OBJECTIVES: Psychiatry in North Korea is believed to seem very different from psychiatry in South Korea. However, there is nearly no information regarding psychiatry in North Korea until now. Our study aimed to get information about North Korean psychiatry. METHODS: Three North Korean defectors in South Korea, whose clinical experience as medical doctors in North Korea was over 10 years, were recruited. They underwent the semi-structured interview, content of which included the clinical experience with psychiatric patients, the details of psychiatry, the treatment of psychiatric patients, the stigma of mental illness, and the suicide, in North Korea. RESULTS: In North Korea, psychiatric department was called as 49th(pronounced as Sahsip-gu-ho in Korean). Only patients with vivid psychotic symptoms came to psychiatric department. Non-psychotic depression or anxiety disorders usually were not dealt in psychiatry. The etiology of mental illness seemed to be confined to biological factors including genetic predisposition. Psychosocial or psychodynamic factors as etiology of mental illness appeared to be ignored. Psychiatry was apparently separated from political or ideological issues. The mainstay of psychiatric treatment is the inpatient admission and out-of-date therapy such as insulin coma therapy. Stigma over mental illness was common in North Korea. Suicide is considered as a betrayal to his/her nation, and has been reported to be very rare. CONCLUSION: The situation of psychiatry in North Korea is largely different from that of South Korea. Although some aspects of North Korean psychiatry are similar to psychiatry in former socialist countries, North Korean psychiatry is considered to have also its unique characteristics.
Anxiety Disorders ; Biological Factors ; Convulsive Therapy ; Democratic People's Republic of Korea ; Depression ; Genetic Predisposition to Disease ; Humans ; Inpatients ; Porphyrins ; Republic of Korea ; Suicide

PURPOSE: This study was conducted to describe the perception of parental sex role held by university students and to examine differences in perception of parental sex role according to student characteristics. METHOD: The participants were 336 university students in Gangreung city. The instrument of parental sex role was developed by the researcher and consisted of 3 subcategories; general parent role, parental sex role as a father and parental sex role as a mother. RESULTS: The most positive item of parental sex role as a father is 'the Father's role is teaching about the value of society'. The most positive item of parental sex role as a mother is 'the Mother's role is to be a counselor or friend'. There were significant differences in perception of a father's role according to sex, type of college, fathers who lived with student during childhood, the relationship with the parent, the plan of marriage and having a child, responsibility of child-rearing, and the need for education for the parental role. There were significant differences in perception of the mother's role according to sex, grade, type of college, birth order, type of family, persons who lived with student during childhood, the relationship with the parent, plan of marriage and having a child, responsibility of child-rearing, and the need for education for the parental role. CONCLUSION: The parental sex role changes overtime. Thus, it is important to identify university student's perception of parental sex roles as pre-parent preparation for parenting.
Birth Order ; Child ; Counseling ; Education ; Fathers ; Gender Identity* ; Humans ; Marriage ; Mothers ; Parenting ; Parents* ; Ritodrine

OBJECTIVES: This study sought to determine ethnic difference in physical violence and to see if ethnicity is an independent predictor of violence by surveying eight Korean or Han ethnic elementary schools in Yanji city, China. A total of 2,316 school children from fourth through sixth grade participated the study. METHODS: Participants completed a questionnaire on sociodemographic background and experiences of physical violence during the previous year using the Conflict Tactics Scale. The history of physical violence was categorized as within the family, by peers, or by teachers. RESULTS: Han children reported significantly higher rates of physical abuse compared with Koreans (76.2% vs. 54.9%, chi2=116.12, df=1, p=<.001). Binary logistic regression analysis identified five risk factors for physical violence:(1) ethnic Han (odds ratio [OR]=3.01, 95% confidence interval [CI]=2.47-3.66), (2) boys (OR=2.76, 95% CI=2.28-3.36), (3) poor economic status (OR=1.69, 95% CI=1.17-2.42), (4) single or absent parents (OR=1.42, 95% CI=1.09-1.86), (5) interaction of fourth-graders with promotive or neutral opinions of corporal punishment (OR=2.41, 95% CI=1.86-3.13). Ethnicity remained an independent risk factor after other sociodemographic variables were controlled. CONCLUSION: These findings showed cross-cultural risk factors of child physical abuse, including ethnicity which previously identified as a factor in literature. This study particularly reports lower prevalence of physical violence in ethnic minority, Korean-Chinese, compared with the Han ethnic group. This result explained a special environment of Korean self-government district and the successful adaptation of the ethnic minority to the mainstream culture.
Asian Continental Ancestry Group* ; Child ; Child Abuse ; China ; Ethnic Groups ; Humans ; Logistic Models ; Parents ; Prevalence* ; Punishment ; Surveys and Questionnaires ; Risk Factors ; Violence*

