Korean Journal of Psychopharmacology (대한정신약물학회지)

Korean College of Neuropsychopharmacology (대한정신약물학회)
권호 표지

Effects of Paroxetine on Symptoms of Hwa-Byung

화병 증상에 대한 Paroxetine의 효과

  • Sung-Kil, Min (Department of Psychaitry, Yonsei University College of Medicine) ;
  • Shin-Young, Suh (Department of Psychiatry, College of Medicine, CHA University) ;
  • Duk-In, Jon (Department of Psychaitry, Hallym University College of Medicine) ;
  • Hyun-Ju, Hong (Department of Psychaitry, Hallym University College of Medicine) ;
  • Sang-Jin, Park (Department of Psychiatry, National Health Insurance Corporation Ilsan Hospital) ;
  • Ki-Jun, Song (Department of Biostatistics, Yonsei University College of Medicine)
  • 민성길 (연세대학교 의과대학 정신과학교실) ;
  • 서신영 (CHA 의과대학교 정신과학교실) ;
  • 전덕인 (한림대학교 의과대학 정신과학교실) ;
  • 홍현주 (한림대학교 의과대학 정신과학교실) ;
  • 박상진 (국민건강보험공단 일산병원 정신과) ;
  • 송기준 (연세대학교 의과대학 의학통계학교실)
  • Published : 2009.04.30

⟨ Previous Next ⟩

Abstract

Objective：This study consists of a single open clinical trial to evaluate the treatment effects of paroxetine on symptoms of hwa-byung, a Korean culture-related anger syndrome. Methods：Eighty-nine patients with depressive disorders, anxiety disorders, somatoform disorders, or self-labeled hwa-byung were treated with paroxetine (Paxil CR) 12.5-37.5 mg/day for 8 weeks. Treatment effects were evaluated using the Hamilton Depression Scale (HAMD), the State and Trait Anger Inventory (STAXI), and the Hwa-byung Scale. Results：Scores on all items；total score on the Hwa-byung Scale；scores on state anger, trait anger, and anger-in；total score on the STAXI；and total score on the HAM-D decreased significantly after eight weeks of paroxetine treatment compared to baseline. Conclusion：Paroxetine was shown to be effective for treating symptoms of hwa-byung, a chronic anger syndrome.

본 연구는 화병 증상에 대한 paroxetine의 치료효과를 알아보기 위한 단일개방성 임상시험이다. 89명의 우울증, 불안장애, 신체형장애, 적응장애 그리고 자가진단의 화병을 가진 환자를 대상으로 paroxetine HCl(팍실CR) 12.5~37.5 mg/day를 4주간 투여하였다. 치료효과는 HAM-D, STAXI 그리고 화병척도로 평가하여 치료 전후를 반복측정 자료의 분산분석방식으로 분석하였다. 그 결과, HAM-D 총점, 화병척도의 총점과 모든 항목들의 점수, 그리고 STAXI의 총점, 상태분노, 특성분노, 분노억제 등의 점수에서 치료 전에 비해 치료 후에 통계적으로 유의한 감소가 있었다. 이러한 결과는 paroxetine이 화병 증상에 효과적인 치료약물임을 시사한다.

