{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,11]],"date-time":"2026-07-11T03:36:19Z","timestamp":1783740979095,"version":"3.55.0"},"reference-count":11,"publisher":"American Medical Association (AMA)","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Netw Open"],"abstract":"Importance<\/jats:title>Migrant and refugee populations are increasing globally, and children and adolescents in these populations are particularly susceptible to mental disorders. North Korean refugee (NKR) youths now living in South Korea share a culture, language, and history with South Korean (SK) youths, making these 2 groups suitable for studying the environmental factors in psychiatric health.<\/jats:p><\/jats:sec>Objective<\/jats:title>To compare the risk of developing mental illness and individual psychiatric disorders among NKR youths and SK youths.<\/jats:p><\/jats:sec>Design, Setting, and Participants<\/jats:title>This cohort study obtained data from Korea\u2019s National Health Insurance Service claims database from 2005 to 2021. Participants were aged 1 to 18 years between 2007 and 2010 who had no prior psychiatric claims, whether as outpatients or inpatients. Children and adolescents of the SK general population matched 1:10 on sex and age were compared with the NKR youth population. Statistical analyses were performed from August 2024 to March 2025.<\/jats:p><\/jats:sec>Main Outcomes and Measures<\/jats:title>Risk, presented as hazard ratio (HR), of developing psychiatric disorders in NKR youths compared with SK youths. This risk was assessed using a Cox proportional hazards regression model and Kaplan-Meier time-to-event probabilities.<\/jats:p><\/jats:sec>Results<\/jats:title>In total, 1618 NKR youths (810 males [50.1%]; mean [SD] age, 9.48 [4.62] years) and 308\u202f927 SK youths (194\u202f331 females [62.9%]; mean [SD] age, 11.80 [4.72] years) were included in this study. NKR youths showed a significantly higher risk of developing psychiatric disorders (HR, 1.29; 95% CI, 1.17-1.43) compared with SK youths. Individual psychiatric disorder risks were higher for NKR youths, including posttraumatic stress disorder (HR, 2.33; 95% CI, 1.34-4.06; P<\/jats:italic>\u2009=\u2009.003), attention-deficit\/hyperactivity disorder (HR, 1.67; 95% CI, 1.32-2.11; P<\/jats:italic>\u2009&amp;lt;\u2009.001), bipolar affective disorders (HR, 1.61; 95% CI, 1.20-2.15; P<\/jats:italic>\u2009&amp;lt;\u2009.001), major depressive disorder (HR, 1.53; 95% CI, 1.33-1.75; P<\/jats:italic>\u2009&amp;lt;\u2009.001), and anxiety (HR, 1.25; 95% CI, 1.11-1.42; P<\/jats:italic>\u2009&amp;lt;\u2009.001).<\/jats:p><\/jats:sec>Conclusions and Relevance<\/jats:title>In this cohort study, compared with SK youths, NKR youths showed a significantly higher risk of developing psychiatric disorders overall and individual psychiatric disorders, such as posttraumatic stress disorder, attention-deficit\/hyperactivity disorder, bipolar disorder, major depressive disorder, and anxiety. This finding is important for establishing medical and educational service plans and policies for the increasing number of refugee youths in South Korea.<\/jats:p><\/jats:sec>","DOI":"10.1001\/jamanetworkopen.2025.12941","type":"journal-article","created":{"date-parts":[[2025,5,29]],"date-time":"2025-05-29T15:31:02Z","timestamp":1748532662000},"page":"e2512941","source":"Crossref","is-referenced-by-count":5,"title":["Psychiatric Health Risks in North Korean Refugee Youths Resettled in South Korea"],"prefix":"10.1001","volume":"8","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 Hospital, Kyung Hee University College of Medicine, Seoul, South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Minha","family":"Hong","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Kyung Hee University Hospital at Gangdong, Kyung Hee University College of Medicine, Seoul, South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"In-Hwan","family":"Oh","sequence":"additional","affiliation":[{"name":"Department of Preventive Medicine, University of Ulsan College of