Predicting Behavior Problems in Korean Preschoolers: Interactions of the SLC6A4 Gene and Maternal Negative Affectivity

OBJECTIVE: This study aimed to investigate whether maternal negative affectivity (MNA) moderates the effect of genetic polymorphism of SLC6A4 on behavior problems in children. METHODS: Study participants comprised 143 preschoolers and their mothers from South Korea. The Childhood Behavior Checklist and Emotionality, Activity, and Sociability adult scale were used to measure child behavior and maternal affectivity. DNA from saliva was genotyped to determine serotonin transporter polymorphism. RESULTS: MNA appeared to exert effects in externalizing (b=5.78, p<0.001) and internalizing problems (b=6.09, p< 0.001). Interaction between SLCA4 polymorphism and MNA showed effects on externalizing (b=−7.62, p<0.01) and internalizing problems (b=−9.77, p<0.01). Children with two short alleles showed considerable differences in both externalizing and internalizing problems according to MNA; however, children with one short allele or none showed relatively few differences in behavior problems due to maternal affectivity. CONCLUSION: The effect of SLC6A4 polymorphism on child behavior seemed to be moderated by MNA. In addition, the impact of MNA was found to vary based on a child’s genetic risk. High MNA may trigger the risk allele while low MNA causes the risk allele to illicit less behavior problems. Children with two short variants of the SLC6A4 gene may benefit from intervention that modulates MNA.

Hermann Hesse's Depression, Pietism, and Psychoanalysis / 신경정신의학

Hermann Hesse's personal life (1877–1962) is characterized by traumatization caused by suppressive pietistic discipline of his parents during his youth, and depression in his middle age accompanied by psychoanalysis treatment. At the age of 15, he was admitted to mental institutions due to defiant behavior. With this traumatic experience, his psychosexual development seemed inhibited during his adolescence. At age 39, depression developed precipitated by the death of his father. Hesse had received Jungian psychoanalysis from Dr. Lang and Dr. Jung over a 10-year period. However, psychoanalysis could not prevent the recurrence of depression. His appreciation of psychoanalysis became critical. Meanwhile, Hesse announced that he had been a Protestant Christian. In his 50s, he began to create new novels which, beyond polarity based on Jungian psychoanalysis, described the journey toward a greater harmonious and spiritual oneness. Pietism was at one time the reason of his pain, but became life-long support for Hesse's spiritual maturity. He was diagnosed with type II bipolar disorder. The main dynamic factors are thought to be ambivalence, feelings of guilt regarding his aggression toward his parents, and sexual conflict. His coping mechanisms seemed to include pietistic self-control, avoidance, scholarship and creation of literature. By writing the autobiographical Bildungsromans, Hesse tried not only to master his own personal problems but to enlighten readers. However, it seemed that he could not overcome the feelings of guilt associated with leaving his father.

Research on Psychiatric Treatment by Psychiatrists of Chosun-Governor Hospital and Keijo Imperial University Hospital in Korea during Japanese Colonial Rule / 신경정신의학

This review describes the types of psychiatric treatment studied during the Japanese colonial period of 1910–1945 in Korea, known at the time as Chosun. Twenty-nine research papers and abstracts on psychiatric treatment were reviewed, which were published in the Shinkeigaku-zassi (Neurologia), the Seishin-shinkei-gaku zassi (Psychiatria Et Neurologia Japonica) and the Journal of Chosun Medical Association, by faculty members of the department of neuropsychiatry, Chosun-Governor Hospital and Keijo (Seoul) Imperial University School of Medicine. The major research area was biological psychiatry and biological treatment, as Japanese pioneers in psychiatry at that time had introduced German psychiatry into Japan. Professor Kubo published the most papers, followed by Dr. Hattori, Dr. Hikari, and Professor Suits. In Chosun-Governor Hospital, research on prolonged sleep therapy was an active field. In the Imperial University Hospital, malarial fever therapy, sulphur-induced fever therapy, and insulin shock treatment were the most frequent research topics. Some were tried for the first time in the Japanese Empire, which reflected the pioneering position of the university. These achievements are attributed to Professor Kubo. Six papers on psychotherapy were published. Among them, two papers were on persuasion therapy, three papers were case reports of psychoanalytic therapy, and one paper on Freud. However, this psychoanalytic therapy research seemed to be limited trials conducted following literal guidance, and no further development was noted. Generally, research was characterized by simple design, small numbers of subjects, lack of objective evaluation method, lack of statistical treatment, and especially lack of ethical consideration comparing with today's standard.

