Anxiety and Depression among North Korean Young Defectors in South Korea and Their Association with Health-Related Quality of Life

Abstract

PurposeThis study examined anxiety and depression among 108 North Korean adolescent and young adult (age, 12-29 years) defectors who settled in South Korea, and evaluated the relationship between their mental health and health-related quality of life (HRQoL).Materials and MethodsSubjects completed a questionnaire that included the Hospital Anxiety and Depression Scale (HADS), the Short Form with 36 questions (SF-36; consists of mental and physical health components) for measuring HRQoL, and items related to the period of time since defection and settlement and socio-demographic variables.ResultsAmong the participants, 53.7% scored≥8 on the anxiety measure questionnaire, and 22.2% scored≥11; 36.1% of the participants scored≥8 on the depression measure questionnaire and 14.8% scored≥11. Both anxiety and depression subscales were associated with lower scores of total SF-36, physical component and mental component score. Depressive symptom appeared more frequently among the subjects who had lived in South Korea for <1 year than among the subjects who had lived in South Korea for 2 year or longer (odds ratio=3.77, 95% confidence intervals=1.12 to 12.70).ConclusionAmong North Korean adolescent and young adult defectors, anxiety and depression were associated with lower HRQoL. Therefore, it is needed to develop strategies to screen for mental health and intervene to reduce anxiety and depression during their early resettlement stage.

Mental health status of North Korean refugees in South Korea and risk and protective factors: a 10-year review of the literature

“…For adolescent NKRs, a shorter duration of stay in South Korea was associated with higher prevalence or severity of both internalizing and externalizing problems in most studies (Baek et al, 2007; Choi et al, 2011; Lee, 2011; Shin & Kim, 2015), except for a few studies noting no significant association with depression (Cho et al, 2011; Kim, Park, & Park, 2014). Given the tendency of improvement in mental health with time observed in other young refugee populations (Montgomery, 2010), adolescent NKRs may experience more psychological and behavioural disturbances in the early years of settlement and adapt better with time, although the time effect may differ depending upon the context in resettlement locations (Reed, Fazel, Jones, Panter-Brick, & Stein, 2012).…”

“…Firstly, for emotional disorders, 33–51% of NKRs were classified as having depressive symptoms in eight studies (Ahn et al, 2012; Choi, Min, Cho, Joung, & Park, 2011; Jeon et al, 2009; Kim et al, 2011; Kim, Kim, Kim, Cho, & Lee, 2011; Lee et al, 2007; Y. Lee, J. Jun, Y. Lee et al, 2016; Nam, Kim, DeVylder, & Song, 2016); and 43–54% of NKRs were classified as having anxiety symptoms in two studies (Ahn et al, 2012; Choi et al, 2011). When using a single scale for both depression and anxiety symptoms, 10–48% of NKRs were classified as having a clinical level of depression and anxiety symptoms in four studies (Cho & Kim, 2010; Y. Kim, 2013; Kim, Jeon, & Cho, 2010; Shin, Lee, & Park, 2016).…”

“…Choi and Kim (2011)Female adult NKRs193634.7 (18–69)Psychiatric symptoms (MMPI-2, SCL-90-R)NoS. Choi et al (2011)Adolescent and young adult NKRs10819.4 (12–29)Anxiety/Depression (HADS)NoY. Choi et al (2009)Male adult NKRs22735Personality and Psychopathology (K-PAI)NoY.…”

“…Lee et al (2016a)DepressionAdult NKRs304CES-DCut-off score: 2444%Nam et al (2016)DepressionAdolescent NKRs108HADSCut-off score: 836%S. Choi et al (2011)Depression and anxietyFemale adult NKRs401HSCL-25Cut-off score: 1.7510%Cho and Kim (2010)Depression and anxietyAdolescent NKRs200HSCL-25Cut-off score: 1.7531%Y. Kim (2013)Depression and anxietyAdult NKRs500HSCL-25Cut-off score: 1.7548%Y.…”

“…So far, the mental health effects of longer stay periods in third countries have shown variable results. While some studies noted no significant association between length of stay and NKRs’ psychiatric symptoms (Ahn et al, 2012; Cho & Kim, 2010; Choi et al, 2011; Kim et al, 2010; Lee, 2011), other studies noted that adolescent and adult NKRs who stayed longer in third countries reported greater levels of psychological problems, including depression, PTSD, suicidal ideation, and alcohol abuse (Baek et al, 2007; Cho et al, 2011; Jung & Choi, 2017; Kim, 2010, 2013; Kim et al, 2011; Shin et al, 2016). Given that longer periods of time in third countries were related to an increased number of traumatic experiences among NKR (Kim et al, 2010), longer stay may thus increase the mental health risks posed by distressing or traumatic experiences in the immigration process (Baek et al, 2007).…”