• Title/Summary/Keyword: psychosomatic

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Psychobiological Approach for Post-Traumatic Stress Disorder (외상후 스트레스 장애의 정신생물학적 접근)

  • Park, Ki-Chang
    • Korean Journal of Psychosomatic Medicine
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    • v.4 no.1
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    • pp.124-137
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    • 1996
  • As the society becomes more industrialized and modernized, we have more chances to experience a serious traumatic event. Post-traumatic stress disorder (PTSD) has 3 major categories of symptoms such as memory disturbance, hyperarousal and avoidance or numbness. I reviewed the psychobiological evidences in 3 main categories of symptoms and the biological treatment after a brief review of the epidemiology, psychosocial etiology and diagnosis of PTSD. The memory disturbance of PTSD might be developed by the potentiation of the memory pathway mediated by norepinephrine. PTSD induces HPA axis abnormality, it might also develop hippocampal dysfunction, which might contribute to the memory disturbance. The kindling effect develops desensitization, which might develop reexperiencing of the traumatic events and hyperarousal state. Chronic aroused state of locus ceruleus with resultant chronic maladaptive state of norepinephrine system, might develop hyperarousal state. Social avoidance and physical numbing state in PTSD might be caused by serotnin or opiate system. Stress induced analgesia might be developed by opiate reliesed against the acute stress. The biologic research results would help the selective treatment of PTSD.

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MMPI of Out-Patients with Irritable Bowel Syndrome (과민성 대장증후군 내원환자의 MMPI 군집분석)

  • Park, Keon-Young;Cho, Sun-Mi;Chung, Young-Ki
    • Korean Journal of Psychosomatic Medicine
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    • v.4 no.1
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    • pp.54-63
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    • 1996
  • In this cluster analysis of out-patients with irritable bowel syndrome (IBS) we described the psychological features and personality patterns of these patients. The Minnesota Multiphasic Personality Inventory (MMPI) was administered to 29 IBS patients who received treatment in the gastroenterology department of Ajou University Hospital to produce individual profiles for each patient. The 29 profiles with 13 standard scales, 15 content scales and 11 personality scales were subjected to cluster analysis resulting in three clusters of the original sample. Titles used to describe the psychological features and personality patterns seen in the three clusters included : (1) depression and anxiety : (2) somatization and denial of affect ; (3) anger overcontrol. Future studies on the treatment of IBS patients may well consider these features, as IBS patients have different psychological patterns.

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A Case of Woman with Histrionic Personality who Suffered from Chronic Gastrointestinal Dysfunction (만성 위장장애를 호소하는 히스테리성 성격의 여자)

  • Song, Ji-Young
    • Korean Journal of Psychosomatic Medicine
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    • v.1 no.1
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    • pp.101-108
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    • 1993
  • A case of a 38 year-old woman with histrionic personality who had chronic epigastric pain, dyspepsia and alternating bowel habit for more than 10 years was presented in detail on its course of two times of admission and follow-up. The diagnosis was thought as psychophy-siological disorder or gastrointestinal motility disorder of undefined etiology rather than hypo-chondriasis or Briquet's syndrome. She was characterized by sustained illness behavior and combined several physical illnesses. i.e. tuberculosis. anemia and hepatic stone. These physical diseases led to a blurring of psychological and physical boundaries regarding symptom formation. The points on consultation from medical part to psychiatric department were discussed and the supposed causal mechanisms in non-organic functional gastrointestinal disturbances were also reviewed. Physical and psychological modalities for the treatment and the abnormal illness behavior were mainly emphasized in this case.

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Postmenopausal Hormone Replacement Therapy (폐경후 여성호르몬 보충요법)

  • Park, Hyoung-Moo
    • Korean Journal of Psychosomatic Medicine
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    • v.4 no.1
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    • pp.98-108
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    • 1996
  • Korean women are now living almost 1/3 of their life after menopause. Sex-steroid hormone deficiency adversely affect various fields of physical & mental activity and quality of life during this period. Therefore, replacement of deficient hormone is thought to be natural therapeutic modality. Postmenopausal syndrome is recently redefined as an endocrinopathy with both short-and long-term sequelae, as a result of cessation of ovarian function. Hormone replacement therapy taken at or near time of menopause alleviates shot-term acute menopausal symptoms such as vasomotor disturbances and psychological problems. HRT also beneficially affects some of intermediate symptoms such as urogenital atrophy and cutaneous problems. The major benefits of long-term use were reductions in risk of long-term sequelae, that is, total fracture by 50-60%, cardiovascular disease by 50% and cerebrovascular disease by 30-40%, respectively. In addition, HRT may also positively influence Alzheimer's disease, reduce the colorectal cancer risk and increase longevity of the life. In conclusion, all postmenopausal women should consider preventive HRT when there are no contraindications.

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Therapeutic Approaches to the Patients Who were Referred for Psychiatric Consultation from Medical Departments - Psychopharmacotherapy in Medically Ill Patients - (정신과에 의뢰된 내과계 환자들에 대한 치료적 접근 - 정신약물치료 -)

  • Na, Chul
    • Korean Journal of Psychosomatic Medicine
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    • v.1 no.1
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    • pp.92-97
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    • 1993
  • Successful management of mental symptoms requires proper diagnostic tools and comprehensive treatment including psychotherapy, physical therapy and psychopharmacotherapy. For this purpose. valid and reliable diagnostic instruments need to be developed. and the data regarding various treatment methods in medical and psychiatric comorbid conditions should be available. Because mental symptoms originate from various aspects of biological, psychological and social factors. each aspect may have slightly different therapeutic goal. Alterations in pharmacokinetics and pharmacodynamics of medically ill and/or old patients may complicate the treatment outcomes. Best psychopharmacological treatment needs to be elaborated in various states. Mental symptoms of the medically ill patients may be treated more effectively with an eclectic approach.