Research by Psychiatrists of Chosun Chongdokbu Hospital and Keijo Imperial University in Korea during Japanese Colonial Rule / 신경정신의학

Eighty-three of 114 original articles and abstracts of research published by neuropsychiatrists of Chosun Chongdokbu Hospital (the Japanese colonial government hospital in Korea) and Keijo (Seoul) Imperial University Hospital during the Japanese colonial period (1910-1945) in journals including Shinkeigaku-zassi (Neurologia), Seishin-shinkei-gaku zassi (Psychiatria Et Neurologia Japonica), and The Journal of Chosun (Korea) Medical Association were reviewed. Most articles were on clinical research based on descriptive and biological psychiatry while only 4 articles were on dynamic psychiatry, probably because Japanese pioneers in psychiatry had introduced German psychiatry into Japan during the 1880s. The first paper was written by Dr. Shim Ho-sub. Professor Kubo of Keijo (Seoul) Imperial University published most articles, followed by Dr. Hikari, Dr. Hattori, and Dr. Sugihara. There were more articles on symptomatic psychosis and morphine addiction, followed by general paralysis, schizophrenia, neurological diseases, narcolepsy, epilepsy, and neurasthenia. The meaningful articles even for today were comparative studies between Japanese and Koreans and articles on opioid use disorder in Korea. Authors reported a markedly lower rate of psychotic inpatients in the population of Koreans compared with Japanese. Japanese researchers argued that, because of simpleness in social life in Korea and less violence or excitement in symptoms, Korean mental patients could be cared for by family or members of the community, or be treated by shamanism rather than bringing them to a public mental hospital, and poverty also prohibited hospital care. Finding of higher ratio of schizophrenia to manic-depressive psychosis among Koreans than Japanese was discussed in relation to delayed cultural development of Korea compared to Japan. In addition, traditional customs prohibiting marriage between relatives in Korea was related to low prevalence of manic-depressive psychosis, local endemic malaria was related to low prevalence of general paresis, and poor general hygiene was related to high prevalence of epilepsy. Unclear (undifferentiated) form of psychotic symptoms including hallucination and delusion was reported in more Koreans than Japanese. Also Korean patients showed a more atypical form in diagnosis. Authors added that they had found no culture-specific mental illness in Korea. However, no Korean psychiatrists were included as author in such comparative studies. Comparative studies on constitution between Koreans and Japanese mental patients and prisoners were also unique. However, no Korean psychiatrists participated in such comparative studies. In studies on morphine addiction in Koreans, Japanese researchers argued that such studies were necessary to prevent introduction of morphine-related criminal phenomena to Japan. Meanwhile, Dr. Kubo had left a notion on adaptation problems of Japanese living in the foreign country, Korea. Nevertheless he reported nothing about psychosocial aspects of mental illness in relation to political, cultural, and economic difficulties Koreans were experiencing under the colonial rule of Japan. These general trends of studies based on German biological and descriptive psychiatry and policies of colonial government to isolate "dangerous" mental patients in hospital appeared to reflect colonial or ethnopsychiatry of those days. These policy and research trends seem to have worsened stigma attached to mental disorders. Japanese tradition of psychiatric research was discontinued by return home of Japanese scholars with the end of WWII and colonial rule.

