed and compared in terms of methodology such as trial design, patient selection, efficacy & safety evaluation, and so on. On the basis of this review of the trials and the regulations and guidelines of KFDA, we suggest some points to be considered for a good clinical trial of a herb for depression. Results : Although every trial had its own unique design, procedure, objectives and so on, all trials used randomizing and double blinding methods. If there is no ethical problem, a placebo-controlled design should be considered in a herbal antidepressant clinical trial for depression. Conclusions : Some points to be considered in an optimal & good clinical trial for an antidepressive herbal medicine were suggested as follows: 1) randomizing and double blinding manner is essential, 2) if there is no ethical problem, placebo control design should be considered, 3) the trial period should be 6 weeks, 4) out-patients will be recruited as subjects, 5) investigators will be well-trained psychiatrists or medical doctors, 6) the number of subjects should be calculated by statistical methods, 7) subjects should be diagnosed by DSM-IV criteria, 8) subjects who have current risk of committing suicide should be excluded, etc.

• Anxiety and mood
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• v.10 no.1
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• pp.17-23
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• 2014

Objective : Panic disorders are frequently accompanied by major depressive disorder (MDD). There is insufficient information about which clinical factors in panic disorder are associated with comorbid MDD. The aim of this study is to identify clinical factors related with comorbid MDD in patients with panic disorder. Methods : Two experienced psychiatrists diagnosed panic disorder based on DSM-IV criteria. This diagnosis in the 275 subjects was confirmed again by Mini-International Neuropsychiatric Interview (MINI). Lifetime comorbid psychiatric diagnoses were examined by MINI. The Hamilton Depression Scale (HAMD), Hamilton Anxiety Scale (HAMA) and Panic Disorder Severity Scale (PDSS) were used to assess the severity of depressive, anxiety and panic symptoms. Results : The result of MINI showed that 95 patients (34%) with panic disorder satisfied the diagnosis of MDD. Multivariate logistic regression model showed that comorbid generalized anxiety disorder (GAD) and the symptom of "fear of losing control or going crazy" were associated with MDD in patients with panic disorder. In female patients, the "chills or hot flushes" symptom was also associated with comorbid MDD. Conclusion : These results showed that coexisting GAD and certain symptoms of panic are associated with comorbid MDD.

• Sleep Medicine and Psychophysiology
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• v.8 no.2
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• pp.138-143
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• 2001

Sleepiness is associated with many different conditions and, as a neglected topic, it can be the cause of serious psychological and social disadvantages. In the aspect of learning, additional problems may arise from poor progress in school caused by the effect of sleepiness on concentration, memory, and other cognitive functions. Narcolepsy is by no means the most common cause of excessive sleepiness. Nonetheless, it is not a rarity, especially in young people. The non-specific nature of early features of narcolepsy, combined with very limited awareness that the condition can start in various ways, leads to many misinterpretations. Misinterpretation of narcolepsy symptoms is not confined to the medical profession. Teachers may well be critical of a student with narcolepsy because of their perception of narcolepsy symptoms as laziness, poor motivation, or difficult behavior and dull learning ability. Inappropriate reactions by parents, teachers, and peers, based on misinterpretation of narcolepsy symptoms or the patient's reactions to them, make a difficult situation worse. Especially in Korea, where schooling is focused on college entrance examinations, the problem is very serious and intensified by inappropriate or delayed diagnosis and treatment. Therefore, psychiatrists should be aware that narcolepsy in young adolescents is not rare and that they need to be familiar with its clinical features in both its classic and less obvious forms. Narcolepsy should be suspected if a adolescent's excessive sleepiness can not be explained in other ways. Therefore, we report on two patients who portray the tendency of dull learning ability and are mistaken as idle students. We diagnosed narcolepsy through polysomnography and multiple sleep latency testing. We treated the students with methylphenidate and pemolin. The students showed improvement in learning ability and were able to adapt better to school.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.14 no.1
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• pp.36-52
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• 2003

Attention deficit/hyperactivity disorder is one of the most comminly treated conditions in the child psychiatric units and results in substantial impairment in peer, family and academoc functioning. For 70% to 80% of children with a diagnosis of ADHD, stimulant tratment results in successful improvement of the core ADHD symptoms. However, children with ADHD have high level of comorbidity and may respond differently from children with ADHD without comorbidity. Therefore they may need specific treatment plan. We reviewed efficacy and safety of prescribed medication for treating children with ADHD, the relationship between ADHD and the comorbid conditions and treatment algorithm projects of ADHD with/without comorbid conditions performed Korean and American child psychiatrists. Our main objective is to increase the uniformity of treatment and improve the clinical outcomes of children with comorbid ADHD.

• Korean Journal of Health Education and Promotion
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• v.26 no.3
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• pp.97-110
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• 2009

Objectives: This study investigated Korean public's beliefs on helpfulness of various resources and preferred ways of addressing symptoms of mental health problems. Methods: A household survey was conducted on a stratified sample of adults aged between 18 and 74 (N=1,584). The participants were asked to provide their opinion on helpfulness of 39 resources for problems presented in the vignette, either depression(DEP) or schizophrenia(SPR). Descriptive statistics and factor analysis were conducted to summarize their opinion and to identify the underlying structure of beliefs about helpfulness of various resources. Results: Counselors/psychologists/social workers, family, psychiatrists, other therapists, and religious leaders were believed to be the most helpful. Methods that require one's initiatives marked percentages much higher than those of 'waiting to get better' or 'dealing with it alone'. The percentages for medications were lower than other methods in general, but higher than those of a western sample especially on antidepressants and anti-psychotics. Psycho/social approach was favored more for SPR than for DEP, and popular/cultural approach was favored much more for DEP than for SPR; physical/medical approach was strongly unfavored against DEP. Conclusion: Strategies need to be developed for utilizing various helpful resources to diversify modality of mental health services and facilitate referrals and gatekeeping. The differences in beliefs on helpfulness of various methods between DEP and SPR point to the need for problem-specific strategies.