A Study on the Diagnosis of Hwabyung

Objects：The aim of this study was to find out the differences in comorbidity of DSM-Ⅲ-R diagnosis and in symptom pattern 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 coexist 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 four 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-Hwabyung in 73.5% accuracy. Conclusion：The results suggest that Hwabyung is an atypical psychiatric syndrome combined with characteristic somatization symptoms, depression and anxiety.prohibitio