In this review article, the author tried to predict the characteristic features of psychiatric population and mental health problems in a new century in Korea. Accordingly the desirable attitude of psychiatrists and the scope of psychiatry were suggested. As problem areas, problems of adolescence, senility, family, stragglers, quasireligion, community mental health and transcultural practice were predicted. As psychiatrists' scopes to be accomplished, subspecialty in practice, community-based approach, cooperation with parapsychiatric and religious personnels, transcultural approach in practice, accomplishment of desirable mental health delivery system were suggested. Finally, psychiatric education suitable for the future society was emphacized for the better contribution.
Adolescent ; Education ; Ethnopsychology ; Humans ; Korea* ; Mental Health ; Psychiatry

OBJECTIVE: Research suggests that the contents of delusions in schizophrenia are influenced by culture and social environment. However, few studies have investigated the chronological change of such delusions within a society. To investigate specifically the changes in the persecutory delusions of schizophrenia that have occurred over time, we compared the nature of the persecutors and their persecutory behaviors among inpatients with schizophrenia. METHODS: All admissions to the psychiatric unit of Hanyang University Guri Hospital with discharge diagnoses of schizophrenia during two different five-year time frames (1996-2000 and 2006-2010) were reviewed. From their inpatient medical records, we investigated the descriptions of persecutors and their persecutory behaviors in the delusions of 124 patients (54 in the1990s and 72 in the 2000s). RESULTS: Overall, persecutory behaviors and nature of persecutors in the delusions of schizophrenia did not differ between the two time frames. However, subgroup analysis revealed that in women but not in men, rejection as a persecutory behavior was significantly higher in the 1990s (p<0.05). CONCLUSION: The ten-year time interval may be too short to find significant changes in delusional content in general. However, our additional finding in women may be a result of the tremendous change in status of Korean women during the last decade.
Delusions ; Ethnopsychology ; Female ; Humans ; Inpatients ; Male ; Medical Records ; Rejection (Psychology) ; Schizophrenia ; Social Environment

OBJECTIVE: This study compared the symptomatic emotional traits of elderly South Korean patients with hwa-byung and those with depression. METHODS: We enrolled 58 patients with hwa-byung, 180 patients with depression, and 181 healthy control subjects. All participants completed the Hwa-byung Scale, Hamilton Depression Rating Scale (HDRS), Beck Depression Inventory (BDI), Geriatric Depression Scale (GDS), State Trait Anger Expression Inventory (STAXI), Reaction Inventory (RI), and Aggression Questionnaire (AQ). Chi-square tests and a one-way analysis of variance with Games-Howell post-hoc tests were used to compare demographic variables and scores. RESULTS: A binary logistic regression analysis was used to examine risk factors for hwa-byung. Scores in the hwa-byung group were higher than those in the depression group for the HDRS; BDI; GDS; trait anger STAXI subscale (trait anger temperament and trait anger reaction); state anger and anger expression STAXI subscales (anger-in, anger-out, and anger control); physical and verbal aggression as well as anger and hostility AQ subscales; and disturbance, embarrassing circumstances, personal disrespect, and unpleasant encounters RI subscales. A binary logistic regression analysis demonstrated that the state anger STAXI subscale, verbal aggression and anger AQ subscales, and unpleasant encounters RI subscale were significantly associated with hwa-byung. CONCLUSION: Elderly patients with hwa-byung had more severe anger traits and states as well as higher depression severity compared to those diagnosed with clinical depression. Excessive anger and anger reactivity to unpleasant factors may be risk factors for hwa-byung, whereas the appropriate expression (rather than suppression) of anger may decrease the risk of hwa-byung.
Aged* ; Aggression ; Anger ; Depression* ; Ethnopsychology ; Hostility ; Humans ; Logistic Models ; Risk Factors ; Temperament

For improving mental health of the future unified Korea, proper preparation would be necessary in the fields of clinical, social, and cultural psychiatry. Clinically, a diagnostic and treatment system for mental illness should be re-established after Korean unification. There should also be specific preparation for suicides, trauma- or stress-related disorders, somatizations, substance abuse, and childhood psychiatric problems which are expected to rapidly increase in North Korean areas after the unification. In the field of social psychiatry, de-stigmatization and de-institutionalization of those with mental illness would be important after the unification. Education of mental health professionals in North Korean areas would also be crucial. Culturally, it would be necessary to expect the psychological change of both South and North Koreans.
Community Psychiatry ; Democratic People's Republic of Korea ; Education ; Ethnopsychology ; Korea ; Mental Health ; Substance-Related Disorders ; Suicide

