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Jang SY, Seo SR, Kim K, Choi HO, Lee CK. Association Between Atopic Dermatitis and Suicidal Behaviors in North Korean Adolescent Defectors From 2011 to 2019. Psychiatry Investig 2024; 21:52-62. [PMID: 38198830 PMCID: PMC10822740 DOI: 10.30773/pi.2023.0018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Revised: 06/12/2023] [Accepted: 09/17/2023] [Indexed: 01/12/2024] Open
Abstract
OBJECTIVE To evaluate the association between atopic dermatitis (AD) and suicidal behaviors in adolescent defectors among residents who escaped from North Korean (adolescent defectors, n=423) and adolescents with South Korean parents (Korean adolescents, n=540,265). METHODS The study used data from the Korea Youth Risk Behavior Survey conducted from 2011 to 2019. Differences in general characteristics, health behaviors, suicidal ideation, suicide plans, suicide attempts, and AD between adolescent defectors and Korean adolescents were examined. Multiple logistic regression analysis was used to determine the association between AD and suicidal behaviors. RESULTS The adolescent defectors group had lower AD (16.3% vs. 24.2%), poorer subjective health (10% vs. 6%), smoked more (47% vs. 18%), drank more (60% vs. 43%), lived with family less frequently (56% vs. 96%), and were more than twice as likely to have depression (42% vs. 27%), suicidal ideation (30% vs. 14%), a suicide plan (23% vs. 5%), or have made a prior suicide attempt (19% vs. 3%) compared with the Korean adolescent group (p<0.001). The adjusted odds ratio for the adolescent defectors group compared to the Korean adolescent group was 1.66 for suicidal ideation, 3.59 for suicide plans, and 4.34 for suicide attempts (p<0.001). AD was found to be associated with suicide plans and attempts in adolescent defectors and associated with suicidal ideation in Korean adolescents. CONCLUSION AD was significantly associated with suicide plans and suicidal attempts among adolescent defectors and suicidal ideation in Korean adolescents, based on a random sample of middle- and high-school students.
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Affiliation(s)
- Shin Yi Jang
- Imaging Center, Heart Vascular Stroke Institute, Samsung Medical Center, Seoul, Republic of Korea
| | - Su Ra Seo
- The National Health Insurance Service, Wonju, Republic of Korea
| | - Kyeongsug Kim
- Graduate School of Clinical Nursing Science, Sungkyunkwan University, Seoul, Republic of Korea
- Department of Nursing, Samsung Medical Center, Seoul, Republic of Korea
| | - Hye Ok Choi
- Department of Nursing, Samsung Medical Center, Seoul, Republic of Korea
| | - Chang-Kwan Lee
- Department of Nursing, Gangseo University, Seoul, Republic of Korea
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2
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Erol E, Koyuncu Z, Batgı D. Quality of Life, Depressive Symptoms, and Personality Traits in Syrian Refugee Adolescents. CHILD INDICATORS RESEARCH 2022; 16:641-653. [PMID: 36310917 PMCID: PMC9589654 DOI: 10.1007/s12187-022-09983-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 09/30/2022] [Indexed: 06/16/2023]
Abstract
PURPOSE Refugee adolescents' quality of life (Qol) was not investigated during the Covid-19 pandemic which have a potential impact on refugee adolescents' Qol. In this study, it is planned to investigate refugee adolescents' Qol and its association with depression and quality of life. METHODS 301 refugee adolescents aged between 14 and 18 who immigrated from Syria was included in the study. Personality Inventory for DSM-5 Brief Form (PID-5 BF), Beck Depression Scale, and Life Quality Scale was used as assessment tools. The data were tested using structural equation modeling. RESULTS Both depressive symptoms and personality traits are associated with low Qol. Also, depression mediated the relationship between personality disorder and Qol. CONCLUSION This is the first study that investigates Qol in Syrian refugee adolescents during the pandemic. This study draws attention to the importance of depressive symptoms and personality traits management for improvement of Qol in Syrian refugee adolescent population. HIGHLIGHTS • Depressive symptoms are associated with low Qol in refugee adolescents.• Personality traits are associated with low Qol in refugee adolescents.• Depressive symptoms have a mediator role between personality traits and Qol.
