*Article* **Factors Affecting Changes in the Mental Health of North Korean Refugee Youths: A Three-Year Follow-Up Study**

**Yoanna Seong and Subin Park \***

Department of Research Planning, Mental Health Research Institute, National Center for Mental Health, Seoul 04933, Korea; ynnn0208@korea.kr

**\*** Correspondence: subin21@korea.kr; Tel.: +82-2-2204-0108

**Abstract:** This study identified factors affecting changes in depression of 64 North Korean refugee youths (NKRYs) aged 13 to 23 years (40 female) using follow-up data over a three-year period. We collected intrapersonal factors (emotional regulation strategies, resilience, quality of life) and external factors (psychological and practical support, family adaptation, and cohesion) to understand the preventative and risk factors affecting changes in depression. The trend of depression symptoms significantly increased, and the proportion of people classified as depressed (cut-off score = 21) increased steadily from 45.3% to 59.4% in the third year. In addition, we conducted a panel regression analysis, which showed that individual internal factors had a statistically significant effect on changes in depression. Specifically, expressive suppression of emotions was shown to increase depression over time. Resilience and life satisfaction were significant factors reducing depression in this study. On the other hand, external factors were not significantly related to changes over time in depression of NKRYs. Interventions for NKRYs at risk of depression are necessary and should include ways to enhance resilience and life satisfaction, and foster ego strength by recognizing emotions and promoting healthy emotional expression.

**Keywords:** North Korean refugee youths (NKRYs); depression; emotional regulation strategy; expressive suppression; resilience; life satisfaction