Professor McLaren (2). His Theories of Psychiatry / 신경정신의학

Professor Dr. Charles I. McLaren (1882-1957) of the Department of Psychiatry, Severance Union School of Medicine in Seoul, Korea had introduced not only Christianity but medicine and psychiatry of his time with his own theories to Korea while he had served as a Christian missionary from Australia to Korea from 1911 to 1941. Based on his view of Christianity and knowledge of modern science and medicine, he tried to explore the etiology, symptoms, treatment and spiritual meaning of mental disorders including general paresis, dementia praecox, mania, melancholia, paranoia, neurasthnenia, hysteria, hypochondriasis, and even psychophysiological disorder. Though he accepted that mental disorders are related to disrupted functions of brain or neurons, he believed that fundamental causes of insanity is spiritual. Regarding etiology, he suggested that people's choice not to follow God's logos by their free-will and consequent disharmony with nature or human society or failure of self to adapt to reality causes mental disorders. And he explained psychotic phenomena in view of Christian spirituality. In addition, he argued "psychic" (psychological or spiritual) conflict, sensitivity and guilt feeling as a possible etiology of psycho-neurosis including neurasthenia, hysteria and hypochondria. Conflict includes not only sexual conflicts but social conflicts related to family, job, money, or guilt feeling. He also emphasized the meaning and purpose of life in relation to development of mental illness. Remarkably, he introduced idea of "spill-over" to explain how emotional problems influence autonomic dysfunction resulting in psycho- physiological symptoms. He can be recognized as a psychiatrist who integrated bio-medical descriptive psychiatry with psycho-social approach, dynamic psychotherapy and even spiritual approach as a fundamental one. Though many scientific criticism can be given to his theories of psychaitry, he is deserved to be rediscovered and recognized as a pioneer who had shown another apprach to mental disorders to present psychiatrists who are lost in confusion with so many uncertainties in regard to understanding and treating mental disorders.

Psychiatric Disorders of North Korean Defectors in South Korea : Four Case Report / 신경정신의학

OBJECTIVES: Cases of psychiatric disorders are reported with a review of literature on mental health problems in North Korean defectors in South Korea. METHODS: Four patients who were admitted to a psychiatric hospital with major depression, schizophrenia, bipolar affective disorder, or mixed disorder of conduct and emotions of adolescent were studied. RESULTS: The most common precipitating factor was the separation from close persons they had been dependent on. Defector-specific stress included unfamiliar culture of South Korea, lack of ability to adapt to South Korean society, uselessness of past education and professional skills, stress with regard to being identified or discriminated as a North Korean defector, and guilt feeling for leaving their family behind in North Korea. North Korean defector-specific clinical findings were noted; these included reluctance to expose themselves as North Koreans, negative emotional reaction to discrimination of South Korean neighbors, submissive and passive attitude, loneliness, anxiety for the future related to refugee status, and strong stigma related to psychiatry. CONCLUSION: This case report suggests that an individualized or tailored treatment that considers their unique psychosocial situation, which especially focuses on discrimination and social support, is needed for North Korean defectors with mental disorders.

Professor Charles I. McLaren, MD (1) : His Life and Medical Philosophy / 신경정신의학

Professor Charles I. McLaren (1882-1957) was an Australian Christian missionary and a professor of psychiatry in Korea. As the first psychiatrist from a Western country, he accomplished tremendous achievements in clinical, teaching and writing activities as well as in his missionary work. He graduated from the University of Melbourne in 1906 and, after residency training under Professor Dr. Sir Richard Stawell at the Royal Melbourne Hospital, he and his wife came to Korea in 1911. He practised medicine at Margaret Whitecross Paton Memorial Hospital in Chinju, Korea and later was appointed as a professor of psychiatry at the Severance Union Medical School in Seoul, Korea. He left Korea for a while to participate in WWII as a military doctor and he also once traveled to Vienna to learn new skills, including fever therapy and psychoanalysis. Because of his love for the Korean people, Dr. McLaren not only introduced into Korean society modern Western psychiatry and a humanitarian approach to patients with mental disorders, but he also practised medicine according to his own unique medical philosophy drawn from Christian spirituality and he educated Korean native students in psychiatry and Christianity. He and his wife also made efforts to improve old customs in Korean society. Because he argued against Japan's enforcement of emperor-worship, he had to resign from the Severance Medical College in 1939, and he returned to Chinju. Immediately after the bombing of Pearl Harbour, he was arrested, imprisoned, interned, and subequently expelled to Australia in 1942. In Melbourne, received wide press coverage and great controversy. He lectured widely and contributed to various professional and other publications, covering not only subjects in Christianity and medicine/psychiatry, but also his opinions about the war and Japan, communism and the White Australia policy. As a Christian me-dical doctor and scientist, he was interested in the "nature of man", the relationship or interaction between body (brain and/or material) and mind/spirituality, the origin of human consciousness in relation to time-space energy, the healing of disease, and the etiology of mental illness and spiritual treatment. He was passionate in his stated belief that God's Word applied to the whole spec-trum of human relationships, from personal to international, as well as to the natural world. Dr. McLaren kept his conservative Christian beliefs, but he respected traditional Asian philosophies. His thoughts and experiences were publically expressed through lectures, journals and books, not only in Korea but also in China and Australia. He was a man of compassion, courage and ceaseless intellectual activity, a pioneer of psychiatry and a lifelong explorer of the Bible. Korean psych-iatrists, who may feel confused by the many complicated new medical theories and advanced technologies, still find Dr. McLaren's simple and clear teachings on science, medicine, and human nature and his practice of caring for mental patients with a compassionate, humanitarian and Christian attitude a challenging example to emulate.

