A Study on the Diagnosis of Hwabyung / 신경정신의학

ABSTRACT

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.