Lim Kyungho, Baek Jiwon, Kim Hokon, Kim Ocksim, Chu Sang Hui, Jung Young-Chul
Department of Psychiatry, Yonsei University College of Medicine, Seoul, Republic of Korea.
Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea.
Psychiatry Investig. 2024 Nov;21(11):1203-1210. doi: 10.30773/pi.2023.0351. Epub 2024 Nov 18.
This study aimed to explore the relationship between suicidal ideation and specific trauma and social discrimination among North Korean defectors.
A total of 448 North Korean defectors were recruited from online and offline communities and counseling centers. Participants provided sociodemographic and psychiatric history information via an online survey. Various assessment tools, including the Traumatic Event Checklist for North Korean Defectors, International Trauma Questionnaire, Experiences of Discrimination Scale, UCLA Loneliness Scale (short-form), and World Health Organization Quality of Life Instrument, Short Form (WHOQOL-BREF), were employed. Multiple logistic regression analysis was used to examine the association between suicidal ideation and different types of trauma and discrimination.
Among participants, 38.4% reported experiencing suicidal ideation. The most prevalent trauma was "unwanted separation from spouse, parent, or sibling" (69.4%), and the primary form of discrimination was "unfairness during employment" (35.7%). After adjusting for relevant variables, experiencing "extreme life-threatening hardship," "unwanted separation from a child," and "discrimination in income" significantly increased the likelihood of suicidal ideation. Importantly, unlike other refugee groups, interpersonal violence like torture or sexual abuse did not significantly contribute to suicidal ideation in this population. These findings highlight the unique vulnerabilities of North Korean defectors and suggest that income-related discrimination, unwanted separation from children, and life-threatening hardships are critical factors influencing suicidal ideation. Limitations such as recall biases and the cross-sectional nature of the data should be acknowledged.
This study underscores the need for tailored psychiatric support for North Korean defectors, recognizing their distinctive needs compared to other refugee populations.
本研究旨在探讨朝鲜脱北者自杀意念与特定创伤及社会歧视之间的关系。
从线上和线下社区及咨询中心招募了448名朝鲜脱北者。参与者通过在线调查提供社会人口学和精神病史信息。使用了各种评估工具，包括《朝鲜脱北者创伤事件清单》、《国际创伤问卷》、《歧视经历量表》、《加州大学洛杉矶分校孤独量表（简版）》和《世界卫生组织生活质量量表简表（WHOQOL - BREF）》。采用多元逻辑回归分析来检验自杀意念与不同类型创伤和歧视之间的关联。
在参与者中，38.4%报告有自杀意念。最普遍的创伤是“与配偶、父母或兄弟姐妹意外分离”（69.4%），主要的歧视形式是“就业期间受到不公平对待”（35.7%）。在对相关变量进行调整后，经历“极端危及生命的艰难困苦”、“与孩子意外分离”和“收入方面的歧视”显著增加了自杀意念的可能性。重要的是，与其他难民群体不同，诸如酷刑或性虐待等人际暴力在这一人群中对自杀意念的影响并不显著。这些发现凸显了朝鲜脱北者独特的脆弱性，并表明与收入相关的歧视、与孩子的意外分离以及危及生命的艰难困苦是影响自杀意念的关键因素。应认识到数据存在回忆偏差和横断面性质等局限性。
本研究强调需要为朝鲜脱北者提供量身定制的精神支持，认识到他们与其他难民群体相比有独特的需求。