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Affiliation(s)
- Elif Erol
- Clinical Psychologist, Department of Clinical Psychology, Istanbul Rumeli University, Istanbul, Turkey
| | - Zehra Koyuncu
- Medical Doctor, Department of Child and Adolescent Psychiatry, Cerrahpasa Medical Faculty, Istanbul University-C, Campus Kocamustafapasa Street No: 53 Cerrahpasa, 34098 Fatih Istanbul, Turkey
| | - Dilara Batgı
- Clinical Psychologist, Department of Clinical Psychology, Istanbul Rumeli University, Istanbul, Turkey
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3
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Kim HJ, Yang S, Park D. Routes Out of Child Abuse to School Adjustments: A Comparison Between North Korean Adolescent Refugees and Native South Korean Adolescents. CHILD & ADOLESCENT SOCIAL WORK JOURNAL : C & A 2022:1-12. [PMID: 36246099 PMCID: PMC9551245 DOI: 10.1007/s10560-022-00885-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 09/18/2022] [Indexed: 06/16/2023]
Abstract
This study aimed to examine pathways from child abuse to school adjustment and the roles of self-control and academic stress on the link among North Korean adolescent refugees living in South Korea and native South Korean adolescents. A total of 610 students (adolescents from South Korea = 325 and adolescents from North Korea = 285) living in South Korea, from juniors in middle schools to seniors in high schools, were interviewed in 2017. Multigroup structural equation modeling was used to examine differences in the country of origin on the pathways from abuse to school adjustment via self-control and academic stress. North Korean adolescent refugees were less likely to adjust to their school life than South Korean adolescents. Academic stress was found as a significant mediator between self-control and school adjustment in both South Korean and North Korean adolescents. Child abuse was associated with self-control of South Korean adolescents. Childhood abuse from parents can have an overall influence on individual characteristics and school life for adolescents. By paying attention to this process, comprehensive solutions are urgently required not only to intervene in the problem of abusive parenting behaviors but also to block the path of the expanding negative consequences among both groups of adolescents.
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Affiliation(s)
- Hee Jin Kim
- Bangmok College of General Education, Myongji University, Seoul, South Korea
| | - Sejung Yang
- Silver School of Social Work, New York University, New York, NY USA
- Department
of Mathematics and Statistics, The University of Vermont, 82 University Place, Innovation Hall E220, Burlington, VT 05405 USA
| | - Daejun Park
- Department of Social Work, Ohio University, Athens, OH USA
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Choi J, Hack T, Lee J. Fear of Crime among Female North Korean Defectors in South Korea. INTERNATIONAL JOURNAL OF OFFENDER THERAPY AND COMPARATIVE CRIMINOLOGY 2022; 66:227-248. [PMID: 33533270 DOI: 10.1177/0306624x21992362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Although some studies have focused on immigrants' fear of crime in the United States, it is important to point out that the number of North Korean defectors to South Korea has rapidly increased since the 1990s. Therefore, understanding factors associated with fear of crime for North Korean immigrants, especially female defectors, is important for ensuring their successful transitions into South Korean culture. The present study used existing survey data from a sample of female North Korean defectors to explore factors related to fear of crime. Results indicate that the number of North Korean friends, language proficiency, and patriarchal attitudes toward gender were significant predictors of fear of crime for the North Korean female defectors. Findings are described and discussed as a potential source for policymaking to reduce North Korean immigrants' acculturative stress and fear of crime and to encourage smooth transitions into new cultures.
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Affiliation(s)
| | - Tay Hack
- Angelo State University, San Angelo, TX, USA
| | - Julak Lee
- Chung-Ang University, Seoul, South Korea
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5
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Renner A, Jäckle D, Nagl M, Hoffmann R, Röhr S, Jung F, Grochtdreis T, Dams J, König HH, Riedel-Heller S, Kersting A. Predictors of psychological distress in Syrian refugees with posttraumatic stress in Germany. PLoS One 2021; 16:e0254406. [PMID: 34347775 PMCID: PMC8336813 DOI: 10.1371/journal.pone.0254406] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Accepted: 06/28/2021] [Indexed: 01/23/2023] Open
Abstract
Syria has been the main country of citizenship of refugees in Germany since 2013. Syrians face numerous human rights violations in their country that can be accompanied by the experience of potentially traumatic events, loss and displacement. Along the migration process, refugees are exposed to various factors that can have an impact on mental health. The aim of this study is to investigate sociodemographic, war- and flight-related as well as post-migration factors as predictors of posttraumatic stress, depression, somatization and anxiety in Syrian refugees with posttraumatic stress symptoms based in Germany. Data were based on the baseline sample of the "Sanadak" randomized-controlled trial. A total of 133 adult Syrian refugees participated in the study. A questionnaire covered sociodemographic and flight-related questions as well as standardized instruments for symptoms of PTSD (PDS-5), depression (PHQ-9), somatization (PHQ-15), anxiety (GAD-7), generalized self-efficacy (GSE), religiousness (Z-Scale), social support (ESSI) and mental health stigma (SSMIS-SF). Linear regression models were executed to predict mental health outcomes. Sociodemographic predictors (i.e., female sex, higher education) and flight-related predicting factors (i.e., variability of traumatic events) have a negative impact on mental health in Syrian refugees with posttraumatic stress symptoms in Germany. Mental health stigma predicts worse mental health outcomes. Post-migration factors have a major impact on mental health, such as low income, lack of social support, low life satisfaction or a strongly felt connection to Syria. Somatization is an important manifestation of mental distress in Syrian refugees with posttraumatic stress symptoms. Our study showed a range of factors predicting the mental health of Syrian refugees with posttraumatic stress symptoms. Measures to foster mental health could be securing financial security, promoting gender equality and tailored psychosocial programs addressing mental health stigma, loss and social support networks.
