KISEP Original Article J Korean Neuropsychiatr Assoc Vol 45, No 1 북한이탈주민의외상후스트레스장애에대한 3 년추적연구 홍창형 1 유정자 2 조영아 3 엄진섭 4 구현지 1 서승원 1 안은미 5 민성길 1 전우택 6 A 3-Year Follow-Up Study of Posttraumatic Stress Disorder among North Korean Defectors Chang Hyung Hong, MD 1, Jong-Ja Yoo, MS 2, Young-A Cho, PhD 3, Jinsup Eom, MS 4, HyunJi Ku, MS 1, Seung Won Seo, MD 1, Eun Mi Ahn, MD 5, Sung Kil Min, MD 1 and Woo Taek Jeon, MD 6 1 Department of Psychiatry, College of Medicine, Yonsei University, Seoul, 2 The Institute for Korean Unification Studies, Yonsei University, Seoul, 3 Yonsei Counseling Center, Yonsei University, Seoul, 4 Department of Psychology, College of Social Science, Chungbuk National University, Cheongju, 5 Department of Family Medicine, Seoul National University Hospital, Seoul, 6 Department of Medical Education, College of Medicine, Yonsei University, Seoul, Korea Objective:This study is a follow-up of a first survey of 200 North Korean defectors who entered South Korea in 2001. The purpose of this study is to examine changes in the current prevalence of partial PTSD and full PTSD after 3 years and to evaluate related factors. Methods:This study followed up on 151 of the 200 North Korean defectors from our first survey. 20 interviewers conducted face-to-face interviews and assisted defectors in completing a self-report assessment. The traumatic events which participants with chronic PTSD and delayed onset PTSD experienced were then examined. Results:Over the 3 years, the current prevalence rate of partial PTSD was reduced from 31.8% to 5.3%, and the current prevalence rate of full PTSD was reduced from 27.2% to 4.0%. Of particular interest was that 88.8% of those diagnosed with full or partial PTSD in the first survey had recovered after 3 years. Conclusion:The current prevalence rate of partial and full PTSD rapidly decreased during 3 years. (J Korean Neuropsychiatr Assoc 2006;45(1):49-56) KEY WORDS:North Korean defectors Partial PTSD Full PTSD Follow-up study Traumatic event. 서 론 49
방법 대상 연구방법 평가도구 - 50
Full PTSD와 partial PTSD의진단 북한내및탈북과정중외상경험 통계분석 결과 인구사회학적특성및 partial PTSD 와 full PTSD의유병률변화 51
만성 PTSD와지연발병형 PTSD 북한내및탈북과정중경험한외상사건의개수와 partial and full PTSD와의관계 Table 1. Demographic characteristics of 3 diagnotstic groups non-ptsd, partial PTSD, and full PTSD Variable Non-PTSD n=137 p-ptsd n=8 f-ptsd n=6 Total n=151 Sex* Male 079 92.9 4 4.7 2 2.4 085 100.0 Female 058 87.9 4 6.1 4 6.1 066 100.0 Age years Male 38.010.6 32.007.4 49.004.2 37.910.5 Female 36.509.9 45.214.7 39.012.3 37.110.4 Total 37.310.3 38.612.9 42.310.9 37.610.4 Educational level in High school 085 90.4 5 5.3 4 4.3 094 100.0 North Korea* College 020 90.9 1 4.5 1 4.5 022 100.0 Graduate School 032 91.4 2 5.7 1 2.9 035 100.0 Education in South Korea* Yes 054 91.5 4 6.8 1 1.7 059 100.0 No 083 90.2 4 4.3 5 5.4 092 100.0 Duration of defection month 20.615.4 29.314.6 26.808.9 21.315.3 Duration of residence in South Korea month 51.507.6 46.408.3 49.506.6 51.107.7 No. of family members who entered South Korea together 02.401.5 01.500.9 02.000.9 02.301.5 No. of family members who is living together in South Korea 02.701.3 02.601.1 01.600.8 02.701.3 Living with their spouse* Yes 070 92.1 5 6.6 1 1.3 076 100.0 No 067 89.3 3 4.0 5 6.7 075 100.0 Marriage in North Korea* Yes 077 90.6 4 4.7 4 4.7 085 100.0 No 060 90.9 4 6.1 2 3.0 066 100.0 Marriage in South Korea* Yes 036 87.8 3 7.3 2 4.9 041 100.0 No 101 91.8 5 4.5 4 3.6 110 100.0 Frequency %, MeanSD, period between escape from North Korea and entry into South Korea, p-ptsdpartial PTSD, f-ptsdfull PTSD 2001 1 st survey 151Non PTSD 62 p-ptsd 48 f-ptsd 41 43 1 3 36 4 1 58 3 2 2004 2 nd survey 151Non PTSD 137 p-ptsd 8 f-ptsd 6 Fig. 1. Change in the number of defectors in each of the 3 diagnostic groups Non PTSD, partial PTSD, full PTSD over 3 Years. p-ptsdpartial PTSD, f-ptsd full PTSD. 52
Table 2. Comparison of the cumulative number of types of traumatic events among the 3 diagnostic groups in the first survey Frequency Non- PTSD n=62 p-ptsd n=48 f-ptsd n=41 F Tukey post hoc test Total No. of traumas by type in North Korea* 25 items 07.44.3 09.73.9 08.74.5 4.241 p-ptsdnon PTSD During defection* 19 items 05.33.0 07.33.7 06.12.8 4.850 p-ptsdnon PTSD Total* 44 items 12.76.2 16.96.5 14.86.3 6.168 p-ptsdnon PTSD MeanSD, p0.05, p0.01, p-ptsdpartial PTSD, f-ptsdfull PTSD Table 3. Comparison of the cumulative number of types of traumatic events among the 3 diagnostic groups in the second survey Frequency Non-PTSD n=137 p-ptsd n=8 f-ptsd n=6 Total No. of traumas by typein North Korea* 08.44.4 08.04.0 11.03.4 1.117 25 items During defection* 06.03.2 06.43.0 08.75.3 1.906 19 items Total* 44 items 14.46.5 14.44.1 19.78.2 1.902 MeanSD, p-ptsdpartial PTSD, f-ptsdfull PTSD p p p F 고찰 53
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결론 55
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