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Original Articles
Association between psychosocial safety climate and depression risk among Korean workers
Soo Kyung Cho, Seong-Sik Cho, Maureen F. Dollard, May Young Loh, Mo-Yeol Kang
Epidemiol Health. 2025;47:e2025044.   Published online August 13, 2025
DOI: https://doi.org/10.4178/epih.e2025044
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  • 80 Download
AbstractAbstract AbstractSummary PDF
Abstract
OBJECTIVES
Psychosocial safety climate (PSC) reflects an organization’s commitment to safeguarding workers’ psychological health and safety. While international evidence links low PSC to poor mental health outcomes, its association with depression has not been well established in Korea. This study aimed to examine the relationship between PSC and depression among Korean workers, utilizing a large-scale, population-based survey.
METHODS
We analyzed data from 5,337 wage employees who participated in the fifth wave of the Korean Work, Sleep, and Health Study. Depression was measured using the 9-item Patient Health Questionnaire, and PSC was assessed with a validated 4-item scale. Participants were classified into low-risk, intermediate-risk, and high-risk groups based on their PSC scores. Multivariable logistic regression was conducted to estimate the association between PSC and depression, with stratified analyses performed according to gender, age, and occupational characteristics.
RESULTS
The prevalence of depression increased as PSC scores decreased. Compared to the low-risk group, the intermediate-risk and high-risk PSC groups exhibited 1.19 times and 2.69 times higher risks of depression, respectively, suggesting a clear exposure-response relationship. Stratified analyses indicated that associations were stronger among individuals without union representation or access to occupational health and safety resources.
CONCLUSIONS
These findings underscore the critical role of PSC in workplace mental health. Promoting a high PSC may help reduce depression risk and support mental well-being among workers. Interventions considering vulnerable subgroups are warranted to create psychologically safer work environments in Korea.
Summary
Korean summary
-본 연구에서는 한국 근로자에서 심리사회적 안전풍토(PSC) 점수가 낮을수록 우울 위험이 유의하게 높아짐을 확인하였다. -PSC 중간위험군과 고위험군의 우울 위험은 저위험군에 비해 각각 1.19배, 2.69배 높았다. -연구 결과는 근로자의 정신건강 증진과 국가적 정책 수립을 위해 직장에서의 PSC 강화를 강조한다.
Key Message
-This study demonstrates that lower psychosocial safety climate (PSC) scores are associated with a significantly higher risk of depression among Korean workers. -The risk of depression was 1.19 times higher in the intermediate-risk PSC group and 2.69 times higher in the high-risk PSC group compared with the low-risk group. -Findings highlight the importance of strengthening PSC in workplaces to improve employee mental health and guide national policies.
Associations of self-rated health, depression, and work ability with employee control over working time
Heejoo Ko, Seong-Sik Cho, Jaesung Choi, Mo-Yeol Kang
Epidemiol Health. 2025;47:e2025036.   Published online July 8, 2025
DOI: https://doi.org/10.4178/epih.e2025036
  • 4,193 View
  • 65 Download
AbstractAbstract AbstractSummary PDF
Abstract
OBJECTIVES
Work-time control (WTC), defined as employees’ ability to influence their work schedules, is a crucial determinant of work-life balance and well-being. This study aims to evaluate the associations between WTC and health-related outcomes among Korean workers and examine potential effect modifications by working hours and shift work status.
METHODS
This study analyzed data from the 2024 wave of the Korean Work, Sleep, and Health Study, a nationwide panel study of workers aged 19 years to 70 years (n=5,195). WTC was measured using a 6-item scale, and participants were categorized into low (≤12) or high (>12) WTC groups. Outcomes included self-rated health (SRH), depression (measured by the Patient Health Questionnaire-9), and work ability (WA; measured by the Work Ability Index). Logistic regression models were used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for poor SRH, moderate-to-severe depression, and poor WA, adjusting for demographic and occupational variables. Subgroup analyses assessed effect modifications by working hours and shift work.
