Background
: Psychogenic and physical aspects of health is interesting issue in the field of family medicine. We intended to study the relationship between physical illness and symptoms with self esteem, and hoped to understand disease in general behavioral context.

Methods : We selected 124 persons who visited family medicine OPD in Paik Hospital from August 3 to August 20, 1995, and answered questionnaire frankly. The qestionnaire consisted of Rosenberg self esteem scale as parameter of self esteem and Hopkins symptomcheck list as parameter of physical health. The third author analyzed the medical record and rated the severity of disease as grade I-VII, for another parameter of physical health. The other factors-age, sex, marriage, education level, family, income-were analyzed by self esteem.

Results : We divided the study population into two groups, low self esteem group and high self esteem group. In low self esteem group, the persons complain more symptoms in Hopkins symptom check list significantly(P=0.0009). Those who were highly educated had significantly higher self esteem(P=0.047). The severity of disease, sec, age, marriage, type of family, income showed no significant relationship with self esteem.

Conclusion : The education level was the factor that influence self esteem. The person of low self esteem complains more symptoms. So we should consider self esteem in medical practice.

Background
: The red cell distribution width(RDW) has been reported to be of value in discriminating iron deficiency anemia(IDA) from the anemia of the other causes(non-IDA). The combination of a low MCV and a high RDW may indicate iron deficiency anemia. The purpose of this study was to discriminate IDA form anemia, using automated blood cell count alone.

Methods : We collected 139 cases of anemia in outpatients, with 80 cases of IDA and 59 case of anemia due to other causes, from July 1995 to September 1996 in department of family medicine, Pusan Paik hospital.

Results : The sex distribution was 39(28.1%) in male, 100(71.9%) in female. The age distribution was 15 to 79 year. The hemoglobin level and MCV in IDA(9.5±1.6g/dl, 77.5±8.9fl) was significantly lower than those in non-IDA(10.1±1.5g/dl, 87.6±10.5fl)(P=0.042, P<0.001, respectively). And mean RDW in IDA(16.9±3.3%) was significantly higher than that in non-IDA(15.1±3.2%)(P<0.001).
In discriminating IDA from anemia, we drew receiver operating characteristic curves(ROC curves) with each value of MCV and RDW. The cut-off value of MCV was 83fl, and in that value, the sensitivity and specificity were 75.9% and 72.9%, respectively. The cut-off value of RDW was 14.3%, and the sensitivity and specificity were 78.2% and 57.6%, respectively. We combined each value of MCV with RDW, the cut-off value were 83fl of MCV and 14.3% of RDW, and the sensitivity and specificity were 76.3% and 71.3%, respectively.

Conclusion : The sensitivity and specificity of MCV, RDW and combination of MCV and RDW were not so high in discriminating IDA from the anemia of the other causes in ambulatory patients.