The Illness Intrusiveness Rating Scale (IIRS) measures illness-induced disruptions to 13 domains of lifestyles, activities, and interests. A stable three-factor structure has been well documented; however, the cross-cultural validity of this scale needs to be tested. This study investigated the factor structure of the Korean version of IIRS in 712 outpatients at a university medical center. A predominant diagnosis of the patients was rheumatoid arthritis (47%). The Center for Epidemiological Studies-Depression Scale (CES-D), and Health Assessment Questionnaire (HAQ) were also administered. Exploratory Principal Component Analysis identified a two-factor structure, "Relationships and Personal Development (RPD)" and "Instrumen-tal", accounting for 57% of the variance. Confirmatory analyses extracted an identical factor structure. However, a goodness-of-the fit test failed to support two-factor solution (X2 =138.2, df=43, p<.001). Two factors had high internal consistency (RPD, alpha=.89; Instrumental, alpha=.75) and significantly correlated with scores of HAQ (RPD, r=.53, p<.001; Instrumental, .r=44, p<.001) and CES-D (RPD, .r=55, p<.001; Instrumental, .r=43, p<.001). These findings supported construct validity of the Korean version of IIRS, but did not support cross-cultural equivalence of the factor structure.
Adult ; Aged ; Asian Continental Ancestry Group ; *Cross-Cultural Comparison ; Factor Analysis, Statistical ; Female ; Humans ; Male ; Middle Aged ; Reproducibility of Results ; *Sickness Impact Profile

OBJECTIVES: This study investigated the psychosocial factors and clinical symptoms related to the duration of untreated psychosis (DUP) in 35 consecutive first-episode inpatients with schizophrenia. METHODS: Data from 35 schizophrenic patients were obtained from two general psychiatric inpatient units at a university medical center. These data included scores from Index of Social Position (ISP), Positive and Negative Syndrome Scale (PANSS) and Symptom Checklist-90-Revised (SCL-90-R) as well as socio-demographic informations. RESULTS: Among socio-demographic variables, lower social position (r=.610, p<.001), male sex (r=.407, p=.015), and grew up in rural area (r=.335, p=.045) were significantly correlated with DUP. The interpersonal sensitivity of SCL-90-R was the only symptomatic variable significantly correlated with DUP (r=.379, p=.027). However, after controlling interactive effects of the variables, only lower social position and interpersonal sensitivity remained significant. Lower social position was more influential on DUP than interpersonal sensitivity in the multiple regression model. CONCLUSION: Both social and symptomatic factors independently influenced DUP in schizophrenic patients. Lower social position defined by education and occupation of patients or caretakers may reflect barriers to psychiatric services or poor identification of mental illness. This together with patients' subjective distress in interpersonal interactions may delay the intervention of psychiatric services.
Academic Medical Centers ; Education ; Humans ; Inpatients ; Male ; Occupations ; Psychology ; Psychotic Disorders* ; Schizophrenia*