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Affiliation(s)
- Anna Renner
- Department of Psychosomatic Medicine and Psychotherapy, University of Leipzig, Leipzig, Germany
- * E-mail:
| | - David Jäckle
- Department of Psychosomatic Medicine and Psychotherapy, University of Leipzig, Leipzig, Germany
| | - Michaela Nagl
- Department of Psychosomatic Medicine and Psychotherapy, University of Leipzig, Leipzig, Germany
| | - Rahel Hoffmann
- Department of Psychosomatic Medicine and Psychotherapy, University of Leipzig, Leipzig, Germany
| | - Susanne Röhr
- Institute of Social Medicine, Occupational Health and Public Health (ISAP), Medical Faculty, University of Leipzig, Leipzig, Germany
| | - Franziska Jung
- Institute of Social Medicine, Occupational Health and Public Health (ISAP), Medical Faculty, University of Leipzig, Leipzig, Germany
| | - Thomas Grochtdreis
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Judith Dams
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Hans-Helmut König
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Steffi Riedel-Heller
- Institute of Social Medicine, Occupational Health and Public Health (ISAP), Medical Faculty, University of Leipzig, Leipzig, Germany
| | - Anette Kersting
- Department of Psychosomatic Medicine and Psychotherapy, University of Leipzig, Leipzig, Germany
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Jin SS, Dolan TM, Cloutier AA, Bojdani E, DeLisi L. Systematic review of depression and suicidality in child and adolescent (CAP) refugees. Psychiatry Res 2021; 302:114025. [PMID: 34090083 DOI: 10.1016/j.psychres.2021.114025] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Accepted: 05/16/2021] [Indexed: 10/21/2022]
Abstract
Child adversity and trauma has been shown to have incredible detrimental effects physically and mentally in the subsequent adult life. Importantly, refugee minors are especially vulnerable to trauma. Thus far there are numerous studies examining cohorts of child and adolescent refugees and their impact on mental health in general and post-traumatic stress disorder (PTSD), but none have focused specifically on depression and suicide. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed for the current systematic review. 25 articles out of 2660 queried were identified to be included in the review. Overall, CAP refugees have increased risk for major depressive disorder and suicidality compared to the general population to which they have immigrated, regardless of origin. Due to the differences in the assessment tools used, it is hard to parse out if mood disturbance was secondary to major depressive disorder (MDD) or PTSD, or that suicidality is independent or a sequela of MDD/PTSD. Given the vulnerability of CAP refugees after trauma future studies are needed to further elucidate their risk of concurrent depression and suicidality, so as to facilitate appropriate treatment.
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Affiliation(s)
- Shawn S Jin
- Harvard South Shore Psychiatry Residency Training Program; Department of Psychiatry, Harvard Medical School, Boston, MA; Department of Psychiatry, VA Boston Healthcare System.