RESULTS
Higher WTC was associated with lower odds of poor SRH (OR, 0.73; 95% CI, 0.62 to 0.86), moderate-to-severe depression (OR, 0.71; 95% CI, 0.61 to 0.83), and poor WA (OR, 0.62; 95% CI, 0.46 to 0.84). These associations were significant among daytime workers but not shift workers. The protective effects of WTC were attenuated among workers whose working hours exceeding 52 hr/wk.
CONCLUSIONS
Higher WTC is associated with better health and work outcomes, emphasizing its importance for employee well-being. However, its benefits may be limited among shift workers and employees working excessive hours.
Summary
Korean summary
- 근로시간 통제권(WTC)이 높은 근로자는 주관적 건강상태가 더 좋고, 우울 위험이 낮으며, 근로능력이 높은 것으로 나타났다. - 이러한 보호 효과는 주간 근로자에서만 유의하였으며, 근로시간이 주 52시간을 초과할 경우 효과가 약화되었다.
Key Message
- Higher work-time control (WTC) was associated with better self-rated health, lower risk of depression, and improved work ability among Korean workers. - The protective effects of WTC were significant for daytime workers but not for shift workers, and benefits diminished when weekly working hours exceeded 52.
COVID-19: Cohort Profile
Cohort profile: Cardiovascular Metabolic Etiological Research Center COVID-19 Mental Health Survey (CC-MHS)
Sun Jae Jung, Dongkyu Lee, Ji Su Yang, Sunghyuk Kang, Hyejin Kim, Jeong Hyun Ahn, Yunseong Heo, Jieun Noh, Changhyun Kim, Hyeon Chang Kim
Epidemiol Health. 2025;47:e2025033.   Published online June 30, 2025
DOI: https://doi.org/10.4178/epih.e2025033
  • 5,194 View
  • 115 Download
AbstractAbstract AbstractSummary PDF
Abstract
The Cardiovascular Metabolic Etiological Research Center COVID-19 Mental Health Survey (CC-MHS) is a comprehensive longitudinal cohort study investigating the mental health impact of the coronavirus disease 2019 pandemic by utilizing pre-existing baseline data from the Cardiovascular Metabolic Etiological Research Center cohort (2013-2018). This study assesses physical health, lifestyle changes, and mental health using validated tools, including the Patient Health Questionnaire-9, Generalized Anxiety Disorder-7, and the PTSD Checklist for DSM-5, and evaluates a population of urban and suburban Korean participants across multiple dimensions. Through online surveys, the research identified gender-specific social support mechanisms, showing that men benefit from larger social networks, whereas women derive protective effects from stronger emotional connections. Key findings underscore complex interactions among demographic factors, psychological variables, and public health responses, especially in the context of vaccination attitudes and trust in pandemic management. The CC-MHS delivers critical insights into mental health trajectories during global health crises, offering valuable evidence for developing adaptive public health strategies and for understanding the intricate relationships between individual psychological resilience and broader societal health challenges.
Summary
Korean summary
본 CC-MHS 코호트는 팬데믹 이전 4,060명 대상 CMERC 기초자료 활용하였다 본 CC-MHS 코호트는 우울, 불안, PTSD 등 정신건강 평가를 7차례 추적조사하였다. 본 코호트에서는 성별 보호요인과 사회적 지지·신뢰의 중요성 규명하였다.
Key Message
In CC-MHS, we utilized pre-pandemic baseline data from 4,060 adults in the CMERC cohort. We conducted 7 waves of mental health surveys assessing depression, anxiety, PTSD, and resilience. In this cohort, we identified gender-specific protective factors and emphasized the importance of social support and trust.