We investigated the major trends in health aid financing in the Democratic People's Republic of Korea (DPRK) by identifying the primary donor organizations and examining several data sources to track overall health aid trends. We collected gross disbursements from bilateral donor countries and international organizations toward the DPRK according to specific health sectors by using the Organization for Economic Cooperation and Development creditor reporting system database and the United Nations Office for the Coordination of Humanitarian Affairs financial tracking service database. We analyzed sources of health aid to the DPRK from the Republic of Korea (ROK) using the official records from the ROK's Ministry of Unification. We identified the ROK, United Nations Children's Fund (UNICEF), World Health Organization (WHO), United Nations Population Fund (UNFPA), and The Global Fund to Fight AIDS, Tuberculosis and Malaria (GFATM) as the major donor entities not only according to their level of health aid expenditures but also their growing roles within the health sector of the DPRK. We found that health aid from the ROK is comprised of funding from the Inter-Korean Cooperation Fund, private organizations, local governments, and South Korean branches of international organizations such as WHO and UNICEF. We also distinguished medical equipment aid from developmental aid to show that the majority of health aid from the ROK was developmental aid. This study highlights the valuable role of the ROK in the flow of health aid to the DPRK, especially in light of the DPRK's precarious international status. Although global health aid from many international organizations has decreased, organizations such as GFATM and UNFPA continue to maintain their focus on reproductive health and infectious diseases.
Databases, Factual ; Democratic People's Republic of Korea ; Electrical Equipment and Supplies/economics/statistics & numerical data ; Financial Management/*economics/trends ; Health Expenditures/statistics & numerical data ; Humans ; United Nations ; World Health Organization

This study aimed to examine influenza vaccination coverage of North Korean defectors (NKD) in the Republic of Korea (Korea) and explore the factors affected the vaccination coverage. Total 378 NKD were analyzed. Four Korean control subjects were randomly matched by age and gender from the Korea National Health and Nutrition Examination Survey V (n = 1,500). The adjusted vaccination coverage revealed no statistical difference between the defectors group and indigenous group (29.1% vs. 29.5%, P = 0.915). In the aged under 50 group, the vaccination coverage of NKD was higher than that of Korean natives (37.8% vs. 25.8%, P = 0.016). However in the aged 50 yr and over group, the vaccination coverage of North Korean defectors was lower than that of the natives (28.0% vs. 37.6%, P = 0.189). Even the gap was wider in the aged 65 yr and over group (36.4% vs. 77.8%, P = 0.007). Gender and medical check-up experience within 2 yr showed association with the vaccination coverage of NKD. Influenza vaccination coverage of aged defectors' group (aged 50 yr and over) was lower than indigenous people though overall vaccination coverage was similar. Further efforts to increase influenza vaccination coverage of this group are needed.
Adult ; Age Distribution ; Aged ; Aged, 80 and over ; Democratic People's Republic of Korea/epidemiology ; Female ; Humans ; Influenza Vaccines/*therapeutic use ; Influenza, Human/*epidemiology/*prevention & control ; Male ; Middle Aged ; Refugees/*statistics & numerical data ; Republic of Korea/epidemiology ; Sex Distribution ; Vaccination/*utilization ; Young Adult

From 1985 to 1995, 13 children with neurogenic bladder underwent augmentation cystoplasty. Diagnosis in these 13 children included Meningomyelocele in 11 and unknown origin in 2. Indications for augmentation cystoplasty were persists incontinence in 6 patients and progressive upper urinary tract deterioration in Bowel segments were used for augmentation included sigmoid colon in 1 patient, ileocecal segments incontinence in 6 patients stomach in 3. Dilated ureter also was used in 1 patient. Postoperatively, all the patients have stable upper tracts radiographically and stable or improved renal function. Of 13 patients 12 require clean intermittent catheterization to empty bladder and 10 are completely continent. After operation, bladder capacity increased from 155 ml to 305 ml and there were significant increases in bladder compliance. Hypereflexia was present in 5 patients before operation and in 3 patients after operation. There has been no surgical mortality. Postoperative complications occurred in 4 patients included mild ileus in 2 patients, mucus obstruction in 1, mild hematuria in 1, metabolic alkalosis in 1 and superficial wound infection in All complications were transient and managed medically. the kind of bowel segments did not seem to influence results. We think that augmentation cystoplasty is a therapeutic modality that should be considered as a viable treatment option in selected patients with neurogenic bladder dysfunction.
Alkalosis ; Child ; Colon, Sigmoid ; Compliance ; Diagnosis ; Hematuria ; Humans ; Ileus ; Intermittent Urethral Catheterization ; Meningomyelocele ; Mortality ; Mucus ; Postoperative Complications ; Stomach ; Ureter ; Urinary Bladder ; Urinary Bladder, Neurogenic* ; Urinary Tract ; Wound Infection

