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SO374

Somatic symptoms, but not depression, are associated with unmet medical needs among North Korean defectors

SOMATIC SYMPTOMS ARE ASSOCIATED WITH UNMET MEDICAL NEEDS, BUT NOT DEPRESSION, AMONG NORTH KOREAN DEFECTORS

Unmet medical needs among North Korean defectors were found to be associated with somatic symptom severity, but not with depression.

The aim was to assess the associations of depression and somatic symptoms with unmet medical needs among North Korean defectors (NKD) living in South Korea. A cross-sectional online survey included 1,079 defectors (mean age 52.71 ± 12.37 years; 80.4% women). Depression was measured using the ICD-11–aligned International Depression Questionnaire (IDQ), and somatic symptoms were measured using the somatic subscale of the Depression and Somatic Symptom Scale (DSSS). Logistic regression was performed with adjustment for sociodemographic variables (sex, age, living alone, education, marital status, income, health insurance, and region of residence) and health-related variables (hypertension, diabetes, smoking, and alcohol consumption). Of the participants, 136 (12.6%) reported unmet medical needs; the main reasons were financial burden (52.9%), lack of time (18.4%), perceiving symptoms as mild (9.6%), and fear of medical care (8.1%). In the adjusted model, greater somatic symptom severity was significantly associated with unmet medical needs (adjusted OR = 1.101; 95% CI 1.064–1.139; p < 0.001), whereas a diagnosis of depression was not (adjusted OR = 1.066; 95% CI 0.618–1.837; p = 0.819). The table in the poster also showed that diabetes (adjusted OR = 1.819; 95% CI 1.058–3.127), social drinking (1.613; 1.056–2.465), and heavy drinking (2.035; 1.121–3.694) were associated with increased odds, while being aged 60 or older (0.450; 0.216–0.941) and being covered by Medical Aid (0.563; 0.346–0.915) were associated with lower odds. The findings suggest that individuals with somatic symptoms perceive a greater need for medical care but are unable to access appropriate services, and that psychological distress expressed through somatic symptoms contributes to gaps in healthcare utilization.

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