Culture, spirituality, and mental health. The forgotten aspects of religion and health.

Modern psychiatry has neglected the spiritual dimension of the human mind and the teleologic concept of illness as meaningful sufferings by clinging to the traditional causality principle and rationalistic orientations without clarifying the concepts of religion, spirituality, culture, and mental health. The Jungian viewpoint may bridge the age-old gap in the West between belief and science.

[Hundred years' psychiatry in Korea (1899-1999)].

The western medical knowledges of the human anatomy and physiology including knowledges of central nervous system have probably been introduced into Korea by Prince Sohyon Seja in 1645. The authentic education for the western medicine at the governmental and private medical schools, however, originated from 1899 and the education of mental disease was included in curriculum of Tai-Han-uiwon, the governmental medical school before 1910. In 1913 the first department of psychiatry (Department of Mental Disease) was established at the Chongdokbu-uiwon, the clinic of the Japanese colonial government, the former Korean governmental hospital which has later developed to the Kyongs ong Imperial University Hospital. On the other hand, there was in Severance Hospital Medical College, one Australian missionary psychiatrist McLaren, who has served at Paton Memorial Hospital in Jinju, Korea from 1911, taught neurology and psychiatry from 1913 at Severance Hospital Medical College, established psychiatry ward in 1923 at the Hospital, conducted the ward in humanistic way until 1940. It was the German psychiatry which the Japanese psychiatrists have brought to the Korean peninsula and it remained as major trends of psychiatry in Korea during the Japanese occupation between 1911 and 1945. The academic levels of Kyongsong Imperial University in psychiatry as well as the quality of mental care seemed to be almost equivocal to the psychiatry in Japan. However, psychiatrists scope of social psychiatric issues and of the research interests seemed to be somewhat narrow. Due to the political discrimination for the Korean students, the Koreans had less opportunity for the promotion at the university than Japanese residents in Korea. In 1945, after the end of the Pacific War only about 11 Korean psychiatrists were left in Korea, who organized Korean Neuropsychiatric Association. The Department of Neuropsychiatry of Seoul National University (former Department of Neurology and Psychiatry, Kyongsong Imperial University) was the center for psychiatry training. The Korean War (1950-1953) enabled the interchanges between. Korean and American military psychiatrist, and motivated great change in Korean psychiatry from biologic oriented German descriptive psychiatry to the American dynamic psychobiological psychiatry. The German educational clinical systems were completely displaced by the American system, when internship and residency training system was conducted since 1958. However, there were always attempts to integrate old traditional Korean wisdoms into the modern psychiatry and to introduce European approaches and knowledges in psychiatry. With the rapid industrialization and economic development of the country since the late 1960s and the prevailing social defensive attitudes towards mentally ill patients of the leaders of the military regimes the increase of private asylums appeared where many chronically ill mental patients were kept without adequate treatment. The reform of asylums in the mid 1980s was gradually proceeded by the government leading consequently to the increase of huge mental hospitals in the land. With the democratization of the political situation as well as the social welfare policy of the government in the 1990s and with the steady stimulation elicited by some NGOs Mental Health Act was enacted in 1995 and the community mental health centers were increasingly set up in several districts. In concern with research activities in psychiatry remarkable development in social cultural as well as biological fields are recognized especially since in the 1970s academic societies for the subspecialities of psychiatry have been organized which cover the various schools of psychotherapy, social psychiatry as well as many subspecialities of biological psychiatry. The number of training hospitals have been increased as the result, the number of psychiatry specialists was increased from 93 in 1956 to 1593 in 1999. KNPA (Korean Neuropsychiatric Association) internal and international activities has been expanded. Question is however, the quality of services and the quality of academic achievement. Gradually, the voice was raised to focus more on the quality of research and training activities.

[The introduction of the western psychiatry into Korea: from the mid seventeenth century to 1911, the time of Japanese forced annexation of Korea].

