Lee So Hee, Lee Won Woong, Lee Haewoo, Jun Jin Yong, Noh Jin-Won
Department of Psychiatry, National Medical Center, Seoul, Korea.
Department of Social Welfare, Catholic Kwandong University, Gangneung, Korea.
Ewha Med J. 2025 Apr;48(2):e28. doi: 10.12771/emj.2025.00367. Epub 2025 Apr 10.
This study aimed to identify the types of human rights violations and the associated psychological trauma experienced by North Korean defectors. It also examined the impact of trauma on the defectors' interpersonal relationships, employment, and overall quality of life, while evaluating existing psychological support policies to suggest potential improvements.
A multidisciplinary research team conducted an observational survey and in-depth interviews with approximately 300 North Korean defectors residing in South Korea from June to September 2017. Standardized measurement tools, including the Post-Traumatic Stress Disorder (PTSD) Checklist (PCL-5), Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder Scale-7 (GAD-7), and Short Form-8 Health Survey (SF-8), were employed. Statistical analyses consisted of frequency analysis, cross-tabulation, factor analysis, and logistic regression.
The findings revealed a high prevalence of human rights violations, such as public executions (82%), forced self-criticism (82.3%), and severe starvation or illness (62.7%). Additionally, there were elevated rates of PTSD (56%), severe depression (28.3%), anxiety (25%), and insomnia (23.3%). Defectors who resided in China before entering South Korea reported significantly worse mental health outcomes and a lower quality of life. Moreover, trauma was strongly and negatively correlated with social adjustment, interpersonal relationships, employment stability, and overall well-being.
An urgent revision of existing policies is needed to incorporate specialized, trauma-informed care infrastructures within medical institutions. Furthermore, broad societal education to reduce stigma and enhance integration efforts is essential to effectively support the psychological well-being and social integration of North Korean defectors.
本研究旨在确定朝鲜脱北者所经历的人权侵犯类型及相关心理创伤。研究还考察了创伤对脱北者人际关系、就业及整体生活质量的影响，同时评估现有的心理支持政策以提出潜在改进建议。
一个多学科研究团队于2017年6月至9月对约300名居住在韩国的朝鲜脱北者进行了观察性调查和深入访谈。使用了标准化测量工具，包括创伤后应激障碍检查表（PCL - 5）、患者健康问卷 - 9（PHQ - 9）、广泛性焦虑障碍量表 - 7（GAD - 7）和简短健康调查问卷（SF - 8）。统计分析包括频率分析、交叉表分析、因子分析和逻辑回归。
研究结果显示人权侵犯现象普遍存在，如公开处决（82%）、强迫自我批评（82.3%）以及严重饥饿或疾病（62.7%）。此外，创伤后应激障碍（56%）、严重抑郁（28.3%）、焦虑（25%）和失眠（23.3%）的发生率也有所升高。在进入韩国之前居住在中国的脱北者心理健康状况明显更差，生活质量更低。此外，创伤与社会适应、人际关系、就业稳定性和整体幸福感呈强烈负相关。
迫切需要修订现有政策，在医疗机构中纳入专门的、基于创伤知情护理的基础设施。此外，开展广泛的社会教育以减少污名化并加强融合努力，对于有效支持朝鲜脱北者的心理健康和社会融合至关重要。
