The anger syndrome hwa-byung and its comorbidity

The aim of this study was to identify patients with hwa-byung (HB), a Korean culture-related anger syndrome, and to compare the comorbidities of HB with those of other psychiatric disorders.

The study participants included 280 patients with depressive disorders, anxiety disorders, somatoform disorders, adjustment disorders, or self-labeled hwa-byung. For all patients, the DSM-IV diagnosis was made using the Korean version of the Structured Clinical Interview for the DSM-IV Diagnosis (SCID-1). The diagnosis of HB was made according to research diagnostic criteria of HB. Assessment of HB symptoms was performed using the Hwa-byung Scale.

Female patients were more and mean age was older in HB group than non-HB group. Of 280 patients, 183 patients were diagnosed with HB. Forty-seven of these patients had only HB, and the rest had various comorbid DSM-IV diagnoses, with major depressive disorder (MD) and generalized anxiety disorder (GAD) being the most frequent. The distributions of single diagnoses and comorbid diagnoses were similar for HB, MD and GAD.

Sample size may be small, axis II diagnoses were not assessed, and patients with psychotic features were not included.

Our results suggest that HB, which comprises unique anger-related symptoms, is comparable to MD or GAD in comorbidity profile.