Keywords

References

  1. Min SK, Lee MH, Kang HC, Lee HY. A clinical study of hwabyung. J Korean Med Assoc 1987;30:187-197.
  2. Min SK, Namkoong K, Lee HY. An epidemiological study of hwa-byung. J Korean Neuropsychiatr Assoc 1990;29:867-874.
  3. Min SK, Park CS, Hahn JO. Defense mechanisms and coping strategies in hwa-byung. J Korean Neuropsychiatr Assoc 1993;32:506-516.
  4. Min SK, Kim KH. Symptoms of hwa-byung. J Korean Neuropsychiatr Assoc 1998;37:1138-1145.
  5. Min SK, Lee MH, Shin JH, Park MH, Kim MK, Lee HY. A diagnostic study hwa-byung. J Korean Med Assoc 1986;29:653-661.
  6. Min SK, Hong HJ. A study on prognosis of hwa-byung. Behav Sci Med 2006;5:93-99.
  7. Min SK. Hwa-byung and haan. J Korean Med Assoc 1991;34:1189-1198.
  8. Lin K. Hwa-byung: a Korean culture bound syndrome? Am J Psychiatry 1983;140:105-107. https://doi.org/10.1176/ajp.140.1.105
  9. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. The 4th Edition. Washington DC: American Psychiatric Association; 1994.
  10. Min SK, Suh SY, Song KJ. Symptoms for diagnostic criteria of hwa-byung, an anger syndrome. Psychiatry Invest In Press; 2009.
  11. Min SK, Suh SY, Song KJ. Development of a hwa-byung scale and a research diagnostic criteria of hwa-byung. J Korean Neuropsychiatr Assoc In Press; 2009.
  12. Min SK. Cultural Relatedness of Hwa-byung and beyond. Behav Sci Med 2004;3:97-102.
  13. Fava M, Anderson K, Rosenbaum JF. "Anger attacks": possible variants of panic and major depressive disorders. Am J Psychiatry 1990;147:867-870. https://doi.org/10.1176/ajp.147.7.867
  14. Spielberger CD, Reheiser EC, Sydeman SJ. Measuring the experience, expression, and control of anger. Issues Compr Pediatr Nurs 1995;18:207-232. https://doi.org/10.3109/01460869509087271
  15. Deffenbacher J. Anger disorders. In: Coccaro E, Editor. Aggression. Psychiatric assessment and treatment. New York: Marcel Dekker Inc; 2003.
  16. Min SK. Clinical correlates of hwa-byung and proposal for a new anger disorder. Psychiatry Invest 2008;5:125-141. https://doi.org/10.4306/pi.2008.5.3.125
  17. Min SK, Soh EH, Pyohn YW. The concept of hwabyung of Korean psychiatrists and herb physicians. J Korean Neuropsychiatr Assoc 1989;28:145-154.
  18. Fava M, Rosenbaum JF, Pava JA, McCarthy MK, Steingard RJ, Buffides E. Anger attacks in unipolar depression. Part I: clinical correlates and response to fluoxetine treatment. Am J Psychiatry 1993;150:1158-1163. https://doi.org/10.1176/ajp.150.8.1158
  19. Coccaro EF, Kavoussi RJ. Fluoxetine and impulsive aggressive behavior in personality-disordered subjects. Arch Gen Psychiatry 1997;54:1081-1088. https://doi.org/10.1001/archpsyc.1997.01830240035005
  20. Crockett MJ, Clark L, Tabinia G, Lieberman MD, Robbins TW. Serotonin modulates behavioral reactions to unfairness. Science 2008;320:1739. https://doi.org/10.1126/science.1155577
  21. van Praag HM. Anxiety and increased aggression as pacemakers of depression. Acta Psychiatr Scand 1998;98(393 suppl):81-88.
  22. Han OS, Hong JP. The Korean version of Structured Clinical Interview for DSM-IV. Seoul: Hana Medical Publishing Company; 2000.
  23. Yi JS, Bae SO, Ahn YM, Park DB, Noh KS, Shin HK, et al. Validity and reliability of the Korean version of Hamilton Depression Rating Scale (K-HDRS). J Korean Neuropsychiatr Assoc 2005;44:453-465.
  24. Chon KK, Hahn DW, Lee CH, Spielberger CD. Korean adaptation of the State-Trait Anger Expression Inventory: anger and blood pressure (II). Korean J Health Psychol 1997;2:60-78.
  25. Fava M, Davidson K, Alpert JE, Nirenberg AA, Worthington J, O'Sullivan R, et al. Hostility changes following antidepressant treatment: relationship to stress and negative thinking. J Psychiatr Res 1996;30:459-467. https://doi.org/10.1016/S0022-3956(96)00034-9
  26. Watson D, O'Hara MW, Stuart S. Hierarchical structures of affect and psychopathology and their implications for the classification of emotional disorders. Depress Anxiety 2008;25:282-288. https://doi.org/10.1002/da.20496
  27. Fava GA, Kellner R. Prodromal symptoms of affective disorders. Am J Psychiatry 1991;148:823-830. https://doi.org/10.1176/ajp.148.7.823