| | - Terrance M Dolan
- Harvard South Shore Psychiatry Residency Training Program; Department of Psychiatry, Harvard Medical School, Boston, MA; Department of Psychiatry, VA Boston Healthcare System
| | - Alesia A Cloutier
- Harvard South Shore Psychiatry Residency Training Program; Department of Psychiatry, Harvard Medical School, Boston, MA; Department of Psychiatry, VA Boston Healthcare System
| | - Ermal Bojdani
- Columbia University Vagelos College of Surgeons and Physicians; New York State Psychiatric Institute; New York Presbyterian Hospital/Columbia
| | - Lynn DeLisi
- Department of Psychiatry, Harvard Medical School, Boston, MA; Cambridge Health Alliance
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Seong Y, Park S. Factors Affecting Changes in the Mental Health of North Korean Refugee Youths: A Three-Year Follow-Up Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:1696. [PMID: 33578801 PMCID: PMC7916609 DOI: 10.3390/ijerph18041696] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/24/2020] [Revised: 02/02/2021] [Accepted: 02/08/2021] [Indexed: 11/16/2022]
Abstract
This study identified factors affecting changes in depression of 64 North Korean refugee youths (NKRYs) aged 13 to 23 years (40 female) using follow-up data over a three-year period. We collected intrapersonal factors (emotional regulation strategies, resilience, quality of life) and external factors (psychological and practical support, family adaptation, and cohesion) to understand the preventative and risk factors affecting changes in depression. The trend of depression symptoms significantly increased, and the proportion of people classified as depressed (cut-off score = 21) increased steadily from 45.3% to 59.4% in the third year. In addition, we conducted a panel regression analysis, which showed that individual internal factors had a statistically significant effect on changes in depression. Specifically, expressive suppression of emotions was shown to increase depression over time. Resilience and life satisfaction were significant factors reducing depression in this study. On the other hand, external factors were not significantly related to changes over time in depression of NKRYs. Interventions for NKRYs at risk of depression are necessary and should include ways to enhance resilience and life satisfaction, and foster ego strength by recognizing emotions and promoting healthy emotional expression.
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Affiliation(s)
| | - Subin Park
- Department of Research Planning, Mental Health Research Institute, National Center for Mental Health, Seoul 04933, Korea;
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8
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Amini K, Rahmani M, Asgari M, Fallah R. Predictive Factors of Depression Among Relatives of Brain-Dead Persons: A Descriptive Correlational Study. OMEGA-JOURNAL OF DEATH AND DYING 2020; 86:576-590. [PMID: 33323020 DOI: 10.1177/0030222820974809] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This study aimed to determine the predictive factors of depression among relatives of person deceased by brain death. In this study, 106 first-degree relatives of people who died of due to brain death were studied. Of the study units, 72.64% had levels of depression (severe, moderate, and mild). Among the dependent variables concerning deceased person, age and gender of the deceased were significantly correlated with the depression of their relatives. Among the variables concerning relatives, low level of education, unemployment and time elapsed after brain death have significant role in the incidence or prediction of their depression (p < 0.05). The results indicated a high prevalence of depression among relatives of men aged 30-50 who died because of brain death. It is recommended to consider this fact in planning to care relatives, especially among the low-educated, the unemployed and experiencing the first year of death, of people deceased by brain death.
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Affiliation(s)
- Kourosh Amini
- Social Determinants of Health Research Center, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Mahnaz Rahmani
- Department of Surgery, Mosavi Hospital, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Masoumeh Asgari
- Faculty of Nursing (Psychiatric Nursing), Abhar Islamic Azad University, Zanjan, Iran
| | - Ramazan Fallah
- Department of Bio-Statistics and Epidemiology, School of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran
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9
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Nutsch N, Bozorgmehr K. [The effect of postmigration stressors on the prevalence of depressive symptoms among refugees in Germany. Analysis of the IAB-BAMF-SOEP Survey 2016]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2020; 63:1470-1482. [PMID: 33103207 PMCID: PMC7686213 DOI: 10.1007/s00103-020-03238-0] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Accepted: 10/05/2020] [Indexed: 11/24/2022]
Abstract
BACKGROUND International studies prove the high burden of mental illnesses among refugees. Postmigration stressors in the country of refuge may affect the mental health and result in depression. OBJECTIVES The study examines whether postmigration stressors are associated with the prevalence of depressive symptoms among adult refugees in Germany. METHODS Secondary data analysis based on cross-sectional data of the IAB-BAMF-SOEP Survey of Refugees 2016 (N = 4465) that is representative for Germany. Depressive symptoms were measured using the Patient Health Questionnaire‑2 (PHQ-2). Unadjusted and adjusted odds ratios (ORs) and confidence intervals (CIs) were calculated with binary logistic regression models to examine associations between depression and sociodemographic, postmigration, and psychosocial factors. RESULTS Depressive symptoms show 19.4% of the surveyed refugees. Almost all selected postmigration stressors are significantly associated with depression after adjustment for sociodemographic and psychosocial factors. Unemployment (aOR = 1.48 [1.04-2.12]), loneliness (aOR = 1.14 [1.10-1.18]), and a rejected or undecided asylum application (aOR = 1.34 [1.06-1.70]) increase the odds of depressive symptoms, whereas asylum interviews (aOR = 0.71 [0.56-0.91]) and higher housing satisfaction (aOR = 0.94 [0.91-0.98]) lower the odds of depression. CONCLUSIONS Postmigration stress is associated with the occurrence of depressive symptoms. Sociopolitical interventions considering stressful and protective factors of the postmigration phase can reduce the burden of mental disorders in refugee populations.
