title: Association between defense mechanisms and psychiatric symptoms in North Korean Refugees.
abstract: OBJECTIVE
  Defense mechanism may contribute to psychiatric symptoms. Refugees are vulnerable to various psychiatric symptoms, such as depression, anxiety, somatization, and those associated with post-traumatic stress disorder (PTSD), due to their traumatic or stressful experiences. We aimed to investigate the mediating role of each defense mechanism in the occurrence of specific psychiatric symptoms in North Korean refugees.
  
  
  METHODS
  Among 213 North Korean refugees initially recruited, 201 completed the following questionnaires: the Defense Style Questionnaire, the Center for Epidemiological Studies-Depression Scale (CES-D), the State-Trait Anxiety Inventory-State (STAI-S), the somatization subscale of Symptom Check-List-90-Revised (SCL-90-R), and the Impact of Event Scale-Revised (IES-R). Stepwise regression analysis was performed to determine the defense mechanisms more predominantly associated with specific psychiatric symptoms after controlling for age, sex, number of traumatic experiences, and other psychiatric symptoms (depressive symptoms and/or anxiety).
  
  
  RESULTS
  Higher levels of depression were independently predicted by greater use of resignation. More use of acting out and less use of humor and sublimation independently predicted higher levels of anxiety. Somatization was independently predicted by more use of inhibition. PTSD symptoms were independently predicted by more use of undoing and isolation.
  
  
  CONCLUSIONS
  Specific psychiatric symptoms were associated with specific defense mechanisms in North Korean refugees. Our findings suggest that the manifest psychiatric symptoms of refugees may be mediated by their dominant defense mechanism.
authors.affiliation: Department of Psychiatry, Seoul National Hospital, Seoul, Republic of Korea.
authors.forename: Jin Yong
authors.initials: JY
authors.lastname: Jun
authors.affiliation: Department of Psychiatry, Seoul Metropolitan Eunpyeong Hospital, Seoul, Republic of Korea.
authors.forename: Yu-Jin G
authors.initials: YJ
authors.lastname: Lee
authors.affiliation: Department of Psychiatry, National Medical Center, Seoul, Republic of Korea.
authors.forename: So-Hee
authors.initials: SH
authors.lastname: Lee
authors.affiliation: Department of Psychiatry, National Medical Center, Seoul, Republic of Korea.
authors.forename: So Young
authors.initials: SY
authors.lastname: Yoo
authors.affiliation: Department of Psychiatry, National Health Insurance Service Ilsan Hospital, Goyang, Republic of Korea.
authors.forename: Jungeun
authors.initials: J
authors.lastname: Song
authors.affiliation: Department of Psychiatry, Seoul National University Hospital and Center for Medicine and Korean Reunification, Seoul National University of College of Medicine, Seoul, Republic of Korea. Electronic address: psychical@hanmail.net.
authors.forename: Seog Ju
authors.initials: SJ
authors.lastname: Kim
mesh_terms: D000328:Adult; D001007:Anxiety / Q000523:psychology*; D003674:Defense Mechanisms; D056911:Democratic People's Republic of Korea; D003863:Depression / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012036:Refugees / Q000523:psychology*; D056910:Republic of Korea; D013001:Somatoform Disorders / Q000523:psychology*; D013313:Stress Disorders, Post-Traumatic / Q000523:psychology*