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This page is an AI-assisted Turkish summary of the study presented at the 26th World Congress of Psychiatry. The study belongs to the presenting authors; please refer to the original source when citing it.

SO501

Cumulative stress and ICD-11 adjustment disorder among North Korean refugees: a refugee mental health perspective

CUMULATIVE STRESS AND ICD-11 ADJUSTMENT DISORDER IN NORTH KOREAN DEFECTORS: A REFUGEE MENTAL HEALTH PERSPECTIVE

As the number of current stressors increases among North Korean refugees, the likelihood of probable adjustment disorder rises substantially, independently of trauma history.

The aim was to determine the prevalence of probable ICD-11 adjustment disorder (AjD) among North Korean defectors (NKDs) who had resettled in South Korea and to examine the role of cumulative current stressors. The cross-sectional survey included 1,079 refugees (age 52.71 ± 12.37 years; 80.4% women; 46.4% separated or divorced; 43.2% living alone). Probable AjD was assessed using the International Adjustment Disorder Questionnaire (IADQ), which is aligned with ICD-11 criteria; current stressors were measured using the IADQ's eight predefined categories (cumulative count ranging from 0 to 8); and multivariable logistic regression was performed, adjusting for sociodemographic characteristics and lifetime traumatic experiences during childhood, adolescence, and adulthood. The prevalence of probable AjD was 20.9% (n = 225); the most frequently reported current stressors were personal health problems (51.4%), financial difficulties (38.6%), relationship problems (37.2%), and health problems affecting a loved one (35.1%). Compared with those reporting a single stressor, the adjusted odds ratios for those reporting two, three, and four or more stressors were 4.77 (95% CI 2.417–9.416), 5.96 (95% CI 3.080–11.524), and 12.13 (95% CI 6.773–21.728), respectively (all p < 0.001). Coverage under the Medical Aid program (adjusted OR = 1.536; 95% CI 1.064–2.218; p = 0.022) and a greater number of traumatic experiences in adulthood (adjusted OR = 1.063; 95% CI 1.020–1.109; p = 0.004) were also independently associated with AjD. Cumulative current stressors were strongly associated with AjD independently of trauma history; the authors emphasize that both trauma history and current stressors should be systematically assessed to support successful adjustment.

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