OBJECTIVES: The direct causal relationship between the experience of sexual assault and development of psychiatric disorder remains uncertain. However, studies consistently show that those with history of this horrendous event report a wide range of symptoms, higher level of distress, and various social and psychological problems. This study investigated the prevalence and associated risk factors in a cohort sample of 340 Korean psychiatric patients. METHODS: Data from consecutive 340 new patients were gathered at a psychiatric department of a university affiliated hospital. Participants completed Life Events Scale, Symptom Checklist-90-R, State-Trait Anxiety Inventory, Beck Depression Inventory, and Dissociative Experiences Scale. RESULTS: History of sexual assault was reported by 11.5% of respondents (women 18.6%;men 2.1%). Bivariate analysis revealed that women (p<.001), divorced or widowed and never been married (p<.05), unemployed and students or housewives (p<.05), monthly income more than 2 million Won (p<.05) were associated significantly with experience of sexual assault. All the scores from the scales but Beck Depression Inventory were significantly higher for the sexually assaulted. Multiple logistic regression analysis revealed that women were 12 times more likely to be sexually assaulted (Odds ratio=12.24, 95% CI=3.51-42.64). Other risk factors included younger age and interaction of post-traumatic stress disorder (PTSD) and Global Severity Index. CONCLUSION: This study supported the risk factors of sexual assaults identified in western literature. Clinicians can be alert for any history of sexual assault when younger women with PTSD present higher level of symptomatology.
Anxiety ; Cohort Studies ; Surveys and Questionnaires ; Depression ; Divorce ; Female ; Humans ; Logistic Models ; Prevalence* ; Rape ; Risk Factors ; Stress Disorders, Post-Traumatic ; Weights and Measures ; Widowhood

PURPOSE: Clusterin is a heterodimeric glycoprotein and its expression is related with tissue injury and apotosis. Angitensisn II(ANG II) is known to be associated with the progression of renal disease by inducing renal fibrosis and cell proliferation. This study was designed to investigate the relationship between ANG II and clusterin expression in the kindey and the heart. We also attempted to discriminate the effect of ANG II-mediated hypertension by experimenting with two doses of ANG II-one is high enough to cause hypertension, and the other is not. METHODS: Three groups of Sprague-Dawley rats received ANG II infusion by osmotic minipump at a dose of 50ng/min, 100ng/min and placebo infusion, respectively. After 7 days, their kidneys and hearts were harvested and underwent immunohistochemical staining, RT-PCR, and Western blotting of clusterin. RESULTS: There were no differences in body weight nor organ weight/body weight among the three groups. Blood pressures of control and low-dose ANG group were not changed throughout the study, but that of high-dose ANG group was increased significantly at day 3 and 7. Staining for renal clusterin was diffusely distributed over the cortex and medulla in all 3 groups, but the intensity of staining was different notably in the medulla of control group which showed stronger staining than the ANG II infused groups. Staining intensity was not significantly different between the low and high ANG groups in the heart and kidney. In the kidney, expression of clusterin mRNA and protein were decreased in low-and high-dose ANG groups compared with control. In the heart, expression of clusterin mRNA was decreased in the low- and high-dose ANG groups compared with control. CONCLUSION: We conclude that ANG II decreases clusterin expression in the kidney and heart regardless of systemic hypertension induced by ANG II.
Angiotensin II* ; Angiotensins* ; Animals ; Blotting, Western ; Body Weight ; Cell Proliferation ; Clusterin* ; Fibrosis ; Glycoproteins ; Heart* ; Hypertension ; Kidney* ; Rats* ; Rats, Sprague-Dawley ; RNA, Messenger