Original Articles
Identifying factors associated with mental health status following climate-related disasters: a nationwide longitudinal panel study in Korea
Eunjin Oh, Jaelim Cho, Changsoo Kim, Hyungryul Lim, Kyoung-Nam Kim
Epidemiol Health. 2025;47:e2025014.   Published online March 27, 2025
DOI: https://doi.org/10.4178/epih.e2025014
  • 8,188 View
  • 127 Download
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
Despite the increasing frequency and intensity of climate-related disasters, identifying factors associated with mental health status remains challenging. This study aimed to determine the factors linked to symptoms of depression, anxiety, and post-traumatic stress disorder (PTSD) following heavy rainfall and typhoons.
METHODS
National data on climate-related disaster victims (n=825 for heavy rainfall and n=1,220 for typhoon) from a longitudinal panel in Korea (“Long-term Survey on the Change of Life of Disaster Victims”) and data from individuals unaffected by disasters (n=893) were used. Generalized linear mixed models were employed to evaluate the factors associated with mental health status following climate-related disasters.
RESULTS
Greater disaster severity (e.g., experiencing casualties or asset loss) was associated with higher scores for depression (Patient Health Questionnaire-9), anxiety (Generalized Anxiety Disorder-7), and PTSD (Impact Event Scale-Revised). The association between casualty experience and anxiety score was more pronounced among individuals over 65 years (β [log-transformed score], 1.39; standard error [SE], 0.26; p<0.001), female respondents (β, 1.20; SE, 0.20; p<0.001), those with a low education level (β, 1.18; SE, 0.25; p<0.001), and those with a low income (β, 1.45; SE, 0.26; p<0.001) compared to their counterparts.
CONCLUSIONS
These findings may help guide targeted interventions and shape public health policies and disaster management strategies that prioritize mental health support for the most at-risk populations, ultimately increasing community resilience to climate-related challenges.
Summary
Korean summary
본 연구는 기후 관련 재난 후 우울증, 불안, PTSD와 관련된 요인을 파악하였다. 재난의 심각도가 클수록 정신 건강 악화는 더 심각하였으며 특히 노인, 여성, 낮은 교육 수준과 소득을 가진 취약한 그룹이 더 큰 위험에 처해 있었다. 이 결과는 향후 재난 대응에서 이러한 인구집단을 지원하기 위한 맞춤형 정신 건강 개입과 정책의 필요성을 시사한다.
Key Message
We identified factors associated with depression, anxiety, and PTSD following climate-related disasters, highlighting that greater disaster severity correlates with worse mental health outcomes. Vulnerable groups, such as older adults, women, those with lower education and income, are at higher risk. The findings suggest the need for targeted mental health interventions and policies to support these populations in future disaster responses.
The role of supervisor support in the association between night work and depressive symptoms: a gender-stratified analysis of 22,422 full-time wage workers in Korea
Hee Won Kim, Ji-Hwan Kim, Garin Lee, Hye-Lin Lee, Hayoung Lee, Seung-Sup Kim
Epidemiol Health. 2024;46:e2024079.   Published online September 25, 2024
DOI: https://doi.org/10.4178/epih.e2024079
  • 9,649 View
  • 127 Download
  • 1 Web of Science
  • 1 Crossref
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
This study investigated the relationship between night work, supervisor support, and depressive symptoms among full-time wage workers, with a focus on gender differences.
METHODS
A nationwide sample of 22,422 full-time wage workers from the Sixth Korean Working Conditions Survey (2020-2021) was analyzed. Experiences of night work were categorized into 5 groups based on the number of night work days per month: 0, 1-5, 6-10, 11-15, and 16-31. Depressive symptoms were evaluated using the 5-item World Health Organization Well-Being Index. Supervisor support was assessed with 5 items.
