• Korean Journal of Psychosomatic Medicine
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• v.8 no.1
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• pp.122-140
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• 2000

Somatization disorder is a chronic condition characterized by multiple somatic complaints that are not due to any apparent organic illness. Somatization disorder is related historically to hysteria and hysteria has been defined by the existence of somatic complaints for which no organic reason can be found. Therefore most theories of somatization have focused on the psychodynamic and sociological perspectives. However, the concept that the somatic presentation of emotional distress or psychiatric illness might have a neurobiological basis has also aroused considerable interest. Relative to this perspective, the case of Anna O. which has been considered the prototype of hysteria, was reformulated from a neuropsychological perspective. Several neurophysiological and neuropsychological studies, studies concerning hemispheric differences in symptom presentation of the patients with hysteria have been shown the evidences for the biological basis of somatization. Moreover, recent neuroimaging studies in somatization disorder also show that brain dysfunction in somatization. The author reviewed several candidate theories which could help to explain the process of somatization in the perspective of biological basis and proposed the new neuropsychological model of somatization. The author also examined the possible application of this model to the treatment of somatization disorder and discussed it's limitation and the future directions in this field.

• 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.

• Journal of Korean Academy of Nursing
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• v.33 no.2
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• pp.293-300
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• 2003

Purpose: The purpose of this study was to describe health problems and psychosocial adaptation in children with cancer and to determine the relationship between these two variables. Method: The data were collected from parents of 61 children with cancer, aged 4-11 years at one university hospital in Seoul. The instruments for this study were the Korea Child Behavior Check List (KCBCL) and a physical symptom checklist developed by the researchers. Result: The major health problems were coughing, sleeping disturbances, fatigue and weakness. The total behavior problem score for children in the cancer group was higher than the score for those in the norm group. The scores on the scales for withdrawal, somatic complaints, social immaturity, and internalizing problems were higher in the children with cancer compared to normative findings. Scores on social and school competence in the cancer group were lower than the norms for healthy children. The relationship between health problems and psychosocial adaptation was significant in the subscales of withdrawal, anxiety/depression, internalizing problems and social involvement in the off therapy group. Conclusions: This study shows the various areas that need further study in caring for children with cancer.

• Journal of Korean Academy of Nursing
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• v.33 no.3
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• pp.433-439
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• 2003

Purpose: The purpose of this study was to examine the relationship among subjective symptoms, depression, and stress coping behavior of university students. Method: The survey was carried out on a convenience sample of 298 university students. The questionnaire consisted of each scale for symptoms, depression, and stress coping behaviors. Data analysis procedure included the factor analysis for stress coping behaviors, and the correlation analysis describing a relationship among symptoms, depression, and stress coping behaviors. Result: There were significant correlations between depression and the three types of symptoms: general, psychological, and somatic symptom. Subjects using the negative-emotional-response coping and the self-control coping showed a more severe depression, and those using the problem-solvingㆍreappraisal coping and the positive-emotional-response coping showed a milder depression. Subjects using the negative-emotional-response coping complained of all 3 types of symptoms severely, and those using the positive-emotional-response coping complained of general symptoms mildly. Of five stress coping methods, the negative-emotional-response and the positive-emotional-response coping methods were related to both symptoms and depression significantly. Conclusion: This study suggests that the emotional-oriented coping method has more important role for university student’s depression and their subjective symptoms than the problem-oriented coping or social supports seeking coping. Further study needs to be conducted to help students effective coping mechanism for good mental health. Also it is necessary for university students to recognize that their symptoms are associated with depression.

• Journal of Oriental Neuropsychiatry
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• v.18 no.3
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• pp.193-207
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• 2007

Panic disorder is one of the anxiety disorder, characterized by panic attacks which are discrete episodes of fear accompanied by somatic symptoms such as shortness of breath, palpitations, chest pain, choking, dizziness, trembling and/or faintness. We experienced a 41 year-old male who complained of sudden enervation, unstable blood pressure and anxiety about self's symptoms. We bad given herbal medicines aoh cognitive & behavioral therapy. Results from studies to date suggest the cognitive behavioral therapy(CBTl are useful for depression, anxiety disorder, phobia. He understood his symptom's meaning and tried to overcome fear related to symptoms through exposure training. We concluded that cognitive behavioral therapy can be very effective methods to treat panic disorder, because patient with panic disorder has maladaptive automatic thoughts, based on dysfunctional beliefs like "I'm too weak, I have some problem."

