Hwa-byung (anger syndrome) and a Proposal for a New anger Disorder

Hwa-byung (HB), which literally means anger disorder and this is known as the culture-related chronic anger syndrome of Koreans. Based on these studies and a review of the literature on the anger syndromes of other cultures, author propose a new anger disorder. The rationale for this proposition is first that the clinical correlates of HB, including the epidemiological data, the etiological factors, the symptoms and the clinical course, are unique and different from any other DSM or ICD disorders including depressive disorders. Second, the symptoms of HB are characterized by pent-up anger and somatic and behavioral symptoms related to the release and suppression of anger. Third, a group of patients with only HB and who visit psychiatrists for treatment have been identified. Fourth, anger is thought to be the basic target of treatment for HB patients. Last, anger syndromes like HB have been identified, with various names, in other cultures. By reducing the cultural variation of HB and integrating the common clinical correlates of the syndromes related to anger, a new anger disorder for the mood of anger can be conceptualized, like that for other mood disorders for the corresponding pathological moods. The research diagnostic criteria for HB and the new anger disorder are also suggested. International collaborative studies are needed not only to identify such anger disorder in various cultures, but also to explore giving better treatment to these patients based on the bio-psycho-social model of anger disorder.