Past, Present and Future of Korean Psychiatry

HoYoung Lee 대한신경정신의학회 2004 PSYCHIATRY INVESTIGATION Vol.1 No.1

The history of Korean psychiatry can be epitomized along the stages of westernization and modernization of the nation. The opening of a psychiatric unit of the Japanese colonial government hospital was the first psychiatric treatment facility of western style in Korea, which was later followed by a more humane psychiatric service introduced by a missionary psychiatrist at Severance Hospital. The two mainstreams of Korean psychiatry during colonial days came to end by the outbreak of World War II. The Korean war was a turning point for the modernization of Korean psychiatry due to the influence of American medicine particularly to opportunities for a massive training of professional manpower during and after the war. Many young psychiatrists went abroad for training and their return and dedicated contributions highlighted the establishment of contemporary Korean psychiatry. Today, the level of biological researches attained a world level and the standards of psychiatric education system outstanding in it s excellence. Rapid paces of westernization and modernization was a busy journey to catch up with developed countries mainly to assimilate their progress. Now Korean psychiatry is in stalemate, however, for it now searches for a new identity and directions. For new directions, the suggested were 1) the discovery of a new identity of Korean psychiatry with historical perspective so that a new mind is set forward, 2) integration of brian not only with mind but also with culture, 3) a strategy to form East Asia regional network and hub for more active collaborations with East Asian countries, 4) and a vigorous training program for the leadership of global caliber of young Korean psychiatrists.

Psychiatry in Former Socialist Countries: Implications for North Korean Psychiatry

YoungSu Park,SangMin Park,JinYong Jun,SeogJu Kim 대한신경정신의학회 2014 PSYCHIATRY INVESTIGATION Vol.11 No.4

Very little information is available regarding psychiatry in North Korea, which is based on the legacy of Soviet psychiatry. This paper reviews the characteristics of psychiatry in former socialist countries and discusses its implications for North Korean psychiatry. Under socialism, psychiatric disorders were attributed primarily to neurophysiologic or neurobiological origins. Psychosocial or psychodynamic etiology was denied or distorted in line with the political ideology of the Communist Party. Psychiatry was primarily concerned with psychotic disorders, and this diagnostic category was sometimes applied based on political considerations. Neurotic disorders were ignored by psychiatry or were regarded as the remnants of capitalism. Several neurotic disorders characterized by high levels of somatization were considered to be neurological or physical in nature. The majority of “mental patients” were institutionalized for a long periods in large-scale psychiatric hospitals. Treatment of psychiatric disorders depended largely on a few outdated biological therapies. In former socialist countries, psychodynamic psychotherapy was not common, and psychiatric patients were likely to experience social stigma. According to North Korean doctors living in South Korea, North Korean psychiatry is heavily influenced by the aforementioned traditions of psychiatry. During the post-socialist transition, the suicide rate in many of these countries dramatically increased. Given such mental health crises in post-socialist transitional societies, the field of psychiatry may face major challenges in a future unified Korea.

