[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 Sohyŏn 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 Kyŏngs ŏng 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 Kyŏngsŏng 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, Kyŏngsŏng 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.