RESULTS
Workers who engaged in 1-5 days (prevalence ratio [PR], 1.23; 95% confidence interval [CI], 1.12 to 1.36) and 6- 10 days (PR, 1.17; 95% CI, 1.06 to 1.30) of night work per month exhibited a higher prevalence of depressive symptoms than those without night work. After stratifying by supervisor support levels, workers with 1-5 days, 6-10 days, and 11-15 days of night work per month were more likely to experience depressive symptoms compared to those without night work in the low supervisor support group. In contrast, no association was found between night work (≥6 days) and depressive symptoms in the high supervisor support group. Furthermore, gender differences were notable: female workers with 6-10 days (PR, 1.45; 95% CI, 1.23 to 1.70), and 11-15 days (PR, 1.43; 95% CI, 1.08 to 1.90) of night work per month exhibited a higher prevalence of depressive symptoms, whereas their male counterparts did not. This pattern of gender difference was also found among those with low supervisor support.
CONCLUSIONS
Supervisor support may mitigate the adverse effects of night work on depressive symptoms among full-time wage workers, with differences manifested across genders.
Summary
Korean summary
야간 노동을 하는 사람들의 숫자가 급격히 늘어나고 있다. 이들이 겪는 여러 정신건강의 어려움이 사회적으로 문제가 되고 있지만, 그와 관련해 상사의 사회적 지지가 어떠한 영향을 주고 또 그 영향이 성별에 따라 어떻게 다른 지 충분히 연구된 바 없다. 한국의 6 차 근로환경조사를 분석한 결과, 한달에 1-10 일 야간 노동을 하는 사람들에게서 우울증상이 높게 나타났다. 성별 층화 분석했을 때, 한달에 6-15 일 야간 근무를 하는 여성이 상사의 사회적 지지를 받지 못할 경우 우울 증상이 특히 두드러지는 것으로 나타났습니다. 이번 연구는 야간 노동이 정신 건강에 미치는 부정적 영향을 확인하고, 직장에서의 사회적 지지와 건강한 조직 문화를 조성할 필요성을 보여준다.
Key Message
Night workers play a crucial role in society yet face unique mental health challenges. While a growing body of research have focused on their health problems, the role of supervisor support remains unexplored. Using a nationally representative dataset of workers in Korea, we found that night work was associated with depressive symptoms, especially for those working 1- 10 nights monthly and for females conducting 6-15 days of night work. Strong supervisor support may modify these effects. Our findings underscore the need for organizations to acknowledge the adverse mental health consequences of night work and to foster a supportive workplace culture.

Citations

Citations to this article as recorded by  
  • Network of job demands-resources and depressive symptoms in clinical nursing interns: A cross-sectional study
    Li Chen, Yuanzi Chen, Qiaoyan Wu, Haiyan Wang, Yunjian Qu, Zhangyi Wang
    Nurse Education Today.2026; 159: 106962.     CrossRef
Associations of depressive symptoms with lower extremity function and balance in Korean older adults
Bong Jo Kim, Kyupin Ha, Hyun Soo Kim, Hye Ran Bae, Minkook Son
Epidemiol Health. 2024;46:e2024021.   Published online January 15, 2024
DOI: https://doi.org/10.4178/epih.e2024021
  • 10,916 View
  • 107 Download
  • 1 Web of Science
  • 1 Crossref
AbstractAbstract AbstractSummary PDF
Abstract
OBJECTIVES
The relationship of depressive symptoms to lower extremity function and balance, especially in older adults without a depression diagnosis, remains unclear. Therefore, our study analyzed this relationship using a large sample of Korean older adults.
METHODS
We used data from the Korean National Health Insurance Service’s Health Screening Program database. Individuals aged 66 years who had undergone the National Screening Program for Transitional Ages in Korea and were without a diagnosis of depressive disorder were included. The lower extremity function and balance were evaluated using 2 physical tests, while depressive symptoms were assessed using a 3-question survey. Multivariable-adjusted logistic regression analysis was used to examine the association between depressive symptoms and lower extremity function and balance.
RESULTS
Among 66,041 individuals, those with depressive symptoms showed significantly higher rates of abnormal lower extremity function and abnormal balance. The adjusted odds ratios (aORs) and 95% confidence intervals (CIs) for the association of depressive symptoms to abnormal lower extremity function and abnormal balance were (aOR, 1.34; 95% CI, 1.25 to 1.44) and (aOR, 1.38; 95% CI, 1.29 to 1.48), respectively. Assessment of the relationship based on depressive symptom scores revealed that higher scores were associated with higher aORs (p for trend <0.001). Subgroup analyses further confirmed this relationship, especially among patients with cerebrovascular disease or dementia.
