• Journal of Oriental Neuropsychiatry
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• v.32 no.1
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• pp.67-79
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• 2021

Objectives: The purpose of this study was to report the effect of Korean medicine treatment on a patient with somatic symptom disorder hospitalized after a traffic accident. Methods: The subject for this study was a patient diagnosed with somatic symptom disorder that worsened after a traffic accident. During hospitalization, herbal medicine, acupuncture, psychotherapy, and other treatments were performed. Clinical effect was evaluated using Heart Rate Variability (HRV), BDI (Beck Depression Inventory)-II, BAI (Beck Anxiety Inventory), Global assessment (G/A), and Numerical rating scale (NRS). Results: After 36 days of treatment, BDI-II score was reduced from 17 to 5. BAI score was reduced from 23 to 8. Overall somatic symptoms and pain showed decreases. Conclusions: Korean medicine treatment might be effective for somatic symptom disorder that is worsened after a traffic accident.

• The Journal of Pediatrics of Korean Medicine
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• v.34 no.3
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• pp.55-66
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• 2020

Objectives The goal for this study is to find out the recent trends of the Korean medicine treatment on children and adolescents' somatic symptom and related disorder by reviewing case studies. Methods We found case study reports relevant to 'Korean medicine treatment on somatic symptom and related disorder' through Oriental Medicine Advanced Searching Integrated System (OASIS), National Discovery for Science Leader (NDSL) and Research Information Sharing Service (RISS). The age of the patients was limited to under 20. Results All reported articles showed that the treatments were selected based on both emotional problems and physical symptoms. Herbal medicine was the most commonly used method, and the other methods including acupuncture and psychotherapy were also used. Conclusions This study shows that the common Korean medicine treatment can be widely used for children and adolescents' somatic symptom and related disorder. Further research is needed to evaluate the effectiveness of the treatments, and to develop guidelines for the treatment.

• Korean Journal of Biological Psychiatry
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• v.14 no.4
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• pp.256-261
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• 2007

Objectives : The aim of the present study was to examine whether anxiety and depression of children and mothers were associated with the children's medically unexplained somatic symptoms in attention-deficit/hyperactivity disorder(ADHD). Methods : 83 clinic-referred boys with ADHD and 52 boys without ADHD were included in this study. The frequency of the medically unexplained somatic symptoms, such as general-ache, headache, nausea, eye problems, skin problems, abdominal pain, vomiting was evaluated using the somatic symptom domain of the Child Behavior Checklist(CBCL). Children's anxiety and depression were evaluated using Kovacs Children's Depression Inventory(CDI) and Spielberger's State-Trait Anxiety Inventory(STAI) for children. Maternal anxiety and depression were measured by Spielberger's State-Trait Anxiety Inventory(STAI) and Beck's Depression Inventory(BDI). Stepwise linear regression analysis was used to examine the hypothesis. Results : Score of maternal state anxiety affects the T score of the somatic symptom domain in CBCL significantly(adjusted $R^2$=0.057 ; p=0.026). Conclusion : The frequency of medically unexplained somatic symptom of children perceived by mothers was associated with the high level of maternal state anxiety in ADHD. Frequent maternal report of the children's somatic symptom may be a warrant for the evaluation and management of the maternal state anxiety in ADHD.

• Anxiety and mood
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• v.7 no.1
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• pp.9-15
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• 2011

Objectives : We examined the reliability and validity of the Korean version of the Depression and Somatic Symptom Scale (DSSS) in Korean patients with depressive symptoms. Methods : Participants were 55 outpatients diagnosed with major depressive disorder, a depressive episode of bipolar I disorder, somatoform disorder, panic disorder, generalized anxiety disorder, or post-traumatic stress disorder according to the DSM-IV criteria. We assessed them using the Korean versions of the DSSS, Hamilton Depression Rating Scale (HDRS), and Quick Inventory of Depressive Symptomatology Self Report (QIDS-SR). Results : The Korean version DSSS had a Cronbach's alpha of 0.90. Moreover, each item's correlation with the total score was statistically significant (r=0.24-0.71, p<0.01). The test-retest correlation coefficient (r=0.83, p<0.01) was relatively high, and the DSSS correlations with the HDRS and QIDS-SR were 0.77 and 0.74, respectively. Conclusion : These results demonstrate that the Korean version of the DSSS could be a reliable and valid tool for screening and assessing depressive patients. The Korean version of the DSSS will be a useful tool for screening both depressive and somatic symptoms in Korea.