OBJECTIVE: Posttraumatic embitterment disorder (PTED) is characterized by states of “embitterment”, characteristically similar to “Hwa-byung”, which is a Korean culture-bound syndrome. The present study aimed to assess diagnostic relationships between PTED and Hwa-byung. METHODS: A total of 290 participants completed our survey. PTED and Hwa-byung were diagnosed using a diagnostic interview and scale. Scales for depression, suicide ideation, and anger were used for evaluation. Fisher's exact tests and Mann-Whitney U tests were performed to evaluate diagnostic overlap between PTED and Hwa-byung, and associations of scale scores for depression, suicide ideation, and anger between the PTED, Hwa-byung, and non-diagnosed groups. Associations of these scales between the depressive and non-depressive groups, and suicidal and non-suicidal groups were also evaluated. RESULTS: Among the participants, 1.7% of the sample fit the diagnostic criteria for PTED and 2.1% fit the criteria for Hwa-byung. No individual fit the criteria for both. Anger scores were significantly higher in the Hwa-byung group than in the non-diagnostic group. There were not any significant differences in anger scores between the PTED and non-diagnostic groups. Depression scores were significantly higher in the PTED than in the non-diagnostic groups. In contrast, no significant differences were observed between depression scores in the Hwa-byung and non-diagnostic groups. CONCLUSION: These results suggest that PTED may be a disorder category that is distinct from Hwa-byung.
Anger ; Asian Continental Ancestry Group ; Depression ; Ethnopsychology ; Humans ; Suicide ; Weights and Measures

In order to survey the reality of anxiety and depression among the Koreans residing in china, a study was conducted between January and March of 1991, on the residents of Yun-Kil city, with subjects of 472 Koreans and 479 Chinese. The evaluation was based on the questionnaires, named Combined self-rating anxiety depression scale (CADS), distributed among the subjects. ANOVA and t-test were applied for data processing. The results were as follows: There was not significant difference in the mean of total scores between the two groups. The scores of Koreans were 29.70±7.03, while those of Chinese were 29.45±9.01. The score of the CADS above 50 (clinically significant level) was seen in 12 (2.54%) Koreans and 21 (4.38%) Chinese. The anxiety-depression scores relating to the items of indigestion and decreased appetite, sleep disturbance, apprehension, decreased libido were relatively high among the Koreans. The items appeared low in scores among the Koreans were faintness, fear, suicidal rumination, hopelessness, paresthesias. The highs among the Chinese were facial flushing, anxiousness, dissatisfaction, suicidal rumination. The items appeared low among the Chinese were fear, faintness, paresthesias, weight loss, suicidal rumination. In the compatison of evaluation by items between the two groups, the items placing the Koreans significantly higher over the Chinese are indigestion & decreased appetite, sleep disturbance, apprehension, decreased libldo. The Chinese marked significantly higher in facial flushing, anxiousness, dissastisfaction, suicidal rumination. Those in the case of female (p<0.01 respectively), less than twenty years old (p<0.01 respectively), dissatisfied with family relationship (p<0.01 respectively), with past history of psychiatric hospitalization (Koreans p<0.01, Chinese p<0.05), pessimistic toward future, present, past self image (p<0.01 respectively) had significantly higher scores in both groups. In religion, neither group showed significant difference. In religion, neither group showed significant difference. In marital status, the Koreans showed a higher degree of divorce and separation and the Chinese in singleness (p<0.01 respectively). The Korean were higher in illiteracy and the Chinese had more college education (p<0.01 respectively). In place of growth, The Koreans showed not much difference in the areas while more Chinese grew up un large cities (p<0.01). More Koreans lived in the dormitory while the Chinese were engaged more in self-cooking (p<0.01 respectively), In pocket money per mouth, more Koreans were less than 1 dollar while the Chinese were between 7 and 10 dollars (p<0.01 respectively). There were no significant difference between two groups about religion.
Anxiety* ; Appetite ; Asian Continental Ancestry Group ; China* ; Depression* ; Divorce ; Dyspepsia ; Education ; Ethnopsychology ; Family Relations ; Female ; Flushing ; Hospitalization ; Humans ; Libido ; Literacy ; Marital Status ; Mouth ; Paresthesia ; United Nations ; Weight Loss