The Sociodemographic and Clinical Characteristics of Patients in the Multi-Cultural Mental Health Clinic / 신경정신의학

OBJECTIVES: This study investigated changes in the clinical characteristics of foreign patients receiving psychiatric treatment in a public mental hospital in Seoul over the last nine years. METHODS: We compared the sociodemographic and clinical characteristics of a multi-cultural mental health (MCMH) clinic group of 49 foreign psychiatric patients, who had attended the newly opened special clinic for foreigners during the period August 2009-2010, with those of a general group of 71 foreign psychiatric patients, who had been treated in conventional ways during the period 2002-July 2009. RESULTS: The MCMH clinic group was characterized by voluntary attendances with the assistance of family, friends or supporting organizations. The patients were more likely to have resided longer in Korea, to have Korean citizenship, to be young married immigrant women and to have children. They were also more able to communicate by themselves or with the support of bilingual interpreters and were more likely to receive outpatient-based treatment and to experience longer periods of treatment. In contrast, the general group was characterized by involuntary hospital attendances supported by the police or the embassies of their home countries, and patients received inpatient services. They were also discharged sooner to be sent back to their home countries. Depressive disorder, anxiety disorder, and adjustment disorder were more common in the MCMH clinic group, while schizophrenia, bipolar disorder and a past history of psychiatric disorders were more common in general group. In the MCMH clinic group, those patients with Korean citizenship or permanent residency seemed to maintain consistent and stable treatment with a good prognosis. CONCLUSION: The findings from the specialized multi-cultural mental health clinic suggest that specialized setting for foreigners is more efficient in helping them, particularly for married immigrant women. This means that specialized systematic evaluation and treatment approach needs to be developed to provide culturally relevant mental health services for foreigners living in Korea.

No Evidence of an Association between A218C Polymorphism of the Tryptophan Hydroxylase 1 Gene and Aggression in Schizophrenia in a Korean Population

PURPOSE: We investigated the association between the tryptohan hydroxylase 1 (TPH1) gene and aggression in schizophrenia in a Korean population. MATERIALS AND METHODS: The sample included 61 aggressive patients as well as 104 non-aggressive patients from psychiatric hospitals and 335 healthy volunteers in Korea. Blood samples were collected from all participants for TPH1 A218C genotyping. The patients were administered standard psychiatric interviews as well as a self-report questionnaire for anger-related traits. RESULTS: In the case-control phenotypic comparisons, there was no significant association between the aggressive patients and the TPH1 A218C polymorphism. There was no significant effect of the TPH1 genotype on the anger-related traits, or no significant interaction between the genotype and group (aggressive and non-aggressive patients). CONCLUSION: These findings suggest that TPH1 does not play a major role in aggressive behavior via anger in schizophrenic patients.

Discrimination of Symptoms for Diagnosis of Hwabyung / 신경정신의학

OBJECTIVES: This study aimed to identify the essential symptoms for diagnosing Hwabyung. METHODS: We assessed 221 patients with depressive disorders, anxiety disorders, somatoform disorders, adjustment disorder, and so-called Hwabyung, using a structured diagnostic interview schedule that included the Korean version of SCID-I and the preliminary diagnostic criteria for Hwabyung. To select essential symptoms for diagnosing Hwabyung, we performed statistical analyses including factor analysis and logistic regression RESULTS: Statistical analysis revealed that sensations of heat, an epigastric mass, and something pushing up in the chest ; feelings of unfair treatment ; anger ; respiratory stuffiness ; palpitations; headaches ; sighing ;"haan" ; depressive mood ; frightening easily ; dry mouth; and many thoughts were the essential symptoms for a diagnosis of Hwabyung. CONCLUSION: Based on these results, we suggest a research diagnostic criteria for Hwabyung.

