The family of Kenneth Bae, a US citizen detained in North Korea for nearly two years, voiced anguish Friday after Bae said he felt "abandoned" by the US authorities.
In an interview published Thursday in Choson Sinbo, a pro-North Korean newspaper based in Japan, Bae said he was also suffering from serious lung and liver ailments.
Expressing regret at the apparent stalemate in efforts to secure his release, Bae said "he feels like he was abandoned by the US government," the newspaper said.
An accompanying picture taken in hospital, showed Bae sitting in a chair, wearing a blue prison uniform with the number 103 on his left chest.
It was the first news of Bae, who turns 42 on Saturday, since he received a consular visit from the Swedish embassy in Pyongyang in April.
"After months of silence, it is devastating to hear Kenneth talk about feeling abandoned," his sister Terri Chung said in a statement.
"When we woke this morning to hear news about Kenneth, we joined him in feeling the disappointment, wondering when this will ever end," Chung said.
Bae's family fear he has become a political bargaining chip -- a concern that will have been fuelled by his clearly authorised, and certainly closely vetted, interview with the Choson Sinbo.
Bae was arrested in November 2012 and later sentenced to 15 years' hard labour on charges of seeking to topple the North Korean government.
A tour operator, he was described by a North Korean court as a militant Christian evangelist.
Bae began serving his sentence in May 2013 and was admitted to hospital in August with kidney and liver problems.
"We are afraid that Kenneth has already suffered irreparable damage to his health," Chung said.
"With the threat of Kenneth being sent back to labor camp despite ill health, our family is becoming increasingly desperate to get Kenneth home to seek the medical care he needs."
Bae is the longest-held of three Americans currently in detention in North Korea.
Matthew Miller, 24, was arrested in April after he apparently ripped up his visa at immigration and demanded asylum in the communist state.
Jeffrey Fowle, who entered the North on April 29, was arrested after the 56-year-old reportedly left a Bible at a hotel.
North Korea said last month it would put Miller and Fowle on trial on unspecified charges related to "perpetrating hostile acts".
The US special envoy for North Korean human rights issues, Robert King, has twice travelled to the North to secure Bae's release, only for Pyongyang to cancel at the last minute on both occasions.