Medicine, Seoul, South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10","published-online":{"date-parts":[[2025,5,29]]},"reference":[{"key":"zoi250427r2","doi-asserted-by":"publisher","first-page":"373","DOI":"10.1016\/j.psychres.2018.07.042","article-title":"Health risk behaviors and psychological problems among South Korean, North Korean, and other multicultural family adolescents (2011-2016).","volume":"268","author":"Park","year":"2018","journal-title":"Psychiatry Res"},{"issue":"10","key":"zoi250427r3","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2022.36751","article-title":"Assessing mental illness risk among North Korean refugees and immigrants resettled in South Korea.","volume":"5","author":"Lee","year":"2022","journal-title":"JAMA Netw Open"},{"issue":"3","key":"zoi250427r4","doi-asserted-by":"publisher","first-page":"217","DOI":"10.4306\/pi.2012.9.3.217","article-title":"The psychological problems of North Korean adolescent refugees living in South Korea.","volume":"9","author":"Lee","year":"2012","journal-title":"Psychiatry Investig"},{"issue":"440","key":"zoi250427r5","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1111\/j.1600-0447.2011.01740.x","article-title":"Trauma, exile and mental health in young refugees.","author":"Montgomery","year":"2011","journal-title":"Acta Psychiatr Scand Suppl"},{"key":"zoi250427r6","doi-asserted-by":"publisher","first-page":"53","DOI":"10.2174\/1745017901410010053","article-title":"Prevalence of psychiatric disorders among unaccompanied asylum-seeking adolescents in Norway.","volume":"10","author":"Jakobsen","year":"2014","journal-title":"Clin Pract Epidemiol Ment Health"},{"issue":"4","key":"zoi250427r7","doi-asserted-by":"publisher","first-page":"288","DOI":"10.1097\/01.nmd.0000243751.49499.93","article-title":"Comparing psychological distress, traumatic stress reactions, and experiences of unaccompanied refugee minors with experiences of adolescents accompanied by parents.","volume":"195","author":"Bean","year":"2007","journal-title":"J Nerv Ment Dis"},{"issue":"2","key":"zoi250427r8","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2021.44934","article-title":"Prevalence of mental health disorders among immigrant, refugee, and nonimmigrant children and youth in British Columbia, Canada.","volume":"5","author":"Gadermann","year":"2022","journal-title":"JAMA Netw Open"},{"issue":"2","key":"zoi250427r9","doi-asserted-by":"publisher","first-page":"121","DOI":"10.1016\/S2352-4642(17)30147-5","article-title":"Preventive mental health interventions for refugee children and adolescents in high-income settings.","volume":"2","author":"Fazel","year":"2018","journal-title":"Lancet Child Adolesc Health"},{"issue":"supp 2","key":"zoi250427r10","article-title":"Mental health status of North Korean refugees in South Korea and risk and protective factors: a 10-year review of the literature.","volume":"8","author":"Lee","year":"2017","journal-title":"Eur J Psychotraumatol"},{"issue":"6","key":"zoi250427r11","doi-asserted-by":"publisher","first-page":"541","DOI":"10.30773\/pi.2019.0217","article-title":"Prevalence of DSM-IV major psychiatric disorders among North Korean defectors in South Korea.","volume":"17","author":"Lee","year":"2020","journal-title":"Psychiatry Investig"},{"key":"zoi250427r1","unstructured":"Unikorea. Status of North Korean defectors. Article in Korean. Accessed April 24, 2024. https:\/\/www.unikorea.go.kr\/unikorea\/business\/NKDefectorsPolicy\/status\/lately\/"}],"container-title":["JAMA Network Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/jamanetwork.com\/journals\/jamanetworkopen\/articlepdf\/2834552\/lee_2025_oi_250427_1747687243.61549.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,5,29]],"date-time":"2025-05-29T15:31:03Z","timestamp":1748532663000},"score":1,"resource":{"primary":{"URL":"https:\/\/jamanetwork.com\/journals\/jamanetworkopen\/fullarticle\/2834552"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,5,29]]},"references-count":11,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2025,5,1]]}},"URL":"https:\/\/doi.org\/10.1001\/jamanetworkopen.2025.12941","relation":{},"ISSN":["2574-3805"],"issn-type":[{"value":"2574-3805","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,5,29]]}}}