노인정신의학 : 개요 Overview

오병훈 大韓神經精神醫學會 2002 신경정신의학 Vol.41 No.5

노인정신의학은 정신의학의 한 가지(A branch of psychiatry)이며, ″Old Age Psychiatry″로 명명한다. 노인정신의학은 출발은 노인정신질환은 다른 신체적, 정신적인 질환과 마찬가지로 치료되어 질적인 삶을 유지할 수 있다는 기본에서 출발하였다. 지난 10년간의 대한노인정신의학회를 주축으로 한 노인정신의학의 발전은 연구 분야가 몇몇 분야에 집중되었기 때문에 향후 연구의 폭을 넓혀야 할 과제를 제시해 주고 있다. 특히 만성적인 질병과 노화에 따른 부정적인 면뿐만 아니라 노년기에 일어나는 긍정적이고 창조적인 변화에 대한 연구가 필요하다고 지적하였다. 교육의 측면에서도 소수의 독점적인 아닌 노인정신의학의 폭넓은 발전을 위해서는 실제적으로 노인들에게 도움을 줄 수 있는 방향에서 구체적인 역할을 가지고 의과대학에서부터 fellowship의 과정에 이르기까지 체계적이며, 효율적인 노인의료전달체계를 구축하여 활동하는 체계를 이루어야 하는 함이 제시 되었다. 아울러 노인정신의학이 발전하기 위해서는 우선 의학의 생물학적 노화의 개념에서 벗어나 노년기를 발달사적 견해로 볼 수 있어야 하며 사회정신학적 발달사의 접근으로 노인을 새롭게 이해해야 함이 강조되었다. 결론적으로 볼때, 노인정신의학의 발전방향은 노인 정시건강증진의 차원에서 질적인 삶의 보장은 물론 창조적 삶의 지향이 가장 중요한 의식의 전환으로 제시되어야 할 것이다. 또한 노인환자를 위한 서비스체계의 구축 및 운영에 있어서 행정적 지원체계 구축도 발전방향의 한 축으로 반드시 제시되어야 할 것이다. 나아가 노인정신의학의 기반이 되는 학문적 발전의 국내 외의 폭넓은 교류에 중추적, 주도적 역할을 위한 체계적인 교육, 연구 및 인력양성이 노인정신의학의 Vision으로 제시되어야 할 것이다. ″Old Age Psychiatry″ is a branch of psychiatry. WHO, WPA and IPA strongly suggest that the Old Age Psychiatry is directed to ″Lead(Guide) best possible care of geriatric patients and their families, Education and training for all health and social care workers, Development of appropriate training manuals with culturally appropriate material, Encourage the direction of geriatric psychiatry health policy. To the development of Old Age Psychiatry. Integrated approach and paradigm, Prevention, diagnosis and rehabilitation and Multidisciplinary approaches is essential. And strategies for mental health services, ″Systemic care services and Delivery care services″ is needed. When we review of past 10 year of Old Age Psychiatry in Korea, we have problems such as Inadequate human resources, Training issues, Multi-disciplinary infrastructure, Economic issues. But we hope that Old Age Psychiatry in Korea has a potential to develop and it should be overcome with enthusiasm and patience. In conclusion for the future development of Old Age Psychiatry, Old Age Psychiatry must be based on the disorders in elderly can be treated successfully and improving quality of life and creating of life.

Karl Jaspers’ General Psychopathology (Allgemeine Psychopathologie) and Its Implication for the Current Psychiatry

Seon-Cheol Park 대한신경정신의학회 2019 PSYCHIATRY INVESTIGATION Vol.16 No.2

Karl Jaspers is a psychiatrist, philosopher, and humanist. In 1913, he published the General Psychopathology (GP; Allgemeine Psychopathologie), the first edition. Despite the passage of one hundred years after the GP was published, GP still has a potential value to present a phenomenological and comprehensive viewpoint for psychiatry to overcome Kraepelinian -biological absolutism. The philosophical backgrounds of a Jaspersian phenomenological sense have been related to both the transcendence and the immanence roots. Partly under the influence of a Husserlian distinction between the natural and phenomenological attitudes, a rigid distinction between explanation and understanding has been proposed as the proper epistemological method in Jaspers’ GP. Further, the fact that a distinction between process and development has been presented as the psychical phenomenon is understandable. The integrated and comprehensive viewpoint establishment for the state of “Babylonian confusion of tongues” in German psychiatry as well as the newly initiating phenomenological trend in psychiatry have been the legacies of Jaspers’ GP. Moreover, the common theoretical backgrounds may be shared by the Jaspersian sense and humanitarian approaches in Korean psychiatry. Also, the Jaspersian sense may help the current molecular psychiatry to have a chance to overcome its solipsism and limitations.

Is Psychiatry Scientific? A Letter to a 21st Century Psychiatry Resident

Jose de Leon 대한신경정신의학회 2013 PSYCHIATRY INVESTIGATION Vol.10 No.3

During the development of the DSM-5, even the lay press questioned psychiatr's scientific validity. This review provides 21st century psychiatry residents with ways of answering these attacks by defining the concepts and history of psychiatry (a branch of medicine), medicine and science. Psychiatric language has two levels: first, describing symptoms and signs (19th century descriptive psychopathology developed in France and Germany), and second, describing disorders (psychiatric nosology was developed in the early 20th century by Kraepelin and resuscitated by the US neo-Kraepelinian revolution leading to the DSM-III). Science is a complex trial-and-error historical process that can be threatened by those who believe too much in it and disregard its limitations. The most important psychiatric advances, electroconvulsive therapy and major psychopharmacological agents, were discovered by "chance", not by scientific planning. Jaspers's General Psychopathology is a complex 100-year-old book that describes: 1) psychiatric disorders as heterogeneous and 2) psychiatry as a hybrid scientific discipline requiring a combination of understanding (a social science method) and explanation (a natural science method). In the 21st century Berrios reminds us of psychiatry's unfortunate methodological issues due to hybrid symptoms and disorders, some of which are better understood as problems in communication between interacting human beings; in those situations neuroscience methods such as brain imaging make no sense. A new language is needed in psychiatry. East Asian psychiatry residents, who are not particularly attached to the antiquated language currently used, may be particularly equipped for the task of recreating psychiatric language using 21st century knowledge.

