Prevention and Treatment of Trauma- and Stressor-Related Disorders : Focusing on Psychosocial Interventions for Adult Patients / 신경정신의학

Each year many people are exposed to life-threatening disaster and traumatic events that put them at risk for trauma- and stressor-related disorders such as posttraumatic stress disorder. This report reviews research on the psychosocial interventions currently employed for the prevention and treatment of trauma- and stressor-related disorders. Cognitive behavioral therapy, including cognitive therapy and prolonged exposure, has been shown to improve several outcomes. Considerable progress has also been made in the use of eye movement desensitization and reprocessing. Trauma- and stressor-related disorders are associated with complex outcomes and multiple comorbid emotional, social, and physical health difficulties. Further advances are required in the intervention for populations with complex and chronic forms and in the development of integrated and well-related systems of care.

Quantitative Analysis of Providers' Experiences in the Disaster Behavioral Health Services of South Korea / 신경정신의학

OBJECTIVES: This study was conducted to quantify the six dimensions of obstacles to disaster behavioral health (DBH), which was explored through the previous Qualitative Content Analysis of field workers' experiences after the Sewol Ferry accident and to determine the preference and significance of the details of every dimension. METHODS: Based on the six dimensions and their details, structured questionnaires were devised. The field workers as DBH service providers were requested to choose not only the most urgent item but also the reason for their choice. For the statistical analysis, the field workers were grouped by age, employment period, place of employment, occupation, mental health professional certificate, and experience and education of DBH interventions. Differences of the groups were analyzed using chi-square test. RESULTS: The questionnaires were distributed to 284 field workers for DBH, and a total of 79 usable questionnaires were collected and analyzed. Out of six dimensions, 43% of the field workers primarily suffered from difficulties in vertical relations of the administration system. Vague policy on DBH was the most challenging in difficulties in vertical relations of administration system (32.9%). The details of the other 5 dimensions were also discovered. Several significant differences were identified among groups according to the structured questionnaires. CONCLUSION: This study identifies the six dimensions and their significance as obstacles to DBH services. It may make a contribution to improving laws and systems when deciding on related policies and sorting out urgent problems.

Somatic Symptoms after Psychological Trauma / 정신신체의학

OBJECTIVES: Somatic symptoms after the exposure of psychological trauma frequently developed. However, the somatic symptoms are not covered under the diagnostic criteria of posttraumatic stress disorder(PTSD) in detail, although they are often associated with social and occupational functioning and patient-doctor relationships. The aim of this article is to highlight the potential mechanisms, the common manifestations, and the treatment of the somatic symptoms. METHODS: This article studied the somatic symptoms searched using academic search engines like PubMed, Scopus, Google Scholar, KoreaMed and KISS from the earliest available date of indexing to March 31, 2016. RESULTS: The mechanism of somatic symptoms after the exposure was described as psychological and physiological aspects. Psychological mechanism consisted of psychodynamic theory, cognitive behavioral theory, and others. Physiological mechanism involved changes in neuroendocrine and immune system, autonomic nervous system and central nervous system. Somatization associated with psychological trauma manifested various health conditions on head and neck, chest, abdominal, musculoskeletal, and dermatological and immune system. Few studies described the standardization of treatment for the somatic symptoms. CONCLUSIONS: Clinicians and disaster behavioral health providers should think of the accompanying somatic symptoms during intervention of psychological trauma and PTSD. Further studies are needed on the somatic symptoms seen in psychological trauma and PTSD.