Objectives Psychiatry in North Korea is still poorly understood. Therefore, it is necessary to study the psychopathology and diagnostic classification of North Korean psychiatry. This study examined North Korea’s psychopathology and diagnostic classification system and how it differs from international standards. Methods This study reviewed North Korean medical books and medical journals available at the Information Center on North Korea. This literature review and qualitative content analysis examined 15 medical books and 227 medical articles. Results North Korea’s psychiatric diagnostic classification is based on the International Classification of Diseases, 10th edition (ICD-10), but with some modifications to reflect the circumstances of North Korea. While the research journals mainly used the ICD-10 diagnostic criteria, North Korea has its own diagnostic criteria, which it refers to as the “existing diagnostic criteria.” ‘Neurotic disorders’ were the most common, both in the classification in the medical books and the list of disorders covered in the medical journals. There was an interest in ‘organic mental disorders,’ such as postconccusional syndrome and ‘mental disorders due to encephalic parasitism,’ but relatively little research on mood disorders. There were no studies on suicide and a view that alcohol is abused in capitalist countries. Conclusion This study examined the diagnostic classification system of North Korean psychiatry. Further analyses of the characteristics of the psychopathology used in North Korea can be used to understand North Korean society