The object of this study is to investigate the routes of the introduction of the western psychiatric knowledges and practices in Korea. The historical documents including newspapers and governmental bulletins as well as articles and books on the history of the Korean medicine were examined and the results are as follows: The western knowledge about the brain anatomy and physiology were introduced from China by the enlightened Confucian and Taoistic scholars of Korea in the mid seventeenth century through the Chinese translations of the western science and medicine. Due to the lack of support for the scholars and even persecution by the ruling power to those who had great interests in the western thoughts including sciences, the western medical knowledges could not be actualized in practice. Thus, the active practices of western medicine were started in the late 19th century in Korea through the two routes; one, via Japanese military physicians and the other one, via the western missionary physicians. The psychiatry was lectured by Japanese psychiatrist in 1910 at the medical school of Tai-Han Unwon, the Korean governmental clinic and 1913 at the Severance medical school of Tai-Han Uiwon, the Korean governmental clinic and in 1913 at the Severance medical school by the Australian psychiatrist, McLaren. As the independent department with the psychiatric ward, the first Dept. of Psychiatry was established in 1913 at the colonial governmental clinic, Chosun Chondokbu-Uiwon, the former Tai-Han Ui-won. Medicine as well as psychiatry was introduced into Korea under the political atmosphere of one sided admiration for the western science. The attempts to combine the western medicine with the traditional Korean medicine could not be tolerated by both missionary physicians and the colonial regime.

Expression of Alzheimer's amyloid precursor protein in human lymphocyte.

Beta-amyloid precursor protein (betaAPP) has been shown to be involved in cell growth regulation. In spleen, the majority of cells showing betaAPP like immunoreactivity was found in the T cell-dependent zone. In Northern blot, the expression of betaAPP was increased to reach the peak at 72 h after the treatment of phytohemagglutinin (PHA). But, in cytofluorometry, almost all CD4(+) T helper/inducer cells and the majority of CD(8+) T suppressor/cytotoxic cells show betaAPP immunoreactivity which remained constant during the stimulation with PHA. These results suggest that betaAPP is a surface molecule of T lymphocyte and the turnover or release of APP might be increased with the treatment of T cell mitogen.

Encounter with the west-From my life and works.

This short essay grew out of remarks made by Dr. Rhi, the leading Jungian psychiatrist in Korea, to friends, colleagues, and students at the end of term in 1996 at Union Theological Seminary in New York, where he had been a visiting professor. He shows briefly, succinctly, with that mixture of earnestness and diffidence which characterizes him as a person and as an analyst, what led him to psychiatry as a profession and how his Jungian convictions and understanding brought opposites into easy relationship for him. Shamanism, Confucianism, Buddhism, and Christianity come together here. East meets West in that wholeness which Rhi, like Jung before him, holds always before him as both goal and achievement.

Reliability of the ICD-10 diagnostic criteria for research in mental disorders in the Republic of Korea.

The interrater reliability, confidence and ease of use of ICD-10 diagnostic criteria for research were assessed in the Republic of Korea as part of the field trials of World Health Organization collaborative study. A total of 279 patients were diagnosed according to the ICD-10 diagnostic criteria for research. Interrater reliability, calculated by kappa statistics, was found to be between 0.74 and 0.91 on 2-character categories and between 0.64 and 0.90 on 3-character categories except schizotypal disorder (F21). On the 4-character categories, the agreement in the affective states between raters was lower. The reasons are discussed based on cultural differences.

The health care seeking behavior of schizophrenic patients in 6 East Asian areas.

The patterns of health care seeking behavior of 1061 schizophrenics and the factors that affect the determination of the patterns were studied in 6 areas of 5 nations in east Asia: Hunan and Sichuan Provinces in China, Japan, Korea, Malaysia and the Philippines. The information was gathered through a structured questionnaire developed by the authors. The subjects generally favored psychiatry-oriented health care, but with frequent interruptions or combination with other types of managements. Most Japanese subjects sought care in western medicine, while subjects from Hunan, Sichuan and Korea alternated between western medicine and magicoreligious therapies or traditional herbal medicine. In the Philippines and Malaysia, the majority of the subjects sought magicoreligious therapies first, then later sought western psychiatric care. The choice of western psychiatric care was mostly influenced by the decision maker's knowledge and interpretation of the patient's illness. In determining the choice of management among various types of non-psychiatric management, cost, location, and societal attitudes played substantial roles as well as knowledge and interpretation. Suggestions and opinions were discussed to improve health care services for schizophrenic patients in each community.

