Multiple Somatizer에 관한 임상적 연구 — Somatoform Disorder의 임상적 적용을 위한 연구( I ) ᅳ

Clinical Studies on Multiple Somatizer 一 For The Clinical Application of Somatoform Disrder. in Korea ( I ) —

With the essential criteria of (A) the presence of various multiple somatic complaints related to various itemized organ systems and (B) no elicited evidence of organic basis corresponding to the complaints, a sample of 1,124 multiple somatizer was selected from the patient group of in itial visit to Wonju Christian Hospital of Yonsei Univ. (Wonju city, Kangwon-Do) during 6 months period (April-Sept., 1978), when there was no psych iatric service at the hospital. They were analyzed by review ing the clinical records which had been described by non-psychiatric physicians, and discussed various clin ical aspects as apreliminary study for the clarification and clinical application of the somatoform disorder in Korea. The results were as follows： 1) The rate of multiple somatizer to the whole intial visits was 11.5% with various departmental distribution, showing remarkably higher rate in internal medicine and neurosurgery, accounting for 31.3% and 23.4% each of the initial visits. 2) T he rate was significantly higher in female (15.5%) than in male (7 .1% ), with the peak in their twenties to forties. 3) There was a remark able tendency among non-psychiatric physicians to interpret the multiple somatic symptoms as an organic aisturance by using organic-oriented diagnostic terms, while most patients usually complained their sufferings by using vague and complicated terms. The common somatically oriented attitude of both the physicians and patients could be a ttributed to an influence of the traditional cultural back ground in Korea. 4) Each patient had average 3.8 somatic complaints related to average 2.8 itemized organsystems, particularly gastro in testinal (30.4%), head and sense organ (19.6%),. cardiovascularrespiratory(14.8%) and bodily pain (11 .4% ) symptoms, but complaints related to paresthesia and itchin g , genito-urinary symptoms and sleep disturbance were relatively rare. 5) About 70% of the multiple somatizers were given psychotropic drugs more than once, mostly diazepam for the relieve of somatized symptoms. 6) It was impressed that most of the multiple somatizer were wondering with out adequate psychiatric diagnoses and reasonable therapeutic approaches, and that this trend did not change considerably even after the opening of psychiatric service in this general hospital with very low consultation rate, leaving another problem in the field of consultation-liaison psychiatry.