In this transcultural comparison, we examined areas of stress, coping strategies and psychosomatic symptoms resulting from such strategies in Chinese, Korean-Chinese and Korean high school students. A total of 1,042 second-year high school students participated in this study: 213 Chinese from Yanbien, China: 368 Korean-Chinese from Yanbien, China ; and 466 Koreans from Seoul, Korea. We administered the Stress Questionnaire Form for High school Students(Won and Lee 995), the Ways of Coping-Revised(Lazarus and Folkman 1984) and the Physical Symptom Scale of Stress(Allen and Hyde 1980) to investigate areas of stress, coping strategies and psychosomatic symptoms, respectively. The findings were understood and interpreted from focus group discussions. Although there were no differences in total stress scores among the three groups, there were significant differences in areas of stress. Chinese students manifested the highest stress scores in peer relation, family problem, heterosexual problem, the future-employment, and religious problem. Koreans scored the highest in academic performance, school life, extracurricular activity, psychological-personality problem, value system, and the future-employment. The Korean-Chinese students scored the highest in extracurricular activity, family-economic problem. In terms of collectivism versus individualism, Chinese students' stress was related more toward the collective situation, whereas the Korean students faced increased stress regarding the individual situation. In coping strategies, the Chinese were characterized by active coping, Koreans by passive coping and the Korean-Chinese by a mixture of the two. Koreans had the highest scores in psychosomatic symptoms, suggesting unfavorable coping strategies. The Korean-Chinese students seemed to lie intermediate between Koreans and Chinese in all three study areas, implying their cultural pluralism.
Asian Continental Ancestry Group* ; China ; Cross-Cultural Comparison* ; Cultural Diversity ; Ethnopsychology ; Family Relations ; Focus Groups ; Heterosexuality ; Humans ; Korea ; Surveys and Questionnaires ; Seoul

Eighty-three of 114 original articles and abstracts of research published by neuropsychiatrists of Chosun Chongdokbu Hospital (the Japanese colonial government hospital in Korea) and Keijo (Seoul) Imperial University Hospital during the Japanese colonial period (1910-1945) in journals including Shinkeigaku-zassi (Neurologia), Seishin-shinkei-gaku zassi (Psychiatria Et Neurologia Japonica), and The Journal of Chosun (Korea) Medical Association were reviewed. Most articles were on clinical research based on descriptive and biological psychiatry while only 4 articles were on dynamic psychiatry, probably because Japanese pioneers in psychiatry had introduced German psychiatry into Japan during the 1880s. The first paper was written by Dr. Shim Ho-sub. Professor Kubo of Keijo (Seoul) Imperial University published most articles, followed by Dr. Hikari, Dr. Hattori, and Dr. Sugihara. There were more articles on symptomatic psychosis and morphine addiction, followed by general paralysis, schizophrenia, neurological diseases, narcolepsy, epilepsy, and neurasthenia. The meaningful articles even for today were comparative studies between Japanese and Koreans and articles on opioid use disorder in Korea. Authors reported a markedly lower rate of psychotic inpatients in the population of Koreans compared with Japanese. Japanese researchers argued that, because of simpleness in social life in Korea and less violence or excitement in symptoms, Korean mental patients could be cared for by family or members of the community, or be treated by shamanism rather than bringing them to a public mental hospital, and poverty also prohibited hospital care. Finding of higher ratio of schizophrenia to manic-depressive psychosis among Koreans than Japanese was discussed in relation to delayed cultural development of Korea compared to Japan. In addition, traditional customs prohibiting marriage between relatives in Korea was related to low prevalence of manic-depressive psychosis, local endemic malaria was related to low prevalence of general paresis, and poor general hygiene was related to high prevalence of epilepsy. Unclear (undifferentiated) form of psychotic symptoms including hallucination and delusion was reported in more Koreans than Japanese. Also Korean patients showed a more atypical form in diagnosis. Authors added that they had found no culture-specific mental illness in Korea. However, no Korean psychiatrists were included as author in such comparative studies. Comparative studies on constitution between Koreans and Japanese mental patients and prisoners were also unique. However, no Korean psychiatrists participated in such comparative studies. In studies on morphine addiction in Koreans, Japanese researchers argued that such studies were necessary to prevent introduction of morphine-related criminal phenomena to Japan. Meanwhile, Dr. Kubo had left a notion on adaptation problems of Japanese living in the foreign country, Korea. Nevertheless he reported nothing about psychosocial aspects of mental illness in relation to political, cultural, and economic difficulties Koreans were experiencing under the colonial rule of Japan. These general trends of studies based on German biological and descriptive psychiatry and policies of colonial government to isolate "dangerous" mental patients in hospital appeared to reflect colonial or ethnopsychiatry of those days. These policy and research trends seem to have worsened stigma attached to mental disorders. Japanese tradition of psychiatric research was discontinued by return home of Japanese scholars with the end of WWII and colonial rule.
Asian Continental Ancestry Group* ; Biological Psychiatry ; Bipolar Disorder ; Constitution and Bylaws ; Criminals ; Delusions ; Diagnosis ; Epilepsy ; Ethnopsychology ; Hallucinations ; Hospitals, Psychiatric ; Humans ; Hygiene ; Inpatients ; Japan ; Korea ; Malaria ; Marriage ; Mental Disorders ; Mentally Ill Persons ; Morphine Dependence ; Narcolepsy ; Neurasthenia ; Neuropsychiatry ; Neurosyphilis ; Poverty ; Prevalence ; Prisoners ; Prisons ; Psychiatry* ; Psychotic Disorders ; Schizophrenia ; Shamanism ; Violence