Psychiatry Investig.  2014 Oct;11(4):363-370. 10.4306/pi.2014.11.4.363.

Psychiatry in Former Socialist Countries: Implications for North Korean Psychiatry

Affiliations
  • 1Department of Anthropology, Stanford University, Stanford, CA, USA.
  • 2Center for Medicine and Korean Reunification, Seoul National University College of Medicine, Seoul, Republic of Korea. psychical@hanmail.net
  • 3Department of Family Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea.
  • 4Department of Psychiatry, Settlement Support Center for North Korean Refugee, Ministry of Unification, Anseong, Republic of Korea.
  • 5Department of Psychiatry, Seoul National University Hospital, Seoul, Republic of Korea.

Abstract

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 Treatment of psychiatric disorders depended largely on a few outdated biological therapies.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.

Keyword

Psychiatry; Socialism; North Korea

MeSH Terms

Biological Therapy
Capitalism
Democratic People's Republic of Korea
Hospitals, Psychiatric
Humans
Korea
Mental Health
Neurotic Disorders
Psychotherapy, Psychodynamic
Psychotic Disorders
Social Stigma
Socialism
Suicide
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