Quality of Life of North Korean Defectors in South Korea : Three Years Follow-Up Study / 신경정신의학

OBJECTIVES: This study evaluated the quality of life (QoL) of North Korean defectors in South Korean society in the year 2007 for purposes of comparing it to their QoL in 2004 and identifying demographic variables that influence QoL. METHODS: We used the Korean version of WHOQoL-BREF to evaluate the QoL of 106 North Korean defectors. Other instruments included a questionnaire for discerning demographic data, life experiences, and physical health. RESULTS: For last 3 years, more defectors had higher education, married, and higher income. However, their unemployment numbers did not decrease, while their number of believers in a religion did decrease. QoL scores remained low in the areas of negative feelings, financial resources, dependence on treatment and drugs, recreation and leisure activities, and opportunities for new information and skills, but were high in areas of cognitive mental functions, personal beliefs, work capacity, self-esteem, and transportation. Path analysis suggested that the psychological domain influenced overall QoL while other domains influenced overall QoL indirectly, through the psychological domain. Since 2004, defectors' QoL in the physical domain and in opportunities for education and transportation had improved, while QoL with regard to pain and discomfort, mobility, and negative feelings had worsened. Variables that were negatively correlated with QoL included male sex, higher age, being married, experiencing army service in North Korea, and shorter stays in third countries. In South Korea, QoL was negatively correlated with current physical illness but positively correlated to having a family, a stable job, higher income, and someone to talk with. CONCLUSION: These results suggest that defectors' QoL would be improved by tailored services according to their sex and age, focusing on educational programs to provide new information and skills, support for building families, health services, and community support.

Development of Hwa-Byung Scale and Research Criteria of Hwa-Byung / 신경정신의학

OBJECTIVES : The aim of this study was to identify the characteristic symptoms for diagnosis of Hwabyung (HB), a culture-related anger syndrome in Korea; to construct a rating scale for HB and test its validity and reliability; and propose diagnostic criteria for HB. METHODS : Subjects were male and female Korean patients, who were diagnosed following Structured Clinical Interview (SCID) as having depressive disorders, anxiety disorders and somatoform disorders and who reported as having self-labeled HB. A HB Scale was constructed with 22 of the most common symptoms of HB as identified by previous studies. The HB scale's inter-rated reliability was tested with 60 subjects. Its validity was tested by comparison between a HB only group(n=47) and depressive disorder only group (n=44). Logistic regression analysis was conducted to make a predictive model of HB. Based on these results diagnostic criteria for HB was proposed. RESULTS : Inter-rated reliability in each of all the items and the total score of the HB Scale were statistically significant. The HB scale differentiated HB from depressive disorder with statistical significance. In logistic regression analysis, the ability of the HB model to predict symptoms of heat sensation, ukwool/boon (feeling of unfairness), and subjective anger was high with sensitivity of 80.0%, specificity of 88.4%, accuracy of 84.1% and area under ROC of 0.92. Based on these results and information from previous research, diagnostic criteria of HB were formulated. CONCLUSION : The HB Scale was found to be reliable and valid. Consequently, diagnostic criteria of HB were proposed, to include subject anger, "kwool/boon" (Feeling of unfairness), expressed anger, heat sensation, hostility, "haan", pushing-up in the chest, epigastric mass, respiratory stuffiness, palpitation, dry mouth, sighing, racing thoughts, and lamentation.

Effects of Paroxetine on Symptoms of Hwa-Byung / 대한정신약물학회지

OBJECTIVE: This study consists of a single open clinical trial to evaluate the treatment effects of paroxetine on symptoms of hwa-byung, a Korean culture-related anger syndrome. METHODS: Eighty-nine patients with depressive disorders, anxiety disorders, somatoform disorders, or self-labeled hwa-byung were treated with paroxetine (Paxil CR) 12.5-37.5 mg/day for 8 weeks. Treatment effects were evaluated using the Hamilton Depression Scale (HAMD), the State and Trait Anger Inventory (STAXI), and the Hwa-byung Scale. RESULTS: Scores on all items ; total score on the Hwa-byung Scale ; scores on state anger, trait anger, and anger-in ; total score on the STAXI ; and total score on the HAM-D decreased significantly after eight weeks of paroxetine treatment compared to baseline. CONCLUSION: Paroxetine was shown to be effective for treating symptoms of hwa-byung, a chronic anger syndrome.