CONCLUSIONS
This study revealed an association between depressive symptoms and the abnormal lower extremity function and balance of 66-year-old individuals without a diagnosis of depressive disorder.
Summary
Key Message
• This study investigated the associations of depressive symptoms with lower extremity function and balance in 66-year-old individuals without a diagnosis of major depressive disorder.
• Older adults with depressive symptoms showed significantly higher levels of abnormal lower extremity function and balance than those without.
• Higher depressive symptom scores were associated with higher odds ratios for abnormal lower extremity function and balance.

Citations

Citations to this article as recorded by  
  • Association of kidney function and proteinuria with lower-extremity dysfunction in older Korean adults: a cross-sectional study
    Bongjo Kim, Eun-Bin Lim, Young Sang Lyu, Minkook Son, Youngmin Yoon
    The Korean Journal of Internal Medicine.2025; 40(5): 823.     CrossRef
Association of plain water intake with self-reported depression and suicidality among Korean adolescents
Jung Woo Lee, Yookyung Kim
Epidemiol Health. 2024;46:e2024019.   Published online January 9, 2024
DOI: https://doi.org/10.4178/epih.e2024019
  • 13,022 View
  • 122 Download
  • 2 Web of Science
  • 3 Crossref
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
Adolescent depression and suicidality are serious health problems worldwide. Lower plain water intake has been proposed as a risk factor for depression in adults. This study investigated the association of daily plain water intake with self-reported depression and suicidality among Korean adolescents.
METHODS
We used nationwide data from 112,250 students aged 12-18 years who participated in the Korean Youth Risk Behavior Web-based Surveys in 2019 and 2020. Daily plain water intake was categorized as <1 glass, 1-2 glasses, and ≥3 glasses. The adjusted odds ratios (aORs) with 95% confidence intervals (CIs) for self-reported depression and suicidality were calculated using multiple regression analyses.
RESULTS
The weighted prevalence rates of self-reported depression, suicidal ideation, suicide planning, and suicide attempts were 26.7%, 12.0%, 3.8%, and 2.5%, respectively. Of the participants, 3.9%, 18.5%, and 77.7% were categorized into the <1 glass/day, 1-2 glass/day, and ≥3 glass/day groups, respectively. Compared to the reference group (≥3 glass/day), the lowest level of water intake (<1 glass/day) was associated with higher odds of self-reported depression (aOR, 1.30; 95% CI, 1.20 to 1.39), suicidal ideation (aOR, 1.39; 95% CI, 1.27 to 1.55), suicide planning (aOR, 1.46; 95% CI, 1.25 to 1.69), and suicide attempts (aOR, 1.38; 95% CI, 1.15 to 1.67). Moderately lower water intake (1-2 glass/day) showed slightly increased odds of self-reported depression (aOR, 1.05; 95% CI, 1.01 to 1.10) and suicidal ideation (aOR, 1.08; 95% CI, 1.03 to 1.14).
CONCLUSIONS
Lower plain water intake was significantly associated with a higher risk of self-reported depression and suicidality among Korean adolescents. Since this cross-sectional study is unable to establish a causal relationship, it underscores the need for additional longitudinal research.
Summary
Korean summary
- 한국 청소년들에서 하루 물 섭취량이 적을수록 스스로 느끼는 우울감과 자살성향 위험이 증가하였다. - 이 연구는 하루 물 섭취량 측정이 청소년 우울증과 자살성향을 선별할 수 있음을 시사한다.
Key Message
- Lower daily plain water intake is significantly associated with a higher risk of self-reported depression and suicidality in Korean adolescents. - It suggests that daily plain water consumption could potentially serve as a screening indicator to identify depression and suicidality in adolescents.

