Hwa-Byung is a culture-bound syndrome that is found in 4% to 11.9% of women of Korean decent. The condition was initially named the anger syndrome and was based on women’s depression like symptoms. It is predominant among women of Korean heritage. Individual dimensions of the illness include expressions of anger, frustration, hate, animosity, and overall negative feelings toward their significant others or family members. When individuals suppress these symptoms for years, psychosomatic symptoms develop such as anxiety and depression as well as lumps in the upper chest and palpations. The syndrome is most common among older women and they usually self diagnose by telling their family members. A majority of the time Hwa-Byung is ignored due to the language barriers. If the symptoms are reported, in western medicine it is not diagnosed as Hwa-Byung since many physicians are not familiar with this culture-bound syndrome. Instead it gets diagnosed as depression the majority of the time. Hwa-Byung was found prevalent among women of Korean heritage but has not been studied cross culturally. Comparing how such symptoms are perceived among the Korean culture to western medicine helps find different assessment techniques and differentiate between depression and Hwa-Byung. Among the Korean society seeking psychiatric help is stigmatized and viewed as deviant in the community so older women do not show their distress. As a result they become depressed and stress becomes anger. When physicians try and diagnose a patient, language barriers change the dynamic of the doctor-patient relationship. When an older Korean patient avoids eye contact, it does not mean they aren’t telling the truth. Instead it is a sign of respect for the practitioner. Physicians have to also use different demographics when diagnosing and ask questions such as “What brought you here” instead of asking personal information such as marital status, education level, etc. To assess the condition several scales are used such as the Hwa-Byung scale that can differentiate from depression symptoms. To treat and manage the syndrome, both pharmacological and nonpharmacological interventions are used. In order to provide the best treatment and diagnosis, physicians and nurses should offer culturally competent care in order to support the community and provide effective treatment for the patient.
Choi, Myunghan, and Yeom, Hye-A. “Identifying and treating the culture-bound
syndrome of Hwa-Byung among older Korean immigrant women: Recommendations for practitioners.” Journal of the American Academy of Nurse Practitioners 23 (2011): 226-232. Accessed July 18, 2013. doi: 10.1111/j.1745-7599.2011.00607.x