Symptoms to Use for Diagnostic Criteria of Hwa-Byung, an Anger Syndrome

OBJECTIVE: The aim of this study was to identify the characteristic symptoms which can be used for the diagnosis of hwa-byung, a culture-related anger syndrome in Korea. METHODS: The symptoms of the Hwa-byung Scale were correlated with the Korean versions of the Hamilton Depression Rating Scale (K-HDRS) and the State and Trait Anger Inventory (K-STAXI) in 89 patients, who were diagnosed as having major depressive disorder, dysthymic disorder, anxiety disorders, somatoform disorders, or adjustment disorder according to the Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV) criteria and who had self-labeled hwa-byung. Also, the symptoms of the Hwa-byung Scale were correlated with each other. RESULTS: The symptoms of the Hwa-byung Scale which were significantly correlated with the state anger of the K-STAXI but not with the depressive mood (item 1 of K-HDRS) included feelings of unfairness, subjective anger, external anger, heat sensation, pushing-up in the chest, dry mouth, and sighing. The symptoms which were significantly correlated with state anger and depressed mood included respiratory stuffiness, "haan" and hate. The symptoms which were not significantly correlated with depressed mood and state anger included going-out, epigastric mass, palpitation, headache/pain, frightening easily, many thoughts, and much pleading. These symptoms also showed higher correlation with each other in the correlation matrix. CONCLUSION: Our findings suggest that hwa-byung is different from depressive syndrome in terms of its symptom profile, and suggest what symptoms should be included in the diagnostic criteria of hwa-byung, an anger disorder.

Divided Countries, Divided Mind 1: Psycho-Social Issues in Adaptation Problems of North Korean Defectors

A review of studies on the adaptation problems of North Korean defectors in South Korean society and studies of people's adaptation to political and cultural changes in other countries suggests that similar adaptation problems may occur in the process of and after unification. Defectors have various adaptation problems and some of them have psychiatric disorders such as depression and post-traumatic stress disorder (PTSD). The reasons for this were revealed to be the difference in the culture and personality between South and North Korea, which have developed for the last 60 years without any communication with each other, in spite of their common racial and cultural heritage. Economic factors including the lack of skills and knowledge for working at industrialized and competitive society like South Korean society, also aggravate the severity of such adaptation problems. Research on defectors' adaptation problems and on the differences in the culture and mentality between North and South Korea can provide useful information on what kinds of problems may arise during the process of and after unification and what should be done to achieve mutual adaptation and harmonious and peaceful unification.

Clinical Correlates of Hwa-Byung and a Proposal for a New Anger Disorder

This paper reviewed the studies on hwa-byung (HB), which literally means anger disorder and this is known as the culture-related chronic anger syndrome of Koreans. Based on these studies and a review of the literature on the anger syndromes of other cultures, I have proposed a new anger disorder. The rationale for this proposition is first that the clinical correlates of HB, including the epidemiological data, the etiological factors, the symptoms and the clinical course, are unique and different from those of the depressive disorders, which have been postulated to be similar to HB. Second, the symptoms of HB are characterized by pent-up anger and somatic and behavioral symptoms related to the release and suppression of anger. Third, a group of patients with only HB and who visit psychiatrists for treatment have been identified. Fourth, anger is thought to be the basic target of treatment for HB patients. Last, anger syndromes like HB have been identified, with various names, in other cultures. By reducing the cultural variation of HB and integrating the common clinical correlates of the syndromes related to anger, a new anger disorder for the mood of anger can be conceptualized, like that for other mood disorders for the corresponding pathological moods. The research diagnostic criteria for HB and the new anger disorder are also suggested. I propose that the new anger disorder to be included in the new international classification system as a member of the larger family of mood disorders. International collaborative studies are needed not only to identify such anger disorder in various cultures, but also to explore giving better treatment to these patients based on the bio-psycho-social model of anger disorder.

