보길도에서의 홧병에 대한 연구

A Study on Hwabyung in Bokil Island

A study on hwabyung was carried out in Bokil Island which is an isolated island and where traditionally agriculture is the main industry. The subjects were 34 psychiatric patients who had believed themselves to have so-called hwabyung in which these patients was compared with 67 other patients who had not believed themselves to have hwabyung. The diagnostic criteria employed for the comparison were those of DSM-III, and the diagnostic interview was a structured interview for which DIS-III Korean version was used. The greater number of patients with hwabyung were women, and the mean age of patients with hwabyung is higher than that of patients without hwabyung(Table 1). In the hwabyung group, most of the patients had one or two diagnoses, compared with the patients in the non-hwabyung group, most of whom had no diagnosis or one diagnosis only (Table 2,4). The most frequent diagnosis were somatization, generalized anxiety disorder and depression including both major depressive disorder and dysthymic disorder, alone or combined (Table 3,5). When the DSM-III exclusion criteria concerning onset and primary causes were not applied in making a diagnosis, the patients in the hwabyung group have more diagnosis of similar disorders. These results suggest that, compared with non-hwabyung, hwabyung is a syndrome with symptoms sufficiently severe to be diagnosed as neurotic disorders; that hwabyung is diagnostically a somatization, anxiety and depression combined. The precipitating factors for hwabyung as being stated by hwabyung patients themselves were familial, especially marital, conflicts, poverty, financial loss and death of beloved ones. This suggest that the major psychodynamic factors were suppressed anger and loss(Table 6).