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Affiliation(s)
- Niklas Nutsch
- AG2 - Bevölkerungsmedizin und Versorgungsforschung, Fakultät für Gesundheitswissenschaften, Universität Bielefeld, Postfach 10 01 31, 33501, Bielefeld, Deutschland
| | - Kayvan Bozorgmehr
- AG2 - Bevölkerungsmedizin und Versorgungsforschung, Fakultät für Gesundheitswissenschaften, Universität Bielefeld, Postfach 10 01 31, 33501, Bielefeld, Deutschland. .,Abteilung Allgemeinmedizin und Versorgungsforschung, Sektion Health Equity Studies & Migration, Im Neuenheimer Feld 130.3, 69120, Heidelberg, Deutschland.
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10
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A systematic review of socio-ecological factors contributing to risk and protection of the mental health of refugee children and adolescents. Clin Psychol Rev 2020; 83:101930. [PMID: 33186775 DOI: 10.1016/j.cpr.2020.101930] [Citation(s) in RCA: 63] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Revised: 09/01/2020] [Accepted: 10/13/2020] [Indexed: 12/22/2022]
Abstract
In the past decade, millions of children and adolescents have been forced to flee from protracted or newly erupted violent conflicts. Forcibly displaced children are particularly vulnerable for developing mental health problems. However, a timely and systematic review of the current evidence is lacking. We conducted a systematic review of factors contributing to the mental health of refugee children across different socio-ecological levels (individual, family, community, sociocultural). We systematically searched the databases Medline, PsycINFO, Web of Science, and Cochrane for English studies published in peer-reviewed journals between August 2010 and May 2020. Of the 2413 identified studies, 63 were included in the analyses. Only 24 studies were considered to be of high quality. Pre-migration individual (risk: exposure to war-related trauma, female gender) and post-migration family factors (risk: parental mental health problems and impaired parenting, protective: family cohesion) currently have the best evidence base. Post-migration community (protective: school connectedness, support by peers) and sociocultural factors (risk: discrimination and acculturative stress, protective: integrative acculturation) have gained some support in high-income settings. Prevention and intervention approaches should integrate factors across different socio-ecological levels. More longitudinal studies and research in low- and middle-income countries are needed to advance our knowledge on causal mechanisms behind factors contributing to refugee youth's mental health.
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Risk and Protective Factors for PTSD in Caregivers of Adult Patients with Severe Medical Illnesses: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17165888. [PMID: 32823737 PMCID: PMC7459858 DOI: 10.3390/ijerph17165888] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Revised: 08/09/2020] [Accepted: 08/10/2020] [Indexed: 12/13/2022]
Abstract
Caregivers of severely ill individuals often struggle to adjust to new responsibilities and roles while experiencing negative psychological outcomes that include depression, anxiety and Post-Traumatic Stress Disorder (PTSD). This systematic review aims to outline potential risk and protective factors for the development of PTSD in caregivers of adult subjects affected by severe somatic, potentially life-threatening illnesses. Twenty-nine studies on caregivers of adult patients affected by severe, acute, or chronic somatic diseases have been included. Eligibility criteria included: full-text publications reporting primary, empirical data; PTSD in caregivers of adult subjects affected by severe physical illnesses; risk and/or protective factors related to PTSD; and English language. Specific sociodemographic and socioeconomic characteristics, besides the illness-related distress, familiar relationships, exposure characteristics, coping style, and support, were identified as relevant risk/protective factors for PTSD. The review limitations are the small number of studies; studies on different types of diseases; studies with same samples. It is crucial to consider factors affecting caregivers of severely ill adult patients in order to plan effective intervention strategies aimed at reducing the risk of an adverse mental health outcome and at enhancing the psychological endurance of this population.
