Hwabyung: Symptoms and Diagnosis

Special Article

Psychiatry Investigation 2004;1(1):25-8.

Yong Chon Park, MD, PhD

Department of Neuropsychiatry, Hanyang University College of Medicine, Seoul, Korea

Abstract

<p class="MsoPlainText" style="word-spacing: 1; line-height: 150%; margin-top: 0; margin-bottom: 0" align="left"><font face="HY중고딕" size="2">There are two points of views about Hwabyung-the longitudinal view and the cross sectional view. In the longitudinal view, Hwabyung is considered as a disease process, and the symptoms are interpreted dynamically. This view is based on the traditional meaning of Hwabyung. In the cross sectional view, Hwabyung is considered as a disease entity, with a focus on phenomenological understanding. This view attempts to categorize Hwabyung according to the diagnostic criteria of DSM, thereby enabling statistical analysis of this disorder and facilitating the communication of it's diagnosis and treatment between different practitioners and researchers. Therefore, the longitudinal view considers the symptoms of Hwabyung to vary from mild physical and mental symptoms, including neurosis and somatization, to psychosis and death. In studies based on the cross sectional view, the symptoms of Hwabyung patients were statistically processed and it was found that hot or heat sensation, feeling oppressed, sensations of something pushing-up in the chest and epigastric mass are the four major symptoms, most of which are on the neurotic level of physical symptoms. In terms of the diagnosis, there are no objective diagnostic criteria in the longitudinal view, because all of the symptoms caused by anger are referred to as Hwabyung. In the cross sectional view, patients complaining of Hwabyung were diagnosed according to the DSM criteria, and somatization disorder, depression and anxiety were the most frequent diagnoses. The question as to whether Hwabyung is a culture bound syndrome or not remains controversial. Further research on this issue is needed in the future.

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Key words Hwabyung;Symptom;Diagnosis;Korea;Somatization;Depression;Anxiety.