Korean Traditional Medicines as Novel Drugs for Neuropsychiatric Disorders / 대한정신약물학회지

This paper reviews history of new drug development in Korea as well as researchs on development of new psychotherapeutic drug from traditional medicines or natural products in Korea. Korea has a long history of traditional medicine and accumulated knowledge of natural resources. However, only a few new drug have been developed from those natural products. Now many researchers in Korea are devoting themselves to test the possibility of natural products as antipsychotic drugs, antidepressants, anxiolytic drugs and cognitive enhancers. However, only a few graduates from traditional medical schools in Korea are engaging in research on developing new drug from natural products and they are not familiar to research methods of western medicine and pharmacology. For research and development of new drug from natural products or traditional medicines, many researchers should be trained for methodology of basic medicine, pharmacology, pharmacognosy, and oriential pharmacy. Government and pharmaceutical companies need to provide more investment for R & D for new drug from natural products including establishment of data base for component of traditional medicines and natural products, system development integrating information technology, bio-technology and nanotechnology, and international collaboration with advanced countries which have common interest in new drug development from natural products.

Quality of Life of North Korean Defectors in South Korea / 신경정신의학

OBJECTIVES: This study was designed to evaluate the quality of life (QoL) of North Korean defectors in South Korean society and to identify factors influencing their quality of life. METHODS: Subjects consisted of 151 defectors. Instruments were Korean version of WHOQOL-Bref, a questionnaire for demographic data, Beck Depression inventory (DBI) and part of PTSD of Korean version of SCID. RESULTS: Generally QoL of the subjects was relatively higher in relations to domains of psychological and physical health, and facets of negative feeling, transportation, mobility, physical pain and discomfort, personal belief, health and social care, work capacity, self-esteem, and thinking ability. However, QoL was relatively lower in environment domain and lowest in facets of financial resource, leisure activities and opportunity for new information and skills. A higher QoL was related to living with a spouse, having a job, having higher income and religious faith. A lower QoL was related to older age, having larger family, physical diseases, depression and PTSD. Path analysis showed that physical health and psychological domains directly influenced overall QoL while other domains influenced overall QoL indirectly. CONCLUSION: These results suggest that, to improve QoL of defectors, support in providing job and leisure activities, health service, especially mental heath service, and education program for new information and skills are needed.

A 3-Year Follow-Up Study of Posttraumatic Stress Disorder among North Korean Defectors / 신경정신의학

OBJECTIVE: This study is a follow-up of a first survey of 200 North Korean defectors who entered South Korea in 2001. The purpose of this study is to examine changes in the current prevalence of partial PTSD and full PTSD after 3 years and to evaluate related factors. METHODS: This study followed up on 151 of the 200 North Korean defectors from our first survey. 20 interviewers conducted face-to-face interviews and assisted defectors in completing a self-report assessment. The traumatic events which participants with chronic PTSD and delayed onset PTSD experienced were then examined. RESULTS: Over the 3 years, the current prevalence rate of partial PTSD was reduced from 31.8% to 5.3%, and the current prevalence rate of full PTSD was reduced from 27.2% to 4.0%. Of particular interest was that 88.8% of those diagnosed with full or partial PTSD in the first survey had recovered after 3 years. CONCLUSION: The current prevalence rate of partial and full PTSD rapidly decreased during 3 years.

The Korean Version of 4th Revision of Schizophrenia Quality of Life Scale: Validation Study and Relationship with PANSS / 신경정신의학

OBJECTIVES: The present study was performed to verify the validity and value of 4th revision of Schizophrenia Quality of Life Scale (SQLS-R4) as an assessment tool in a Korean-language version (SQLS-R4K). METHODS: The subjects for present study were 174 patients with a diagnosis of schizophrenia as defined by DSM-IV. The SQLS-R4K was administered together with self-report Korean version of World Health Organization Quality of Life-Brief Scale (WHOQOL-BREF) to assess validity. A subset of respondents also completed the SQLS-R4K for a second time to assess test-retest reliability. To evaluate the relationship SQLS-R4K and clinical characteristics, psychotic symptoms and general functioning were evaluated using the Positive and Negative Syndrome Scale (PANSS) and the Global Assessment of Functioning Scale (GAF) score respectively. RESULTS: All the scales of SQLS-R4K showed good internal consistency reliability. The correlations of items with their scale total revealed that all items were significantly correlated with their own scale score. In test-retest reliability, paired t-tests indicated that responses did not alter significantly between the two assessment. There was moderate correlation between WHOQOL-BREF sub-scores and SQLS-R4K score total. Also relevant correlations between PANSS, current GAF and SQLS-R4K were proved. CONCLUSION: From the results of the testing the reliability and validity of the SQLS-R4K, it is concluded that the SQLS-R4K is a simple and reliable scale for measuring quality of life in schizophrenic patients.