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12
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Depression in North Korean refugees: a mixed methods study. Public Health 2020; 185:283-289. [PMID: 32711242 DOI: 10.1016/j.puhe.2020.05.046] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2020] [Revised: 05/07/2020] [Accepted: 05/21/2020] [Indexed: 11/21/2022]
Abstract
OBJECTIVE The objective of this study is to investigate beliefs and experiences about depression in North Korean refugees (NKRs) using both quantitative and qualitative methods. STUDY DESIGN We used an exploratory sequential mixed methods study design with a quantitative survey followed by an in-depth individual interview. METHODS We surveyed 329 NKRs who had been in South Korea for at least a year. Eleven participants were selected from the survey sample to complete an additional individual in-depth interview to obtain further understanding about depression among NKRs in their own words and context. RESULTS About 44% of the sample had mild to severe depression; only 16% indicated that they were being treated for mood disorder. Individual in-depth interviews yielded key themes related to NKRs' depression beliefs and experiences: recognizing depression, factors contributing to depression, overcoming depression, and barriers to seeking help and treatment. Integration of quantitative and qualitative data revealed that although loneliness was one of the prominent subthemes contributing to depression, strong self-determination was noted as being critical to overcoming depression among those who had moderate to moderately severe depression but had no social support. CONCLUSIONS Future efforts should be directed toward an enhanced support network and targeted education about the South Korean healthcare system, particularly in relation to mental health treatment.
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Henkelmann JR, de Best S, Deckers C, Jensen K, Shahab M, Elzinga B, Molendijk M. Anxiety, depression and post-traumatic stress disorder in refugees resettling in high-income countries: systematic review and meta-analysis. BJPsych Open 2020; 6:e68. [PMID: 32611475 PMCID: PMC7443922 DOI: 10.1192/bjo.2020.54] [Citation(s) in RCA: 121] [Impact Index Per Article: 30.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND The number of refugees is at its highest since the Second World War and on the rise. Many refugees suffer from anxiety, depression and post-traumatic stress disorder (PTSD), but exact and up-to-date prevalence estimates are not available. AIMS To report the pooled prevalence of anxiety and mood disorders and PTSD in general refugee populations residing in high-income countries and to detect sources of heterogeneity therein. METHOD Systematic review with meta-analyses and meta-regression. RESULTS Systematic searches (final search date 3 August 2019) yielded 66 eligible publications that reported 150 prevalence estimates (total sample N = 14 882). Prevalence rates were 13 and 42% (95% CI 8-52%) for diagnosed and self-reported anxiety, 30 and 40% (95% CI 23-48%) for diagnosed and self-reported depression, and 29 and 37% (95% CI 22-45%) for diagnosed and self-reported PTSD. These estimates are substantially higher relative to those reported in non-refugee populations over the globe and to populations living in conflict or war settings, both for child/adolescent and adult refugees. Estimates were similar over different home and resettlement areas and independent of length of residence. CONCLUSIONS Our data indicate a challenging and persisting disease burden in refugees due to anxiety, mood disorders and PTSD. Knowing this is relevant for the development of public health policies of host countries. Scalable interventions, tailored for refugees, should become more readily available.
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Affiliation(s)
- Jens-R Henkelmann
- Faculty of Social and Behavioural Sciences, Clinical Psychology Department, Leiden University, The Netherlands
| | - Sanne de Best
- Faculty of Social and Behavioural Sciences, Clinical Psychology Department, Leiden University
| | - Carla Deckers
- Faculty of Social and Behavioural Sciences, Clinical Psychology Department, Leiden University
| | - Katarina Jensen
- Faculty of Social and Behavioural Sciences, Clinical Psychology Department, Leiden University
| | - Mona Shahab
- Faculty of Social and Behavioural Sciences, Clinical Psychology Department, Leiden University; and Clinical Epidemiological Department, Leiden University Medical Center
| | - Bernet Elzinga
- Faculty of Social and Behavioural Sciences, Clinical Psychology Department, Leiden University
| | - Marc Molendijk
- Faculty of Social and Behavioural Sciences, Clinical Psychology Department, Leiden University; and Leiden Institute of Brain and Cognition, Leiden University Medical Center, The Netherlands
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14
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Du N, Zhou P, SiTu MJ, Zhu CZ, Huang Y. Post-traumatic stress disorder and depression symptoms of adolescents survived from a seriously-hit area in China: A 3-year follow-up study. Psychiatry Res 2019; 273:288-295. [PMID: 30677716 DOI: 10.1016/j.psychres.2019.01.063] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2016] [Revised: 01/06/2019] [Accepted: 01/15/2019] [Indexed: 02/05/2023]
Abstract
The objective of this study is to analyze the prevalence of probable PTSD and depression after earthquake and to find the risk factors. Adolescents having experienced an earthquake were recruited (n = 330) and assessed within 1 month of the trauma. Follow-up surveys were conducted 12 months, 24 months and 36 months later, respectively. Symptoms were assessed by the Children's Revised Impact of Event Scale and the Depression Self-Rating Scale for Children. Results indicate that the prevalence of probable PTSD in different stages was 42.2%, 20.1%, 30.3% and 11.2%. The corresponding rate of depression was 32.3%, 20.7%, 31.0% and 30.3%. The sub-symptoms of PTSD, intrusion and arousal, tended to decrease at the 1st year, followed by a rebound at the 2nd year, then dropping again at the 3rd year. The avoidance showed a consistent diminishing. The PTSD symptoms were significantly associated with gender and the degree of earthquake exposure. However, the gender, family relationship and despair played crucial roles in the development of depressive symptoms. Despite of the tendency of timing abatement, the prevalence of probable PTSD and depression might show rebound at the second year, which remind us a vital threshold for psychological intervention.