[On the objectives and the contents of the course: "Introduction to medicine" - a literature investigation].

The education of Introduction to Medicine for the medical students can be traced back to the Hippocratic medicine in ancient Greece, when regarded some essays on the nature of medical care in Corpus Hippocraticum. However, its modern precurser may be the medical historian, Henry Sigerist who published the book: Einführung in die Medizin (Introduction to medicine) in 1931 on the basis of his lecture at Leipzig University. Influenced probably by the German medical tradition the education of the Introduction to Medicine has been flourished in the medical schools in Japan since 1941. In Korea the course has been introduced in 1971 and only few universities have adopted it as the regular course for medical students, while the education of behavioral science in the medical schools became more popular since 1970. The objectives and the contents of the education of the Intorduction to Medicine seem to be different according to the organizer of this course. This study deals with the questions about the objectives and contents of the Introduction to Medicine. Fourteen books by twelve authors entitled with either the Introduction to Medicine or the relevant one which were published in Japan, except for the above mentioned book of Sigerist since 1945 were under the investigation. The motivations and the purposes of the authors for the publications of the books and their contents were compared each other in which the guidelines for the education of Introduction to Medicine were indirectly reflected. ...

[Psychiatric care and its change under the Japanese government in Korea with the special reference to the clinical activities at the Colonial Government Hospital: 'Chosun-Chong-Dok-Bu Ui-Won' (1913-1927)].

The purpose of this is to elucidate the ways of introduction of modern psychiatric care into Korea and to demonstrate the changing patterns of psychiatric care during the time between 1913 and 1927. The study was focused on the clinical activities of the colonial governmental hospital on the basis of the annual reports of the hospital from 1912 to 1928. The investigation has revealed the fact that the first special institution for the care of the mentally ill patients was founded in 1911 in Seoul by the colonial government which was called "Che Saeng Won". It was also confirmed that the first clinical department of the psychiatry in Korea was established in 1913 at the colonial governmental hospital, "Chong-dok-bu Ui-won" which has taken over the role of psychiatric care from Che Saeng Won. The first chairman of the department of pspychiatry was Misuzu Nobuharu and his assistant was Shim Ho-Sub, the first Korean psychiatrist who became assistant professor of psychiatry at Kyongsung medical college in 1916-1917 but moved to Severance hospital and changed his speciality to neurology of internal medicine. The department had two physicians and 4 care persons at the beginning stage and 22 beds for the mentally ill patients in the hospital which had total 330 beds. Later, the department has developed to 54 bed clinic with 4 staff physicians. ...

[Studies on the history of psychiatric diagnosis of the western and the eastern medicine with special reference to the papers presented at the 16th Taniguchi Symposium on the Comparative History of Medicine East and West].

Scientific papers on the history of psychiatric diagnosis presented at the 16th International Taniguchi Symposium for Comparative History of Medicine-East and West which was held in 1991 in Japan were briefly reviewed and discussions and comments interchanged in this meeting were introuduced with some personal appreciation that the meeting was excellently organized and enormously successful. Particularly, the papers of medical historians and the expert in specific area like Indian medicine from North America and Europe were highly instructive. The informal gathering in the evening had offered a fascinating original report such as an old documentary film about Imu, a Japanese culture bound syndrome. One very important point was raised in this review that the comparisons between the Medicine-East and the West, particularly the translation of the Eastern medical descriptions of mental illness into the modern Western pschiatric terms should be very cautiously carried out, because by the crude identification of one medical system with the other system the uniqueness of the illness in a specific time and in a specific place might easily be overlooked. For both Japanese and Korean traditional medicine share with Chinese traditional medicine and yet they preserve their uniqueness, a small group study for comparative East Asian medicine was suggested for the more elaborated clarification of medical terms.