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- 검색키워드
- 저자 : 李基南 (검색결과 1 건)
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元鎬澤,洪元植,張煥日,陳聖太,金光日,李基南,嚴龍燮,金明正 大韓神經精神醫學會 1973 신경정신의학 Vol.12 No.1
Korean psychiatrists are more apt to take the abnormal drinking behavior lightly and regard the psychosomatic symptoms as more serious, comparing with American psychiatrists. On the other hand, physicians as well as adults from the population in Korea are less concerned about the neurotic and psychosomatic symptoms and alcoholic behavior as psychiatric problems. It is the authors' concern to understand such differences in opinion about abnormal behaviors from the cultural and social psychiatric view point. The authors used Dohrenwend's questionaire form of 45 mental symptoms and three additional items i. e., homosexual behavior, symptom of senile psychosis and delusion of jealousy following the authors' interests. Each item was rated by three point cale (psychiatrically very serious=2 points, somewhat serious=1, not serious at all=0) and evaluated with critical ratio. As a preliminary study, the reliability of this questionaire was confirmed by the test-retest method; Spearman's rho was 0,93. The subjects in this study consist of 50 psychiatrists, 49 physicians, 54 herb practitioners and 154 adults from the normal population(60 urban samples and 94 rural samples). The collection was carried out by individual interviews for the physicians and normal samples, by letters for the psychiatrists and the herb practitioners. And the data of American psychiatrists compared in this study were quoted from Dohrenwend's report(27). This study has two parts: one is the cross-cultural comparison between American psychiatrists and Korean ones, the other is intracultural comparison among psychiatrists, physicians, herb practitioners and normal population samples. Inspite of the general notion that Korean psychiatry has been much oriented to American psychiatry for over twenty years, there are definite differences in opinion about the severity of abnormal behaviors between American and Korean psychiatrist, especially about alcoholic behavior and psychosomatic symptoms. Such differences are possibly interpreted as arising from the cultural differences. The American psychiatrists seem to be more concerned about alcoholic behavior probably due to the strict attitude of people and/or the fact that the United States reveals the highest incidence of alcoholism throughout the world. The Korea psychiatrists, however, have much tolerable attitude toward alcoholic behavior according to the cultural tradition. Solitary drinking is hardly found in Korea; drinking in Korea is a suitable way of interpersonal contact. They drink slowly and are not so intensively dependent upon alcohol itself. Dependency need to alcohol can be diffused to the other persons. And they take alcohol with many kinds of side-dishes. These drinking manners seem to be cultural virtues for low incidence of alcoholism in Korea. Thus, Korean psychiatrists as well as adults from normal population have highly tolerable attitude toward alcoholic behavior. Even when some person reveals a destructive behavior after drinking, they grant it as a personal charm. Korea psychiatrists, therefore, are not so nervous about the alcoholic behavior. On the other hard, the psychosomatic problems seem to be serious in Korean mental patients. They are easily apt to express their emotional problems as somatic symptoms possibly due to the disease concept of oriental herb medicine that has a high tendency of projection of emotional conflicts unto the soma. So most of Korean people are not aware that psychosomatic symptoms are originated from the emotional problems, and quite contrary to it, the psychiatrists may be highly conscious of psychosomatic symptoms. Another significant difference is seen in suicidal idea and suspiciousness: American psychiatrists regard them as more serious, and reversely Korean psychiatrists regard them as less serious. Such a pattern may also be derived from the socio-cultural differences. When Koreans are either dissapointed or delighted, they say frequently "I want to die" or "It's funny to death" and so on. This idiomatic expression is far from the real death wish but rather an expression of magnification. And the suicidal idea itself is frequently seen in normal population even suicidal attempt is evaluated as abnormal in Korea. With such reasons, Korean psychiatrists may notice suicidal idea as less serious than American psychiatrists. And the suspiciousness may be a way of living for the people under the historical turmoil and vigorous aculturation, that it is perceived as not so abnormal. The next problem is the marked discrepancy of opinion about abnormal behaviors among psychiatrists, physicians, herb practitioners and normal population samples. The agreement of physicians, herb practitioners, urban samples and rural samples with the psychiatrists on the relative severity of symptoms revealed as Spearman's rho of 0.79, 0.59, 0.58 and 0.44 respectively. It is the main point of problem that physicians are less aware of neurotic symptoms which can appear in the somatic illness, and of psychosomatic symptoms as psychiatric problem. Possible reason is that Korean physician have been oriented to the somatic medicine without proper psychosomatic orientation. On the other hand, the herb practitioners are apt to ignore the severity of psychotic symptoms and on the other, regard the neurotic and psychosomatic symptoms as much as psychiatrists' opinion. And the samples of normal population regard the neurotic symptoms as more serious than the psychotic symptoms, and are not aware of the psychosomatic symptoms as psychiatric problems. Physicians, herb practitioners and samples from the normal population underestimate the alcoholic behavior more than psychiatrists do. The alcoholism according to physicians' opinion is rather somatic problem than psychological one. The herb practitioners and adults from normal population manifest the prominently tolerable attitude toward alcoholic behavior. In conclusion, two kinds of problems can be suggested. One is that the difference between Korean and American psychiatrists in the evaluation on the severity of abnormal behaviors, is possibly due to sociocultural differences. The other is the intracultural difference among psychiatrists, physicians, herb practitioners and adults from normal population. Such a difference suggests that there is a considerable cultural lag in the disease concept and attitude between the modern psychiatry and the cultural tradition. This discrepancy can result in the undesirable wandering of patients for seeking the treatment and some hardship in modern psychiatric practitioning in Korea.
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