Medical students' attitudes toward psychiatry in a Korean medical college

Koh, Kyung Bong Yonsei University, College of Medicine 1990 Yonsei medical journal Vol.31 No.1

새로운 정신의학의 꿈: 윌리엄 메닌저(William C. Menninger)와 정신분석학

이남희 의료역사연구회 2023 의료사회사연구 Vol.12 No.-

2차 세계대전 직후 미국 정신분석학회의 회장을 맡은 윌리엄 C. 메닌저(William C. Menninger)는 정신분석학이 이전까지 고수하던 자신들만의 전문성을 강조하는 고립적인 지위에서 벗어나 좀 더 적극적인 사회적역할을 해야 한다고 역설하였다. 이를 위해 정신의학 분과와의 긴밀한 관계를 수립해야 하며 좀 더 대중적으로거듭날 필요가 있다고 생각하였다. 이는 당시 2차 세계대전을 통해 미국 사회에서 정신건강에 대한 중요성이 드러나며 관련 분과의 발전이 절실한 가운데 갖게 된 인식이었다. 2차 세계대전 중 정신과 의사로서는 가장 높은지위에 올랐던 메닌저는 전후 미국 사회의 정신건강 증진을 위해서 정신의학과 관련된 학문이 양적으로나 질적으로 발전해야 한다고 생각하였다. 그는 이를 위해 종사자 수의 증가나 연구의 확대 등과 같이 정신의학 분과의규모를 확장시킴과 동시에 정신의학이 대중 친화적 요소를 지녀야 한다고 생각하였다. 그리고 이러한 변화를 위해서 폐쇄적인 특성을 보였던정신분석학 자체의 변화를 촉구함과 동시에 프로이트의이론을 기반으로 한 인간의 발달을 설명하는 이론인 정신역동 이론의 주요 개념과 이론을 자신의 저서에 적극적으로 소개하였다. 이 글에서는 메닌저의 1948년에 출간된 세 권의 저작을 포함한 연구를 분석하여 메닌저가추구했던 정신의학 분과의 발전 방향을 살펴보려 한다. 특히 정신역동 이론을 미국 정신의학 분과에 적극적으로수용하는 데 큰 공헌을 했다고 평가받는 메닌저가 당시의 현실을 어떻게 인식하고 있었으며, 전쟁신경증에 대한 대규모 대응이라는 자신만의 경험을 바탕으로 어떤 해법을 추구했는지를 살펴본다. 이를 통해 미국 정신의학의 정신분석과 관련된 전통과 독특한 특성의 연원을 알아보고자 한다. After World War II, psychiatry eagerly wanted to reform the discipline and develop its systematic structure. Among many who tried to establish a new structure of discipline, there is William C. Menninger who ranked the highest level, Brigadier General, during WWII. Delving into the career of William C. Menninger and his scholarly works, this paper strives to capture his quest for rebuilding psychiatry by adopting the theory of psychoanalysis into psychiatry. As a psychiatrist, who had both military and non-military experiences of medicine, and who had been trained as a psychoanalyst himself, Menninger tried to effectively organize psychiatry, so that the discipline could become the spearhead to build a healthy and sane American society. However, the reality that psychiatry had faced during the war was not promising in that sense. At the turn of the century, the discipline had been immersed itself into either state hospitals or individual clinics. These limited experiences could not be utilized for unprecedented large-scale warfare. Menninger, with his experiences during the war, figured out the differences between the goal of military psychiatry and civilian psychiatry. Especially, while the war had been close to the end, there was urgent need to make psychiatry fit in the post-war environment. Menninger believed that it should be psychiatry that could manage this drastic environmental changes by appropriating the psychodynamic theory from psychoanalysis.