Citations

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  • Association between plain water intake and the risk of osteoporosis among middle-aged and elderly people in the United States: a cross-sectional study
    Xudong Wang, Meng Wang, Zijian Guo, Chuan Xiang
    Frontiers in Nutrition.2025;[Epub]     CrossRef
  • Association of constipation with suicidal ideation among US adults and the partial mediating role of depression
    Pengfei Wang, Yan Wang, Hong Li, Feng Gao, Xiaojie Huang, Ying Ye, Xiaohua Yan, Yishun Jin
    Scientific Reports.2025;[Epub]     CrossRef
  • Mitigating Weight Gain Side Effects by Reducing Sugar-Sweetened Beverage Consumption in Youth Newly Prescribed Second-Generation Antipsychotic Medication
    Kristin Bussell, Heidi Wehring, Susan dosReis, Raymond C. Love, Jason Schiffman, John Sorkin, Zhaoyong Feng, Sarah Edwards, Erin Hager, Elizabeth A. Dennis, Kathleen Connors, Kathryn McDonald, Meredith Roberts, Emily Wolfe, Shlomo Resnik, Gloria Reeves
    Nutrients.2025; 18(1): 24.     CrossRef
Performance pressure and mental health among finance workers in Korea: a cross-sectional study
Yu Min Lee, Hyoung-Ryoul Kim
Epidemiol Health. 2023;45:e2023099.   Published online November 7, 2023
DOI: https://doi.org/10.4178/epih.e2023099
  • 16,007 View
  • 219 Download
  • 2 Web of Science
  • 2 Crossref
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
While issues related to mental health, including suicide, have been frequently reported among finance workers, no formal investigation has been undertaken. This study was conducted to analyze correlations between indicators of performance pressure, which is a characteristic of the finance sector, and mental health.
METHODS
An online survey was administered to 1,181 participants. Brief questionnaires were employed to ask general questions about participant characteristics, work environment, and the presence of performance pressure, suicidal thoughts/plans/attempts, depression (indicated by the Patient Health Questionnaire-9), and anxiety (measured with the Generalized Anxiety Disorder-7). Frequency analysis, chi-square testing, and multivariate logistic regression analysis were performed.
RESULTS
Of the 1,181 respondents, 797 (83.5%) reported feeling pressure to perform at work, while 252 (26.4%) admitted to occasional willingness to achieve results even through illegal activities. Multivariate logarithmic regression analysis was employed to examine the correlation between performance pressure and mental health. This analysis revealed that those expressing willingness to achieve results through illegal activities exhibited higher levels of suicidal ideation (adjusted odds ratio [aOR], 1.63; 99% confidence interval [CI], 1.04 to 2.55), plans (aOR, 1.75; 99% CI, 1.01 to 3.01), and attempts (aOR, 2.72; 99% CI, 1.06 to 6.98). Additionally, these individuals demonstrated higher levels of depression (aOR, 2.02; 99% CI, 1.34 to 3.06) and anxiety (aOR, 2.84; 99% CI, 1.81 to 4.46).
CONCLUSIONS
Performance pressure is prevalent within the finance industry. This pressure serves as a major source of stress for employees and is evident in 3 representative indicators of mental health: suicide, depression, and anxiety.
Summary
Korean summary
현대사회에서 많은 조직이 성과에 따른 보상과 처벌규정을 사용하여 인적자원을 관리함으로써 조직의 성장을 꾀한다. 특히 금융업의 경우 성과평가가 평가를 위한 가시적이고 단순한 지표들과 연계되면서, 근로자들은 부여된 실적만을 달성하기 위한 과도한 노력을 기울이게 된다. 이 연구를 통해 그 과정에서 개인들은 과도한 성과압박을 느끼고, 성과압박을 많이 느낄수록 다양한 업무상 정신질환(불안, 우울, 자살생각 및 시도 등)을 경험한다는 것을 보여주었다.
