한국 농촌지역의 신경증 환자에 관한 예비조사

PRELIMINARY SURVEY ON THE NEUROTIC CASES IN A KOREAN RURAL COMMUNITY

Facing the fact that many papers have been out reporting that the mentally ill in Korea express their psychological conflicts through physical symptoms, resulting in many obstacles in psychiatric practice in Korea, the authors tried to evaluate the degree and modes of the physical expression in rural neurotic cases and to correlate the mode of expression with the relevant sociocultural background. Fifty three neurotic cases were collected from 579 out-patients in a County general hospital in U l-Jin、 Kyung-Book during six months from April 1, to September 30. 1974. Mean age was 34. S7±10. 92 years with the range from 16 to 63 years of age. Those in 30s were the most frequent age group. The group of specified neurosis accounted for 51% of all the subjects. Forty nine% of all the subjects were unspecified’ neurosis manifested by vague somatic symptoms without definable anatomico-physiological basis or even in case of the presence of psychological symptoms, not by purely identifiable but very ambiguous, unfamiliar psychological symptoms. All the symptoms complained by the subjects were 180 in number. The symptoms could be devided into two large categories; somatic complaints in 79.5%, and psychological complaints in only 20.5% Mean number of complaints presented by each patient was 3.4- Somatic complaints were noticed significantly more often in female subjects than in males at the level of P<0.01. while psychological ones were found significantly more in male subjects than in females also at the level of P<0.01. Intrafamilial interpersonal relationship was the precipitating factor in 51%, and those with unidentifiable factors occupied 37.7%. In the authors，discussion, the finding that soma tic complaints exceeded the psychological ones was attributed firstly to the traditional social attitude inhibiting verbal expression of one’s emotion, while accepting it s somatic expression, and secondly to the traditional projective tendency in concept of di’ sease. Moreover, the startling abundance of unspecified neurosis was attributed to the peculiar concept of Han-bang that facilitated projection of all emotional conflicts unto the soma with it’s vague anat- omico-physiological knowledge, as well as foregoing traditional cultural climate in Korea. In their finding, intrafamilial interpersonal relationship was the most frequent precipitating factor and the next was cases with no apparent precipitating fators. In this regard, too tight social and emotional ties must play an important role. Values of the individual has been sought, not in himself, but in units of family or community, not in himself, but in we On the other hand, traditional extended family system which is still prevalent in Korean rural society has it’s role. Social authoritarianism derived from the large family system forces individuals to obey to authoritative figures i. e ., to fathers, to husbands, ancestors and for the sake of family reputation and. dignity. Then the individuals must sacrifice, and repress their own needs, even the need to speak out their own emotional conflicts. Lastly, restriction of social activities should be accounted for. Majority of them are engaged in farming profession, hence all the family spend most of the time, mixing only with themselves, under the pressure of traditional authoritarianism. Any other personal relationship is inhibited. Then it seems quite natural to result in the phenomena cited above; intrafamilial relationships accounted for more than half of all precipitating factors and more than one third could not verbalize their inner conflicts directly.