• Journal of Oriental Neuropsychiatry
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• v.14 no.2
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• pp.155-167
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• 2003

Objective : The aims of this study were to show the clinical aspects and to investigate psychiatric traits by SCL-90-R in patients who visited Oriental Medicine Hospital Emergency Room. Method : We studied twenty patients who visited Daejeon University Oriental Medicine Hospital from May, 2003 to September, 2003. Results : 1. The ratio of male to female patients was 1:3 and age distribution was most frequent in 30s&40s. 2. The most frequent cause of illness was stress in occupation and overwork. The greater part of patients came to hospital in 12hours after an attack. 3. In chief problem, somatic symptoms such as headache, dizziness, numbness and chest discomfort were most frequent. In diagnosis, somatization disorder was most frequent. 4. After treatment, most of symptoms were improved. 5. Psychiatric traits by SCL-90-R correlated with somatization and anxiety.

• Korean Journal of Acupuncture
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• v.26 no.4
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• pp.67-75
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• 2009

Objectives : To identify whether and how Korean people understand 'qi deficiency' and related symptoms. Methods : We developed a questionnaire based on the experts' comments and modification asking understanding of 'qi deficiency' and symptoms or situations related with it. Total 128 workers at community healthcare centres across the country completed the questionnaire. They were asked if they know the meaning of the word 'qi deficiency' and to give at least three symptoms or situations that they conceive are related with 'qi deficiency'. The responses were collected and descriptive and frequency analyses were performed. Results : Approximately 79.7% of responders answered that they understand the meaning of the word 'qi deficiency' and of them, 71.6% reported that they experience 'qi deficiency' sometimes or more. Regarding somatic or condition-related responses in qi deficiency, lack of power or energy (26.6%), tiredness or fatigue (22.2%), dizziness (7.2%) or sweating (6.3%) were the most frequently reported symptoms. They related symptoms such as loss of appetite (4.3%) or easily catching colds (2.4%) with qi deficiency. Factors described in traditional pattern recognition of qi deficiency were not exactly matched with the responses from this survey. Conclusions : Korean people have rather a broad concept of qi deficiency covering a range of symptoms and this should be taken into account in developing a deficiency assessment tool.

• Journal of Oral Medicine and Pain
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• v.25 no.2
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• pp.223-228
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• 2000

The relationship between TMD and otologic symptoms such as tinnitus, vertigo and dizziness has been noted for many years. The existence of otologic symptoms in patients with TMD can be explained by the anatomic proximity and embryologic origin of the structures of the ear and the temporomandibular joint, however the pathogenesis of the symptoms is poorly understood. Serveral hypotheses have been proposed. : Eustachian tube hypothesis, the tensor tympani hypothesis, the otomandibular ligament hypothesis, excessive somatic concern hypothesis. Some investigators have reported that palpation of the deep masseter muscle, sternocleidomastoid muscle or clenching can intensify a patient's tinnitus and in that case, TMD therapy would improve their otologic symptoms. Although tinnitus and vertigo are common symptoms in the general population and also increase with increasing age, those are highly significantly associated with TMD compared with control group. This case report describes the possible mechanism and management of otologic symptoms in patient with TMD who has visited our clinic complaining asymmetric tinnitus and dull pain on her left masseter muscle.

• Journal of Electrodiagnosis and Neuromuscular Diseases
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• v.20 no.2
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• pp.124-129
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• 2018

Neuralgic amyotrophy (NA) is an idiopathic disease characterized by muscular atrophy accompanied by neuralgia, where acute pain in the limb, mostly including the shoulders, leads to muscle weakeness and atrophy in the limb days to weeks after the onset of pain. Although its exact pathogenesis is unknown, genetic and nongenetic factors, such as infection, surgery, and trauma are suspected contributors. We report this case as we diagnosed NA of the right lower limb via enhanced MRI as well as EMG and have followed up the patient's prognosis and radiologic changes for one and a half years. In addition, the patient had been diagnosed with neuropsychiatric disorders, such as major depressive disorder and somatic symptom disorder.

• 대한상한금궤의학회지
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• v.15 no.1
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• pp.53-84
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• 2023

Objective : The purpose of this study is to explore the therapeutic potential of Shanghanlun for neuropsychiatric disorders through a comparative review of five neuropsychiatric disorder cases diagnosed with Greater yin disease pattern/syndrome (太陰病). Methods : We collected and compared five neuropsychiatric cases diagnosed and treated with Greater yin disease pattern/syndrome (太陰病) from four korean medicine clinics. Clinical symptoms common to the five cases were analyzed by connecting them with Shanghanlun provision 273 and 279. Results : In all five cases, the improvement of chief complaints and decrease in general anxiety were observed after administration of Gyejigajakyak-tang (桂枝加芍薬湯) and Gyejigadaehwang-tang (圭支加大黃湯). In addition, neuropsychiatric symptoms and physical symptoms that are mentioned in Shanghanlun provision 273 and 279 were confirmed in all five cases. Conclusions : We not only reconfirmed that the core features of Greater yin disease pattern/syndrome(太陰病) proposed in previous studies; zi-tong (自痛), yin-er (因爾), jie-ying (結硬), but also that the physical symptoms associated with fu-man (腹満), tu (吐) and zi-li (自利) were common in the presenting symptoms and past histories of the five patients.