Key Message
Inappropriately selected performance indicators cause performance pressure, which is related to the occurrence of work-related mental disorders. This paper is meaningful in showing the current status of performance pressure in the Korean financial industry and showing the relationship between performance pressure and work-related mental health.

Citations

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  • A Depression, Anxiety, and Stress Scale (DASS‐42) Study on the Mental Health Conditions of Japanese Employees
    Niklas Holzapfel
    Japanese Psychological Research.2025;[Epub]     CrossRef
  • Reframing Technostress for Organizational Resilience: The Mediating Role of Techno-Eustress in the Performance of Accounting and Financial Reporting Professionals
    Sibel Fettahoglu, Ibrahim Yikilmaz
    Systems.2025; 13(7): 550.     CrossRef
Application of a joint latent space item response model to clustering stressful life events and the Beck Depression Inventory-II: results from Korean epidemiological survey data
Hyun Joo Kim, Ye Jin Jeon, Hyeon Chang Kim, Ick Hoon Jin, Sun Jae Jung
Epidemiol Health. 2022;44:e2022093.   Published online October 24, 2022
DOI: https://doi.org/10.4178/epih.e2022093
  • 12,915 View
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  • 3 Web of Science
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AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
According to previous findings, stressful life events (SLEs) and their subtypes are associated with depressive symptoms. However, few studies have explored potential models for these events and incidental symptoms of depression.
METHODS
Participants (3,966 men; 5,709 women) were recruited from the Cardiovascular and Metabolic Diseases Etiology Research Center cohort. SLEs were measured using a 47-item Life Experiences Survey (LES) with a standardized protocol. Depressive symptoms were assessed using the Beck Depression Inventory-II (BDI-II). Joint latent space item response models were applied by gender and age group (<50 vs. ≥50 years old).
RESULTS
Among the LES items, death or illness of close relatives, legal problems, sexual difficulties, family relationships, and social relationships shared latent positions with major depressive symptoms regardless of gender or age. We also observed a gender-specific domain: occupational and family-related items.
CONCLUSIONS
By projecting LES and BDI-II data onto the same interaction map for each subgroup, we could specify the associations between specific LES items and depressive symptoms.
Summary
Korean summary
- 본 연구는 성별, 연령에 따른 생활스트레스 항목과 Beck Depression Inventory-II (BDI-II) 로 측정한 우울증상 사이의 연관성을 Joint Latent space item response model (LSIRM) 방법을 사용하여 탐색하고자 하였다. - 한국 성인 인구집단 (3,966 남성; 5,709 여성)을 대상으로 연구를 수행한 결과, 생활스트레스 항목 중 가족 혹은 가까운 주변인의 죽음 혹은 질환, 법적인 문제, 성적 어려움, 가족 혹은 사회적 관계는 성별, 연령에 무관하게 우울 증상과 연관성이 있었으며, 직업, 일부 가족 관련 항목에서 성별 특이적인 연관성을 관찰하였다.
Key Message
- In this study, we used a joint latent space item response model (LSIRM) to project stressful life events and depressive symptoms as measured by the Beck Depression Inventory-II (BDI-II) onto an interaction map, which represents the interaction of BDI-II items and underlying traits with each SLE, while accounting for heterogeneity by sex and age group. - Among the LES items, death/illness of close relatives, legal problems, sexual difficulties, family relationships, and social relationships shared latent positions with major depressive symptoms regardless of sex or age group. But, in occupational and family-related items, sex-specific associations were observed.

