title: Insomnia in North Korean Refugees: Association with Depression and Post-Traumatic Stress Symptoms.
abstract: OBJECTIVE
  We investigated the prevalence of insomnia and its clinical characteristics in North Korean refugees.
  
  
  METHODS
  North Korean refugees living in South Korea (48 males, 129 females; mean age 38.22±12.24 years) and South Koreans (112 males, 203 females; mean age 39.48±10.32 years) completed the following questionnaires: the Self-reported Questionnaire on Insomnia, Center for Epidemiological Studies-Depression Scale (CES-D), Trauma Exposure Check List for North Korean Refugees, and the Impact of Event Scale-Revised (IES-R).
  
  
  RESULTS
  North Korean refugees had insomnia more often than South Koreans did (38.42% vs. 8.89%). Depression combined with insomnia was also more prevalent in North Korean refugees (28.25% vs. 3.17%). Compared with South Koreans with insomnia, North Korean refugees with insomnia showed higher CES-D scores. The North Korean refugees with insomnia had experienced a larger number of traumatic events, and had higher CES-D and IES-R scores compared to North Korean refugees without insomnia. Insomnia in North Korean refugees was also associated with the presence of significant depressive and post-traumatic stress disorder (PTSD) symptoms.
  
  
  CONCLUSIONS
  Insomnia was common in North Korean refugees and was closely associated with depressive and PTSD symptoms. Our study suggests that complaints of insomnia may indicate more severe psychopathology, especially in refugees.
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, Seoul National Hospital, Seoul, Republic of Korea.
authors.forename: Jin Yong
authors.initials: JY
authors.lastname: Jun
authors.affiliation: Department of Psychiatry, Seoul National University Hospital, Seoul, Republic of Korea.
authors.forename: Yu Jin
authors.initials: YJ
authors.lastname: Lee
authors.affiliation: Department of Psychiatry, Seoul National University Hospital, Seoul, Republic of Korea.
authors.forename: Juhyun
authors.initials: J
authors.lastname: Park
authors.affiliation: Department of Psychiatry, Seoul National University Hospital, Seoul, Republic of Korea.
authors.forename: Soohyun
authors.initials: S
authors.lastname: Kim
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: Yu
authors.affiliation: Department of Psychiatry, Seoul National University Hospital, Seoul, Republic of Korea.; Center for Medicine and Korean Reunification, Seoul National University of College of Medicine, Seoul, Republic of Korea.; Department of Psychiatry, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
authors.forename: Seog Ju
authors.initials: SJ
authors.lastname: Kim
keywords: Depression; Insomnia; North Korean refugee; Post-traumatic stress disorder