Effects of Integrated Psychological Therapy for Schizophrenic Patients / 신경정신의학

OBJECTIVES: This study, as a preliminary one attempting to develop the Korean version of Integrated Therapy for the rehabilitation of schizophrenic patients, was designed to investigate the results of Integrated Psychological Therapy(IPT) and review the problems during the program application. METHODS: Cognitive Differentiation Scale, Problem-Solving Scale, and PANSS(Positive And Negative Syndrome Scale) were administered to schizophrenic inpatients before and after IPT incorporating cognitive differentiation, social perception, verbal communication, social skill and interpersonal problem-solving skill subprograms. The therapy groups were offered activities three times per week during the 12-week program. The control groups were attention-placebo groups for control ling factors such as group interaction and social attention, and were offered psychoeducation. RESULTS: The 12-week IPT groups, compared with the control groups, demonstrated significant improvements in the general psychopathology and the total symptoms of PANSS, but did not in cognitive functions and problem-solving skill. Significant improvements in cognitive functions were found only after cognitive differentiation subprogram and social skill subprogram had limited effects on social skills. But within 12-week IPT groups significant improvements in the positive symptoms, negative symptoms and general psychopathology were found. CONCLUSION: These findings support some effectiveness of IPT, but do not address the unique contribution by cognitive components. Applied to schizophrenic patients in this country, this modality had the problems such as differences in sociocultural and lingual background, duration of treatment, homogeneity in the level of the functioning among group members, management of emotions in activities, and the therapists' skill in the training of cognitive components. So the modification of this modality will be required.

A Study on the Diagnosis of Hwabyung / 신경정신의학

OBJECTS: The aim of this study was to find out the differences in co-morbidity of DSM-III-R diagnosis and in symptom patters between Hwabyung and non-Hwabyung groups. METHODS: The DSM-III-R diagnosis and somatic symptoms related with Hwabyung were studied in 287 patients with depressive, anxiety and somatization disorders: patients were divided into two groups, Hwabyung and non-Hwabyung groups according to the opinions of themselves and their neighbors. Diagnostic criteria was DSM-III-R and instruments for collecting data were Korean version of DIS-III, which included culturally related 21 additional items in somatization disorder. RESULTS: Hwabyung was more prevalent in women and in older ages. Hwabyung group had higher categorized scores of somatization disorder, panic disorder and major depression than non-Hwabyung group. Odds ratio showed that somatization disorder, dysthymia and panic disorder had highest possibility to co-exist with Hwabyung. Somatic symptoms which proved to be characteristics in Hwabyung were headache, blurred vision, palpitation, lump in throat, stomach rumble, chest tightness and stifling, pushing-up in the chest, urinary frequency, facial flushing, frequent sighing, heaviness in the head, shaking in head and pain on eyeballs. factor analysis with somatic symptoms yielded 4 factors. Discrimination analysis with scores of flour factors and categorized scores of DSM-III-R diagnosis showed that somatization factor II (pushing-up in the chest, heaviness in the head, and chest tightness and stifling), major depression and generalized anxiety were most highly related variables with Hwabyung which discriminate Hwabyung from non-Hwabyuag in 73.5% accuracy. CONCLUSION: The results suggest that Hwabyung is an atypical psychiatric syndrome combined with characteristic somatization symptoms, depression and anxiety.