Prevalence of DSM-IV Major Psychiatric Disorders among North Korean Defectors in South Korea.

OBJECTIVE: The aim of this study was to estimate the prevalence of major psychiatric disorders among North Korean defectors (NKD) settled in South Korea. METHODS: The study population consisted of 294 North Korean defectors, aged 18 to 64 years settled in South Korea for 3 years or less. Between June 1, 2016 and October 31, 2016, face-to-face interviews were conducted using the North Korean version of the WHO-Composite International Diagnostic Interview (NK-CIDI) to diagnose DSM-IV psychiatric disorders. RESULTS: The lifetime prevalence of any DSM-IV psychiatric disorders was 62.2% in NKD and 25.0% in the general Korean population. The prevalence of specific disorders in NKD and general Korean population was as follows: 22.3% and 4.9% for major depressive disorder (MDD), 12.2% and 1.4% for post-traumatic stress disorder (PTSD), 18.0% and 4.8% for nicotine dependence, and 14.5% and 11.2% for alcohol abuse. The incidence of every single psychiatric disorder varied in each country. For instance, the generalized anxiety disorder, specific phobia, and alcohol use disorder occurred more frequently in North Korea whereas PTSD was more prevalent in other countries. CONCLUSION: The prevalence of psychiatric disorders among NKD was quite higher than in the general population of South Korea.

Prevalence and Correlates of Suicidal Thoughts and Behaviors among North Korean Defectors.

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.

Treadmill exercise after social isolation increases the levels of NGF, BDNF, and synapsin I to induce survival of neurons in the hippocampus, and improves depression-like behavior.

PURPOSE: We investigated the effects of 8 weeks of treadmill exercise on nerve growth factor (NGF), brain-derived neurotrophic factor (BDNF), and synapsin I protein expression and on the number of 5-bromo-2'-deoxyuridine-5'-mono-phosphate (BrdU)-positive cells in the dentate gyrus of the hippocampus in socially isolated rats. Additionally, we examined the effects of exercise on the number of serotonin (5-HT)- and tryptophan hydroxylase (TPH)-positive cells in the raphe nuclei and on depression behaviors induced by social isolation. METHODS: Forty male Sprague-Dawley rats were divided into four groups: (1) group housing and control group (GCG, n = 10); (2) group housing and exercise group (GEG, n = 10); (3) isolated housing and control group (ICG, n = 10); and (4) isolated housing and exercise group (IEG, n = 10). After 1 week of housing under the normal condition of 3 animals per cage, rats were socially isolated via transfer to individual cages for 8 weeks. Rats were then subjected to treadmill exercise for 5 days per week for 8 weeks during which time the speed of the treadmill was gradually increased. RESULTS: Compared to the GCG, levels of NGF, BDNF, and synapsin I were significantly decreased in the ICG and significantly increased in the IEG (p < 0.001 respectively). Significantly more BrdU-positive cells in the GEG were present as compared to the GCG and ICG, and more BrdU-positive cells were found in the IEG as compared to the ICG (p < 0.001). 5-HT-positive cells in the GEG were significantly increased compared to the GCG and ICG, and more of these cells were found in the IEG as compared to the ICG (p < 0.01). TPH-positive cells in the GEG were significantly increased compared to those in the GCG and ICG (p < 0.05). In the forced swim test, immobility time was significantly increased in the ICG and significantly decreased in the IEG as compared to the ICG (p < 0.01). CONCLUSION: These results showed that regular treadmill exercise following social isolation not only increased the levels of NGF, BDNF, and synapsin I to induce survival of neurons in the hippocampus but also improved depression by increasing the number of serotonergic cells in the raphe nuclei.