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Affiliation(s)
- Na Du
- Department of Psychiatry, the fourth people's hospital of ChengDu, ChengDu city, SiChuan 610000, China.
| | - Peng Zhou
- Department of Emergency, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Ming-Jing SiTu
- Department of Psychiatry, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Cui-Zhen Zhu
- Department of Clinical Psychology, the second people's hospital, Wannan Medical College, WuHu city, AnHui 241000, China
| | - Yi Huang
- Department of Psychiatry, West China Hospital, Sichuan University, Chengdu 610041, China
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15
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Park S, Lee M, Park SJ, Lee MG. Health risk behaviors and psychological problems among South Korean, North Korean, and other multicultural family adolescents (2011-2016). Psychiatry Res 2018; 268:373-380. [PMID: 30103182 DOI: 10.1016/j.psychres.2018.07.042] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2018] [Revised: 05/28/2018] [Accepted: 07/29/2018] [Indexed: 11/26/2022]
Abstract
This study was aimed to investigate the health risk behaviors and psychological problems among North Korean, other multicultural, and South Korean family adolescents. The data were collected from the Korea Youth Risk Behavior web-based survey (2011-2016) data set. A total of 17,195 adolescents (mean age 14.65 ± 0.01 years) were analyzed to compare health risk behaviors and psychological problems among the three groups. Concerning risk behaviors, multicultural family adolescents showed a higher rate of alcohol use, smoking, drug use and sexual relations compared to South Korean family adolescents. Moreover, North Korean family adolescents were more likely to experience those risk behaviors than other multicultural family adolescents. Concerning psychological problems, multicultural family youth displayed more depressed mood, and more suicidal ideation, planning, and attempts when compared with South Korean family youth. Among multicultural families, North Korean family adolescents were more depressed and showed higher suicidality. School-based education and preventive interventions are necessary to manage risk behaviors and psychological difficulties of adolescents in North Korean and other multicultural families.
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Affiliation(s)
- Subin Park
- Department of Research Planning, Mental Health Research Institute, National Center for Mental Health, 127, Yongmasan-ro, Gwangin-gu, Seoul 04933, South Korea.
| | - Minji Lee
- Department of Research Planning, Mental Health Research Institute, National Center for Mental Health, 127, Yongmasan-ro, Gwangin-gu, Seoul 04933, South Korea
| | - Se Jin Park
- Department of Research Planning, Mental Health Research Institute, National Center for Mental Health, 127, Yongmasan-ro, Gwangin-gu, Seoul 04933, South Korea
| | - Min Geu Lee
- Department of Research Planning, Mental Health Research Institute, National Center for Mental Health, 127, Yongmasan-ro, Gwangin-gu, Seoul 04933, South Korea
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16
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Related Factors of Suicidal Ideation among North Korean Refugee Youth in South Korea. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15081694. [PMID: 30096867 PMCID: PMC6121229 DOI: 10.3390/ijerph15081694] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/28/2018] [Revised: 08/06/2018] [Accepted: 08/07/2018] [Indexed: 11/17/2022]
Abstract
This study investigated the factors associated with suicidal ideation among 174 North Korean refugees (aged 13⁻27 years) residing in South Korea. Specifically, we compared sociodemographic, familial, social, and psychological characteristics between participants with and without suicidal ideation. Twenty-nine refugees (16.7%) had exhibited suicidal ideation in the past 12 months. These refugees had significantly lower levels of familial cohesion (U = 1459.0; p < 0.001), self-esteem (U = 1032.0; p < 0.001), and resilience (U = 1190.0; p < 0.001), as well as higher levels of expressional suppression (U = 1202.5; p < 0.001) and post-traumatic stress disorder symptoms (U = 1303.0; p = 0.001), (with Cohen's d > 0.5), compared to those without suicidal ideation. A multiple logistic regression analysis showed that the level of emotional suppression and familial cohesion were significantly associated with suicidal ideation, after controlling for the other variables. Familial and individual interventions, particularly those focused on encouraging emotional expression and familial cohesion, will be useful for North Korean refugee youth, who have a high risk of suicide.
