Correlates of depressive symptoms among North Korean refugees adapting to South Korean society: The moderating role of perceived discrimination

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

“…Song et al (2011)Adult NKRs3250.2 (20–76)Depression (BDI), PTSD (MMPI-II)NoD. Song et al (2016)Adult NKRs20047.7Depression (PHQ-9)NoUm et al (2015)Adult NKRs21641.0Depression (CES-D)NoYoo et al (2017)Female NKRs24240.5Somatization (SCL-90-R)No*indicates prospective study**Mean ages have been rounded off to the nearest tenthBDI = Beck Depression Inventory, BAI = Beck Anxiety Inventory, K-YSR = Korean Youth Self-Report, IAS = Interaction Anxiousness Scale, PTSD = Post-Traumatic Stress Disorder, PDS = Posttraumatic Diagnostic Scale, CPTSD-I = Complex PTSD scale-I, SCL-90-R = Symptom Checklist-90-Revision, SCID = Structured Clinical Interview, HSCL-25 = Hopkins Symptoms Checklist-25, MMPI-2 = Minnesota Multiphasic Personality Inventory-2, HADS = Hospital Anxiety and Depression Scale, K-PAI = Korean version of Personality Assessment Inventory, CES-D = Center for Epidemiological Studies-Depression Scale, STAI = State-Trait Anxiety Inventory, IES-R = Impact of Event Scale-Revised, BPSI-NKR = Brief Psychological State Inventory for North Korean Refugees, DSM-IV = Diagnostic and Statistical Manual of Mental Disorders-IV, PTG = Post-Traumatic Growth, SRG = Stress-Related Growth, PSI-NKR-A = Psychological State Inventory for North Korean Adolescent Refugees, AUDIT = the Alcohol Use Disorders Identification Test, SIS = Suicide Ideation Scale, KTSND = Kano test for social nicotine dependence, DESNO = Disorders of Extreme Stress Not Otherwise Specified, DES-II = Dissociative Experiences Scale II, K-CBCL = Korean version of Child Behaviour Check List, KNHANES = Korea National Health and Nutrition Examination Survey, PHQ-9 = Patient Health Questionnaire-9 …”

“…On the other hand, for adult NKRs, most studies noted a lack of an association between time since resettlement and depression (Cho et al, 2005; Jeon et al, 2009; Kim et al, 2010; Nam et al, 2016; Shin et al, 2016; Song et al, 2016; Um, Chi, Kim, Palinkas, & Kim, 2015; Yoo et al, 2017), and two other studies even reported that female adult NKRs who had been resettled in South Korea for longer periods experienced greater depressive symptoms than did those in an earlier stage of settlement (Kim, 2012a; Lee, Chang, & Jun, 2016). Adult NKRs might have to deal with diverse challenges more directly, such as economic struggles, which might inhibit their psychosocial adaptation even after several years, whereas young NKRs might become more resilient under the protection of schools and parental support.…”

“…The adverse psychological impact of acculturative stress was consistently noted in prior findings, including decreasing NKRs’ self-efficacy and resiliency and increasing passive coping strategies for stressors (Kim et al, 2015; M. Lee et al, 2016; Lim & Han, 2016). Consequently, a high level of acculturative stress was found to predict adverse psychiatric outcomes such as depression, anxiety, and PTSD (Cho et al, 2011, 2009; Y. Kim, 2013; Kim et al, 2015; Lee, 2011; M. Lee et al, 2016; Lim & Han, 2016; Um et al, 2015), even after controlling for traumatic experience or daily life stress (Jeon et al, 2013). Furthermore, acculturative stress was suggested to mediate the adverse effects of risk factors, such as traumatic experience or perceived discrimination, on psychiatric outcomes (Lee, 2011; M. Lee et al, 2016).…”

“…Unlike other family relationship factors, qualitative indexes of family functioning, such as family adaptability and emotional closeness, have consistently predicted NKRs’ decreased psychological problems, including depression (Nam et al, 2016; Um et al, 2015). Additionally, children of NKRs and adolescent NKRs presented less depressive and PTSD symptoms when having greater family support and less conflicts (Shin & Kim, 2015), and feeling greater attachment with parents (Emery et al, 2015).…”

“…Adult NKRs with lower monthly income – especially those with family incomes under US$1000 – were more vulnerable to a wide array of psychiatric symptoms, including depression, anxiety, and somatization, in most reports (Ahn et al, 2012; Jeon et al, 2009; Kim, Lee et al, 2011; Nam et al, 2016; Shin & Lee, 2015; Song et al, 2016), but not all (Cho et al, 2009; Yoo et al, 2017). In particular, no independent relation was noted between low income and depressive symptoms when controlling for other significant variables, such as sociocultural adaptation, family characteristics, and physical health (Cho & Kim, 2010; Um et al, 2015). This suggests that NKRs’ financial resources might influence psychiatric symptoms through variables such as family relationship or health conditions.…”