{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,11]],"date-time":"2026-07-11T14:20:37Z","timestamp":1783779637112,"version":"3.55.0"},"reference-count":18,"publisher":"American Medical Association (AMA)","issue":"10","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Netw Open"],"abstract":"Importance<\/jats:title>The global increase in the numbers of refugees and immigrants has made mental health a major public concern. Although they are divided, North and South Korea share a common ethnic heritage.<\/jats:p><\/jats:sec>Objective<\/jats:title>To investigate mental illness risk among North Korean immigrants living in South Korea and compare it with that of the general South Korean population.<\/jats:p><\/jats:sec>Design, Setting, and Participants<\/jats:title>This retrospective, population-based cohort study was based on National Health Insurance claims data from 2007 to 2019, and North Korean immigrants and refugees (NKIRs) and age-matched and sex-matched members of the general population (GP) were included with a 1:3 ratio. Data were analyzed from March 2022 to August 2022.<\/jats:p><\/jats:sec>Exposure<\/jats:title>Emigration from North Korea to South Korea.<\/jats:p><\/jats:sec>Main Outcomes and Measures<\/jats:title>Mental illness incidence and risk through a Cox proportional risk model adjusted for sex, age, disability, region, Charlson Comorbidity Index score, and insurance premium percentile.<\/jats:p><\/jats:sec>Results<\/jats:title>A total of 37\u202f209 NKIRs and 111\u202f627 members of the GP were enrolled. The final analysis examined 112\u202f851 individuals (73\u202f238 [64.9%] female, median [IQR] age 34 [19-47] years), with 90\u202f235 (80.0%) in the GP and 22\u202f616 (20.0%) in the NKIR group. The propensity score\u2013matching population numbered 24\u202f532 in total, with 12\u202f266 each in the NKIR and GP groups. NKIR patients had a higher mental illness risk than the GP (hazard ratio [HR], 2.12; 95% CI, 2.04-2.21). The multivariable adjusted HRs (95% CI) for developing mental disorders were 4.91 (3.59-6.71) for posttraumatic stress disorder, 3.10 (2.90-3.30) for major depressive disorder, 2.27 (2.11-2.44) for anxiety and panic disorder, 2.03 (1.58-2.60) for bipolar affective disorder, 1.85 (1.53-2.24) for alcohol use disorder, and 1.89 (1.46-2.45) for schizophrenia.<\/jats:p><\/jats:sec>Conclusions and Relevance<\/jats:title>In this study, NKIR individuals showed a significantly higher risk of developing most mental disorders. Interventional strategies can prevent psychiatric morbidity and ensure adequate care for this population.<\/jats:p><\/jats:sec>","DOI":"10.1001\/jamanetworkopen.2022.36751","type":"journal-article","created":{"date-parts":[[2022,10,19]],"date-time":"2022-10-19T15:03:29Z","timestamp":1666191809000},"page":"e2236751","source":"Crossref","is-referenced-by-count":10,"title":["Assessing Mental Illness Risk Among North Korean Refugees and Immigrants Resettled in South Korea"],"prefix":"10.1001","volume":"5","author":[{"given":"Rugyeom","family":"Lee","sequence":"first","affiliation":[{"name":"Department of Preventive Medicine, Kyung Hee University School of Medicine, Seoul, South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sang Min","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Kyung Hee University School of Medicine, Seoul, South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Minha","family":"Hong","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Myongji Hospital, Hanyang University College of Medicine, Goyang, South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"In-Hwan","family":"Oh","sequence":"additional","affiliation":[{"name":"Department of Preventive Medicine, Kyung Hee University School of Medicine, Seoul, South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10","published-online":{"date-parts":[[2022,10,19]]},"reference":[{"issue":"4","key":"zoi221044r3","doi-asserted-by":"publisher","first-page":"857","DOI":"10.1111\/padr.v46.4","article-title":"United Nations Department of Economic and Social Affairs, Population Division World family planning 2020: Highlights, United Nations publications, 2020. 46 p.","volume":"46","author":"Bongaarts","year":"2020","journal-title":"Popul Dev 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