Somatic symptoms among trauma-exposed North Korean defectors: prevalence, correlates, and implications

Abstract

Background: North Korean defectors (NKDs), a predominantly trauma-exposed population, are at high risk for somatic symptoms. Unrecognized and untreated somatic symptoms can profoundly affect health and psychosocial functioning. Therefore, it is crucial to understand and address somatic symptoms in the NKD population. Objective: This study aimed to assess the prevalence of somatic symptoms and to identify and quantify their correlates among trauma-exposed NKDs. Method: Cross-sectional survey data of 438 trauma-exposed NKDs in South Korea were analyzed. Participants completed a survey assessing somatic symptoms, sociodemographic, trauma-related (repatriation experience, trauma exposure, probable post-traumatic stress disorder [PTSD] and disturbances in self-organization [DSO]), health-related (physical activity), and social (loneliness and perceived discrimination) characteristics. Results: Overall, 42 of the 438 NKDs reported moderate-to-severe somatic symptoms. Multiple linear regression and relative importance analyses revealed that higher levels of loneliness (beta = 0.27, p < .001; 25.2% relative variance explained [RVE]) was the strongest correlates of somatic symptoms, followed by older age (beta = 0.24, p < .001; 17.2% RVE), probable PTSD (beta = 0.14, p = .001; 14.6%), greater perceived discrimination (beta = 0.15, p = .001; 14.5%), and probable DSO (beta = 0.10, p = .026; 13.0% RVE). Conclusions: This study provides evidence of the high severity of somatic symptoms among NKDs. Further research is needed to develop and test culturally appropriate interventions to address loneliness and perceived discrimination of NKDs, especially those with comorbid PTSD and DSO symptoms, to help mitigate somatic symptoms.