J Korean Neuropsychiatr Assoc.  2012 Nov;51(6):445-457.

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

• Lee HY
• Choi JY
• Chung YH
• Min SK

Abstract

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.

Keyword

North Korean defectors; Mental disorder; Schizophrenia; Major depression; Bipolar disorder; Conduct disorder

MeSH Terms

Adolescent
Anxiety
Bipolar Disorder
Conduct Disorder
Democratic People's Republic of Korea
Depression
Discrimination (Psychology)
Guilt
Hospitals, Psychiatric
Humans
Loneliness
Mental Disorders
Mental Health
Mood Disorders
Precipitating Factors
Refugees
Republic of Korea
Schizophrenia

Reference

1. Min SK. Divided countries, divided mind 1: psycho-social issues in adaptation problems of North Korean defectors. Psychiatry Investig. 2008. 5:1–13.

2. Kang SR. Development of Trauma Scale for North Korean Refugee. 2001. Seoul: Yonsei Univ.

3. Lee Y, Lee MK, Chun KH, Lee YK, Yoon SJ. Trauma experience of North Korean refugees in China. Am J Prev Med. 2001. 20:225–229.

4. Chang Y, Haggard S, Noland M. Migration Experiences of North Korean Refugees: Survey Evidence from China. 2008. Washington, DC: Peterson Institute;Working Paper Series 084.

5. Jeon W, Hong C, Lee C, Kim DK, Han M, Min S. Correlation between traumatic events and posttraumatic stress disorder among North Korean defectors in South Korea. J Trauma Stress. 2005. 18:147–154.

6. Hong CH, Yoo JJ, Cho YA, Eom J, Ku HJ, Seo SW, et al. A 3-year follow-up study of posttraumatic stress disorder among North Korean defectors. J Korean Neuropsychiatr Assoc. 2006. 45:49–56.

7. Song BA, Yoo SY, Kang HY, Byeon SH, Shin SH, Hwang EJ, et al. Post-Traumatic Stress Disorder, Depression, and Heart-Rate Variability among North Korean Defectors. Psychiatry Investig. 2011. 8:297–304.

8. Jeon WT, Min SK, Lee MH, Lee ES. Adjustment of North Korean defectors in South Korea. J Korean Neuropsychiatr Assoc. 1997. 36:145–161.

9. Cho YA, Jeon WT, Yu JJ, Un JS. Predictors of Depression Among North Korean Defectors: a 3-year Follow-up Study. Korean J Couns Psychother. 2005. 72:467–484.

10. Jeon BH, Kim MD, Hong SC, Kim NR, Lee CI, Kwak YS, et al. Prevalence and correlates of depressive symptoms among North Korean defectors living in South Korea for more than one year. Psychiatry Investig. 2009. 6:122–130.

11. Kim HH, Lee YJ, Kim HK, Kim JE, Kim SJ, Bae SM, et al. Prevalence and correlates of psychiatric symptoms in north korean defectors. Psychiatry Investig. 2011. 8:179–185.

12. Joo SH. Dong-A Ilbo. 2011. 12. 13. Available from http://news.donga.com/Inter/3/02/20111213/42562642/1.

13. Shin YJ, Choi YG, Ryu BG, Min SK. Psychosocial risks of adolescent defectors from North Korea. Behav Sci Med. 2004. 3:46–55.

14. Westermeyer J, Vang TF, Neider J. Migration and mental health among Hmong refugees. Association of pre- and postmigration factors with self-rating scales. J Nerv Ment Dis. 1983. 171:92–96.

15. Bauer M, Priebe S. Psychopathology and long-term adjustment after crises in refugees from East Germany. Int J Soc Psychiatry. 1994. 40:165–176.

16. Lee CH, Min SK, Jeon WT, Kigawa M, Sugawara M. Mental health and quality of life of North Korean defectors living in Japan. Asian J Psychiatr. 2009. 2:95–99.

17. Ebata K, Miguchi M, Tseng WS, Hara H, Niwa I, Kosaka A, et al. Lin YP, Tseng WS, Yeh EK, editors. Migration and transethnic family adjustment: experiences of Japanese war orphans and their spouses in Japan. Chinese Societies and Mental Health. 1995. Hong Kong: Oxford University Press;123–137.

18. Yu JJ. Mental health of North Korean refugees in China: during the protection period. 2006. Seoul: Yonsei Univ.

19. Mollica RF, McInnes K, Poole C, Tor S. Dose-effect relationships of trauma to symptoms of depression and post-traumatic stress disorder among Cambodian survivors of mass violence. Br J Psychiatry. 1998. 173:482–488.

20. Hauff E, Vaglum P. Chronic posttraumatic stress disorder in Vietnamese refugees. A prospective community study of prevalence, course, psychopathology, and stressors. J Nerv Ment Dis. 1994. 182:85–90.

21. Min SK. The quality of life of people in North Korea. Korean Unification Stud. 2000. 4:5–19.

22. Min SK, Jeon WT, Kim DK. Quality of life of North Korean defectors in South Korea. J Korean Neuropsychiatr Assoc. 2006. 45:269–275.

23. Min SK, Jeon WT, Eom JS, Yu SE. Quality of life of North Korean defectors in South Korea: three years follow-up study. J Korean Neuropsychiatr Assoc. 2010. 49:104–113.

24. Choi SK, Min SJ, Cho MS, Joung H, Park SM. Anxiety and depression among North Korean young defectors in South Korea and their association with health-related quality of life. Yonsei Med J. 2011. 52:502–509.

25. Min SK, Jeon WT, Yoon DR. Life and development of adolescents in North Korea. J Korean Neuropsychiatr Assoc. 1999. 38:1047–1062.

26. Cho YA, Jeon WT, Min SK. The ego defense mechanism of North Korean defectors in South Korea. J Korean Neuropsychiatr Assoc. 2004. 43:345–353.

27. Chae JM, Yhi JH. North Korea-South Korea cultural heterogeneity in psychological perspective: focusing on the North Korean defectors' adaptation. Korean J Psychol Soc Issues. 2004. 10:79–101.

28. Kang SR, Kim HJ, Yoon DR, Jeon WT, Min SK. Experience of South Korean NGO volunteers in helping North Korean defectors. Korean Unification Stud. 2001. 5:157–184.

29. Jeon WT. A study on Defector's social adaptation and self-identity. Korean Unification Stud. 1997. 1:109–167.

30. Maaz HJ. Der Gefuelsstau: Ein Psychogramm der DDR. 1990. Berlin: Argon Verlag.