• Korean Journal of Psychosomatic Medicine
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• v.28 no.1
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• pp.89-97
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• 2020

Objectives : We investigated heart rate variability (HRV) patterns in patients with somatic symptom disorder (SSD) and the relationships of these patterns with alexithymia. Methods : In total, 42 patients with SSD and 33 healthy controls were enrolled in this study. Demographic, psychological, and HRV data were assessed at baseline, and 24 patients with SSD were reassessed after 6 months of treatment. The psychological data included somatic symptoms and levels of depression, anxiety, and alexithymia as indicated by the somatic symptom subscale of the Symptom Checklist 90-Revision (SCL-12), Beck Depression Inventory-II (BDI-II), Beck Anxiety Inventory (BAI), and the Toronto Alexithymia Scale 20 (TAS-20), respectively. Results : Patients with SSD had a lower standard deviation of normal-to-normal R-R intervals (SDNN) and lower proportions of adjacent R-R intervals greater than 50 milliseconds (pNN50) compared with controls. These HRV parameters were negatively correlated with alexithymia severity. After treatment, patients exhibited significantly decreased levels of somatic symptoms and reduced anxiety and depression, but there were no significant differences in the HRV parameters. In patients with alexithymia, a high baseline SDNN and pNN50 were associated with a decrease in somatic symptoms. Conclusions : Patients with SSD have different HRV patterns, and several HRV parameters are associated with alexithymia severity. These findings suggest that ANS regulation is involved in the pathophysiology of SSD, mediated by alexithymia. Furthermore, these results suggest that certain HRV parameters may be associated with clinical outcomes of SSD.

• Korean Journal of Psychosomatic Medicine
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• v.8 no.2
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• pp.172-180
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• 2000

Objectives : We investigated the characteristics of perceived stress response and relationship between some variables of gastrointestinal symptoms(esp., dyspepsia) and subscales of perceived stress response inventory(PSRI) in patients with upper gastointestinal disorder when they perceived stress. Methods : 84 patients with upper gastrointestinal disorder(gastritis, gastric ulcer, duodenal ulcer etc.) and 94 normal controls completed the PSRI developed by Korean psychiatrists. The patient group performed the questionnaire including some variables of gastrointestinal symptoms. Results : Internal consistency was statistically significant in all subscales of PSRI. The patient group was significantly higher at total score of PSRI, general somatic symptom subscale score, specific somatic symptom score than control group. As the result of stepwise regression analysis for relationship between some variables of gastrointestinal symptoms ans subscales of PSRI, specific somatic symptom subsclae closely related with illness duration, past illness history and severity of symptom, and the lowered cognitive function & general negative thinking subscale related with the existence of emotional distress. Conclusion : Patients with upper gastrointestinal disorder showed stronger perceived stress response than control group and they experiences somatic symptoms related to autonomic nervous system and/or gastrointestinal symtoms rather than emotional, cognitive, behavioral symtoms when they perceived stress. They also responded to stress as they expeirenced specific somatic symtom when they had long illness duration, past illness history, and high severity of symptom and the existence of emotional distress could develop lowered congnitive function and general negative thinking.

• Korean Journal of Psychosomatic Medicine
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• v.29 no.2
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• pp.95-101
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• 2021

Patients complaining with somatic symptoms are very common in clinical practice, and are often consulted to medical department. But it is difficult to treat well. The treatment of somatic symptom disorder is multi-modal as none of the methods on their own provide a satisfactory outcome. The treatment of somatic symptoms disorders is complicated by lack of boundary, conceptual clarity, and overemphasis on psychosocial causation and effectiveness of psychological treatments. In clinical practice all classes of psychotropics are used to treat somatic symptoms disorder. Drugs such as tricyclic antidepressants, serotonin reuptake inibitors(SSRI), serotonin and noradrenalin reuptake inhibitors (SNRI), atypical antipsychotics are studied. The evidence indicates that these drugs are effective in somatic symptom disorders. All classes of antidepressants seem to be effective against somatic symptom disorders. SSRIs are more effective against hypochondriasis and body dysmorphic disorder, and SNRIs appear to be more effective than other antidepressants when pain is predominant. The author suggest that psychiatrists should know how to treat patients complaining with somatic symptoms by using not only psychotherapeutic approach but also pharmacological treatment. It will be helpful to reduce suffering and increase quality of life of these patients.

