Anger Experience and Expression in Patients with Schizophrenia / 신경정신의학

OBJECTIVES: The prejudice against the mentally deranged persons has an effect on the treatment of the mental illness and is one of the reasons why they have difficulties in social adaptation and rehabilitation. We intended to examine the characteristics and expression of the anger in schizophrenic patients to find how much anger they feel compared with general population. And we tried to find the basis on which the prejudice can be corrected. METHOD: 105 schizophrenic patients were selected according to DSM-IV. Control groups were 43 patients who were admitted to the department of internal medicine in university hospital and 65 healthy adults. The experiences and expressive patterns of anger were surveyed by State-Trait Anger Expression Inventory, Korean edition. And the characteristics of the anger in the schizophrenic patients were compared with those in controls and analyzed. RESULTS: Stateanger was significantly higher in the schizophrenic patients group than in healthy control group and trait-temperament was significantly lower in schizophrenic patients group than in other two control groups. Among the anger expression scales, anger-in and anger-control were significantly lower in schizophrenic patients group than in healthy control group. But trait-reaction and angerout showed no significant difference among three groups. And no significant difference was shown among the anger scales of three groups according to the presence of insight of the disorder. CONCLUSION: It is shown that schizophrenic patients have considerably much anger when compared to healthy control group and insufficient ability to suppress and control the anger. But it may be said that the expressions of anger in schizophrenic patients are not apparent. These results may be due to either the weakness of ego function, which is one of the symptoms of schizophrenia, or negative symptoms following chronicity of the disorder. Unex-pected aggressiveness or violence of them may be triggered by stimuli from the circumstances, if they are not in acute phase. And the misunderstanding of general public that schizophrenic patients are dangerous unconditionally should be corrected by the education. We can't develop the appropriate strategy to cope with the anger of the schizophrenic patients until we under-stand well the characteristics of anger in them.

Frequency and Clinical Characteristics of Pain of the Patients in Psychiatric Out-patient Clinics / 신경정신의학

OBJECTIVES: The purposes of this study were to investigate the frequency and clinical characteristics of pain among the psychiatric out-patients in three clinics. METHODS: A Total of 843 psychiatric adult out-patients (298 subjects from a private clinic, 99 subjects from a general hospital, 446 subjects from a university hospital) were assessed for the presence of pain during OPD follow-up and at the time assessed. And, the presence of organic causes, duration and site of pain, aggravating factors, compensation problems, and prescribed drugs were also investigated. RESULTS: 1) The frequency of pain among psychiatric out-patients was overall 41.3% (44.9% in private clinic, 44.5% in general hospital, and 38.1% in university hospital, respectively). 2) The frequency of pain at the time assessed was 24.1%. In severity of pain, the average of VAS was 46.7+/-18.0mm. Patients of private clinic showed more severe pain than that of general hospital. Moreover, patients who experienced over 'marked' occupied 34.0% and pain as over 'distressed' occupied 26.2%. 3) Only a few subjects had the definite organic causes (1.5-5.9%). The most common site of pain was on head. The patients having a pain over 6 months (i.e. chronic pain) occupied 68.7%. 4) The most common drugs prescribed were anxiolytics; 41.4% of patients were prescribed. The analgesics were prescribed only in 3.2% of patients. CONCLUSION: This result revealed that more than 40% of patients experienced pain in psychiatric OPD and two third of patients were suffered from chronic pain. Therefore, the evaluation and management of pain should be more emphasized.