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17
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An JH, Lee KE, Lee HC, Kim HS, Jun JY, Chang HI, Kim SS, Lee-Tauler SY, Hong JP. Prevalence and Correlates of Suicidal Thoughts and Behaviors among North Korean Defectors. Psychiatry Investig 2018; 15:445-451. [PMID: 30504749 PMCID: PMC5976004 DOI: 10.30773/pi.2017.11.08.3] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2017] [Revised: 10/30/2017] [Accepted: 11/08/2017] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVE Despite the increasing number of North Korean defectors, research on their mental health conditions and suicidal thoughts and behaviors has not been conducted systematically. We examined the prevalence and risk factors of suicidal thoughts and behaviors in North Korean defectors. METHODS This study focused on 300 North Korean defectors recruited from regional resettlement centers in South Korea. In-person interviews based on the North Korean version of the Composite International Diagnostic Interview were conducted to diagnose mental disorders and assess suicidal thoughts and behaviors. Logistic regression analyses were performed to evaluate the association between suicidal thoughts and behaviors and socio-demographic variables, and DSM-IV mental disorders. RESULTS Lifetime prevalence of suicidal ideation, plans, and attempts were 28.3, 13.3, and 17.3%, respectively. Female sex (OR: 2.0, 95% CI: 1.0-3.9), presence of health problems in the past year (2.6, 95% CI: 1.4-4.6), and absence of both South Korean acquaintances (1.9, 95% CI: 1.0-3.4) and North Korean family (1.7, 95% CI: 1.0-2.9) were associated with higher odds of suicidal thoughts and behaviors, after adjusting for participant age, sex, and education. Presence of a mental disorder was associated with a significantly increased odd of suicide ideation, plan, and attempt. Of all mental disorder categories, agoraphobia had the strongest association with suicidal ideation (6.5, 95% CI: 2.0-21.6), plans (7.7, 95% CI: 2.5-23.2) and attempts (12.0, 95% CI: 3.5-40.8). CONCLUSION Suicidal thoughts and behaviors among North Korean defectors are higher than the general population in South Korea, especially show high rates in transit countries. Further study should focus on the changes in suicidal thoughts and behaviors according to the settlement process and early prevention.
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Affiliation(s)
- Ji Hyun An
- Department of Psychiatry, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, Republic of Korea
| | - Kyoung Eun Lee
- Department of Psychiatry, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, Republic of Korea
| | - Hyo Chul Lee
- Department of Psychiatry, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, Republic of Korea
| | - Hae Soo Kim
- Department of Psychiatry, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, Republic of Korea
| | - Jin Yong Jun
- Department of Psychiatry, Seoul National Hospital, Seoul, Republic of Korea
| | - Hye In Chang
- Department of Psychology, Sungkyunkwan University, Seoul, Republic of Korea
| | - Suk Sun Kim
- College of Nursing, Ewha Woman’s University, Seoul, Republic of Korea
| | - Su Yeon Lee-Tauler
- Department of Mental Health, Johns Hopkins University, Baltimore, Maryland, USA
| | - Jin Pyo Hong
- Department of Psychiatry, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, Republic of Korea
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18
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Refugee Health: An Ongoing Commitment and Challenge. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15010131. [PMID: 29342831 PMCID: PMC5800230 DOI: 10.3390/ijerph15010131] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/09/2018] [Revised: 01/09/2018] [Accepted: 01/10/2018] [Indexed: 11/22/2022]
Abstract
Refugees represent a diverse group of displaced individuals with unique health issues and disease risks. The obstacles facing this population have their origins in war, violence, oppression, exploitation, and fear of persecution. Regardless of country of origin, a common bond exists, with refugees often confronting inadequate healthcare resources, xenophobia, discrimination, and a complex web of legal barriers in their new homelands. In many cases, the plight of refugees is multigenerational, manifesting as mental health issues, abuse, poverty, and family disruption. The health trajectory of refugees remains an ongoing commitment and challenge.
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