• Anxiety and mood
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• v.13 no.2
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• pp.100-107
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• 2017

Objective : The purpose of this study was to investigate strategies used to cope with stress and the cognitive characteristics of somatic symptom perception in patients with generalized anxiety disorder(GAD). Methods : A total of 55 patients meeting DSM-5 criteria for GAD and 55 normal controls were recruited for participation in this study. We evaluated subjects using The Way of Stress Coping Questionnaire (SCQ), Somato-Sensory Amplification Scale (SSAS), Symptom Interpretation Questionnaire (SIQ), and the Generalized Anxiety Disorder for 7 Item (GAD-7). We analyzed data using an independent t-test and Pearson's correlation analysis. Results : In terms of SCQ, GAD patients presented significantly lower scores on seeking social support and higher scores on wishful thinking than normal controls. GAD patients had significantly greater amplification of physical sensation in SSAS and higher scores in physical, psychological interpretation subsets of SIQ than normal controls. GAD-7 scores were positively correlated with physical interpretation scores on SIQ. Conclusion : Results reveal that patients with GAD have insufficient coping strategies for stress, greater amplification of body sensations, and tendency towards a physical, psychological interpretation of somatic symptoms.

• Korean Journal of Biological Psychiatry
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• v.16 no.1
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• pp.46-52
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• 2009

Objectives : The goal of this study was to compare the clinical characteristics of panic disorder respiratory subtype(PD-R) and non-respiratory subtype(PD-NR). Methods : 84 patients with panic disorder were enrolled and divided into 2 groups, 29 PD-R and 55 PD-NR. Diagnosis of panic disorder was evaluated using Diagnostic and Statistical Manual of Mental Disorders $4^{th}$ edition and Mini International Neuropsychiatric Interview. They were also measured with Hamilton Rating Scale for Anxiety(HAM-A), Hamilton Rating Scale for Depression(HAM-D), and Panic Disorder Severity Scale (PDSS). Results : PD-R group showed significantly higher scores in PDSS than those of PD-NR group(p=.027). After controlling for the severity of panic disorder and gender, PD-R group showed higher HAM-D and somatic anxiety subscale of HAM-A than those of PD-NR group. Furthermore, results of logistic regression analysis suggested that the somatic anxiety was a possible risk factor of PD-R(OR=1.404,p=0.009). Conclusion : These results suggest that somatic anxiety and depressive symptom would be important clinical characteristics of PD-R.

• Korean Journal of Psychosomatic Medicine
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• v.24 no.2
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• pp.174-183
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• 2016

Objectives : The aim of this study is to evaluate difference of somatic symptoms of anxiety disorder and major depressive disorder and domainal association with suicidal idealization, plan, and attempts. Methods : A total of 359 adults diagnosed with major depressive disorder and anxiety disorder of last one year participated. Participants interviewed with certain sections of Korean version of Composite International Diagnostic interview of CIDI. Sections of interests includes questionnaires regarding somatic symptoms and suicidal idea, plan and attempts of last one year. Results : Chest pain shows more prevalence in major depressive disorder. Symptoms of Headache and loose stool are more prevalent in anxiety disorder. Difficulty in equilibrium and fainting spells are more common somatic complaints of co-diagnosis states of anxiety disorder and major depressive disorder. Comparing 3 domains of pain symptoms, gastrointestinal symptoms and pseudo-neurological symptoms, pain symptom domains, gastrointestinal symptoms domain shows significant statistic difference between diagnosis. Average somatic symptom numbers of each symptom domains increase through suicidal idealization, plan and attempt, accordingly. Conclusions : Our finding shows some of somatic symptoms are more prevalent at certain diagnosis. Since increasing numbers of somatic complaints of each symptom domains goes with the suicidal idealization to suicidal attempts, proper psychiatric evaluation and consultations are crucial for patients with numerous somatic complaints in non-psychiatric clinical settings.