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Therapeutic Approaches to the Patients Who were Referred for Psychiatric Consultation from Medical Departments - Psychosocial Aspects in Consultation-liaison Psychiatry - (정신과에 의뢰된 내과계 환자들에 대한 치료적 접근 - 정신사회적 측면 -)

  • Park, Chong-Cheul
    • Korean Journal of Psychosomatic Medicine
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    • v.1 no.1
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    • pp.98-100
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    • 1993
  • To become an effective and successful consultation-liasion psychiatrist the psychiatrist should consider two aspects of consultation before he/she meets his/her patients. First the psychiatrist should understand the internal need and psychological state of patients who visited their physician before being refered to a psychiatrist So psychiatrists should be careful in the evaluation of the patient's intention whether they are willing to accept the psychiatric treatment approach or not Second the psychiatrist should understand the situation and the physician's internal need in the consultation. Psychiatrists should recognize whether there are any factors which interfere with the mutual understanding and cooperation between physicians and psychiatrist.

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Therapeutic Approaches to the Patients who were Referred for Psychiatric Consultation from Medical Departments - Internist's View about Management of Medical Patients with Psychiatric Problems - (정신과에 의뢰된 내과계 환자들에 대한 치료적 접근 - 내과의사로서의 입장 -)

  • Lee, Sang-In
    • Korean Journal of Psychosomatic Medicine
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    • v.1 no.1
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    • pp.81-91
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    • 1993
  • The consulting internist will encounter patients with psychiatric symptoms and those who take psychotropic medications in many settings. The internist must loam to feel comfortable interacting with patients who display psychiatric symptoms. while maintaining an open and unprejudiced attitude toward their evaluation. The proper delineation of psychiatric disorders from normal emotional reactions resets on a careful history, a mental status evaluation. and a knowledge of psychiatric syndromes. Many physicians tend erroneously to view behavioral changes only in a psychological framework Abrupt changes in behavior, personality, mood. or ability to function should be evaluated for possible organic causes. Then, the internists should take their consultation to psychiatrists and freely discuss psychologic problems of the patients.

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Psychosocial Aspects of Menopause Syndrome (폐경기 증후군의 사회심리적 측면)

  • Kim, Hyun-Woo
    • Korean Journal of Psychosomatic Medicine
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    • v.4 no.1
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    • pp.120-123
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    • 1996
  • Regarding menopause as a turning point in woman's lift, the author reviewed the psychosocial aspects of menopause. Seeing menstruation as the symbolic meaning of female sexuality, psychoanalysts argue that menopause, the loss of symbolic meaning of female sexuality, may bring a mourning reaction to woman. It is reported that the high ratio of depression does not have a serious relationship with the menopause syndrome, and that depression cannot be viewed as a different symptoms. It is also proved that most women successfully recover themselves from temporary menopause symptom. Research data shows that some women have a negative thought on the meaning of menopause. Others, however, have a positive concept on the meaning of menopause because of the feeling of release and freedom. In sum, the author suggests that psychosocial consideration is very important as much as bilogical consideration in considering the meaning of menopausal syndrome.

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Voxel-Based Morphometry Study of Gray Matter Abnormalities in Neurodegenerative Disease with Obsessive-Compulsive Behaviors

  • Lee, Kang Joon;Miller, Bruce L.
    • Korean Journal of Psychosomatic Medicine
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    • v.22 no.2
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    • pp.130-137
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    • 2014
  • Objectives : Obsessive-compulsive(OC) symptoms have yet to be directly studied in neurodegenerative conditions involving behavioral changes. To examine regional abnormalities in the brains of dementia patients with OC symptoms, we assessed the gray matter density using voxel-based morphometry(VBM). Methods : We performed brain magnetic resonance imaging(MRI) with VBM analysis in 106 dementia patients with OC behaviors. In this study, OC behaviors were investigated in patients with neurodegenerative disease using the modified Manchester Behavior Questionnaire. Results : The OC behavior scores were correlated with structural brain volume using VBM. The total OC symptom score correlated negatively with the volume of both putamens, the right middle orbitofrontal gyrus, both anterior cingulate cortices, and the left insula(p<0.001, uncorrected). No gray matter reductions were associated specifically with the OC symptom sub-categories. Conclusions : Our results suggest that abnormalities in these brain regions may play an important role in the pathophysiology of OCD in neurodegenerative disease. This is the first lesion study to investigate the neural basis of OCD behaviors in neurodegenerative disease.

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Alexithymia : Concept and Implications for Treatment (감정표현불능증 : 그 개념과 치료적 함의)

  • Ham, Byung-Joo;Kim, Leen
    • Sleep Medicine and Psychophysiology
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    • v.9 no.1
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    • pp.18-23
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    • 2002
  • Alexithymia represents deficits in the cognitive processing and regulation of emotions. It is observed in many cases of psychosomatic disease, anorexia nervosa, panic disorder, depression etc. Many studies have shown that alexithymia is associated with maladaptive styles of emotion regulation, low emotional intelligence, interhemispheric transfer deficit, and reduced rapid eye movement density. Psychotherapies that enhance emotional awareness may be effective in alleviating the difficulties of alexithymic individuals. Aexithymia is useful for constructing the role of personality and emotions in the pathogenesis of psychiatric disorders. It may serve as a bridge between neurobiology and psychology. We review recent alexithymia theory and research and their implications for treatment of psychosomatic disorders.

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