일본의 사회정신의학의 역사

한선호(Sun Ho Han),仲村禎夫(Nakamura Sadao ) 대한사회정신의학회 2000 사회정신의학 Vol.5 No.1

연구목적: 이 연구의 목적은 일본의 사회정신의학의 역사를 연구하여 한국의 사회정신의학의 발전을 도모하기 위함이다. 연구방법: 여러 문헌고찰을 통하여 일본의 사회정신의학의 정의와 대상, 사회의 변천 및 법률개정에 따른 사회정신의학의 변화를 알아보았다. 결 과: 사회정신의학회에서 발표된 연제는 다음과 같이 분류할 수 있다. 1) Community Psychiatry (지역사회정신의학), 2) 정신보건(노동환경에서 일어나는 정신보건, 학교정신보건 등), 3) 가족정신의학의 문제, 4) 정신장해-정신의료에 대한 접근, 5) 사회병리에 대한 접근. 결 론: 한국의 사회정신의학의 발전을 위해서는 1) 세부분류의 체계화가 이루어져야 하며, 2) 여러 학제간의 논의와 상호간의 공동연구가 요구되고, 3) 더 나아가서 국제 적인 비교 및 공동연구가 필요하다. Objectives:The purpose of this study was to contribute to the development of Korean social psychiatry by researching history of Japanese social psychiatry. Methods:By reviewing several literatures, authors investigated changes of definition and object of Japanese social psychiatry and also studies of changes of social psychiatry result from alterations of society and laws in Japan. Results:Subjects presented in the social psychiatry association could be classified into the following;1) Community psychiatry, 2) Mental health(mental health in labor environments, school mental health etc.), 3) problems in family, 4) approach to mental disorder - mental care, 5) approach to sociopathology. Conclusions:To develop Korean social psychiatry;1) subclassifications must be systematized, 2) discussions and cooperations among variable scientific societies should be made, 3) furthermore, international comparison and cooperative study must be indispensable.

법정신의학의 개략

장동원(Dong Won Chang) 대한사회정신의학회 2000 사회정신의학 Vol.5 No.1

법정신의학은 법과 정신의학이라는 서로 다른 두 전문분야가 만나는 부분을 다루는 학문이다. 법정신의학은 크게 두 분야로 나눌 수 있는데 하나는 법의 집행에 정신의학이 관여하는 부분이고 다른 하나는 정신과 치료에 대한 법적인 규제가 된다. 현재 법정신의학에서 문제가 되는 주요 이슈로는 행위능력, 의료과오, 형사책임능력, 고지후 동의, 비자발적 입원, 비밀보장 등이 있다. Forensic psychiatry operates at the interface of two disparate disciplines:law and psychiatry. Although most cases in forensic psychiatry practice produce no conflicts, functioning at the interface of these two disciplines can lead to confusion and ethical dilemmas. Forensic psychiatry can be divided roughly as the psychiatry in the practice of the law and legal regulation of psychiatry. Some major issues in forensic psychiatry are reviewed briefly.

A Foundation for a “Cheerful Society”: The Korean War and the Rise of Psychiatry

신지혜,임성빈 대한의사학회 2023 醫史學 Vol.32 No.2

One of the most remarkable medical achievements of the Korean War was the development of psychiatry. During the Korean War, soldiers and prisoners of war (POWs) experienced “gross stress reaction” and manifested poor concentration and memory as well as clinical depression and social alienation. Rest and relaxation rotations served as the primary treatment for their conditions. Civilians also bore the brunt of the war’s effects. Delusions of grandeur and megalomania appear to have been common among Koreans, but there were few mental health facilities to provide treatment and care. Out of the furnace of war, psychiatry emerged as a newly specialized field, and in the 1950s, Korea became the very place where military psychiatry training under the U.S. military laid the groundwork for civilian psychiatry. This essay aims to enrich the study of mental illness during and after the Korean War by providing a more detailed picture of the mental problems experienced not only by veterans and POWs, but also by civilians in Korea. Examining mental health issues from this period is challenging due to the scarcity of resources for delving into the minds of the civilians involved. Taking military psychiatry as a starting point, this essay goes beyond existing scholarship to discuss psychiatry-related responses to the Korean War, including the influence of military psychiatry on civilian psychiatry, the endeavors of medical professionals and government policies, and contemporary expressions of mental distress during and after the war.