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  • Cohort profile: Cardiovascular Metabolic Etiological Research Center COVID-19 Mental Health Survey (CC-MHS)
    Sun Jae Jung, Dongkyu Lee, Ji Su Yang, Sunghyuk Kang, Hyejin Kim, Jeong Hyun Ahn, Yunseong Heo, Jieun Noh, Changhyun Kim, Hyeon Chang Kim
    Epidemiology and Health.2025; 47: e2025033.     CrossRef
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    Edward Ashby Weston Hannemann, Anastasia Ejova
    Anxiety, Stress, & Coping.2025; : 1.     CrossRef
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Gender differences in the association between multimorbidity and depression in older Korean adults: an analysis of data from the National Survey of Older Koreans (2011-2017)
SeoYeon Hwang, Jin Young Nam, Jeong Hyun Ahn, Soojin Park
Epidemiol Health. 2022;44:e2022049.   Published online May 24, 2022
DOI: https://doi.org/10.4178/epih.e2022049
  • 20,764 View
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AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
Previous studies have shown that people with multimorbidity have a higher risk of depression than those without multimorbidity. However, few studies have examined the association between depression and multimorbidity in men and women separately. Since the rates of depression and multimorbidity are different in men and women, it is necessary to examine whether gender differences affect their association.
METHODS
This study included 30,138 participants (aged ≥ 65 years) from the National Survey of Older Koreans (2011-2017). Depression was defined using the Korean version of the Geriatric Depression Scale (SGDS-K). Multimorbidity was defined as people who had 2 or more chronic diseases, including arthritis, diabetes, heart disease, hypertension, pulmonary disease, cancer, stroke, or osteoporosis. Multiple logistic regression analysis was performed to determine the association between depression and multimorbidity.
RESULTS
In total, 22.2% and 30.7% of men and women, respectively, had depression. Those with multimorbidity had a higher risk of depression than those without chronic conditions; specifically, the difference in risk among men was greater than that among women. Age was considered a moderator for women. While the effects of pulmonary disease, stroke, and cancer were especially substantial in the integrated analysis, gender differences were observed related to various chronic conditions comorbid with heart disease.
CONCLUSIONS
There are gender differences in the association between multimorbidity and depression among older Korean adults. Therefore, gender-specific care should be provided to reduce depression in older adults with multimorbidity.
Summary
Korean summary
복합만성질환을 가진 남성 노인이 복합만성질환을 가진 여성 노인보다 우울증을 경험할 위험이 높았다. 특히 심장질환을 가진 남성 노인과 여성 노인은 심장질환을 포함한 만성질환의 개수에 따라 우울증 위험에 차이가 있었다. 노인들의 수명 향상을 위해 성별 차이를 고려한 치료 방안과 정책이 마련되어야 한다.
Key Message
Multimorbidity was associated with a high-risk of depression in older Korean adults and the effects of multimorbidity differed by gender.

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COVID-19: Special Article
Mental health of Korean adults before and during the COVID-19 pandemic: a special report of the 2020 Korea National Health and Nutrition Examination Survey
Hyunsuk Jeong, Suyeon Park, Jihee Kim, Kyungwon Oh, Hyeon Woo Yim
Epidemiol Health. 2022;44:e2022042.   Published online April 25, 2022
DOI: https://doi.org/10.4178/epih.e2022042
  • 32,255 View
  • 588 Download
  • 23 Web of Science
  • 22 Crossref
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
Coronavirus disease 2019 (COVID-19) and the associated social distancing, limited freedom, and fear of an uncertain future are expected to have substantial mental health effects. We investigated mental health responses in the community during the first year of the COVID-19 pandemic in Korea.
METHODS
We used 2016-2019 and 2020 data from the Korea National Health and Nutrition Examination Survey (KNHANES) to assess pre-pandemic and pandemic mental health status, respectively, in terms of perceived severe stress, depression, and suicidal plans. All analyses were gender-stratified. Pre-specified subgroup analyses were performed according to age, employment status, and household income.
RESULTS
The percentage of Korean adults with suicidal plans increased significantly from 1.3%p (95% confidence interval [CI], 1.1 to 1.5) in 2016-2019 to 1.8%p (95% CI, 1.4 to 2.1) in 2020. Individuals in their 20s and 40s showed a marked increase in suicidal plans (1.2%p; 95% CI, 0.0 to 2.3 and 0.9%p; 95% CI, 0.0 to 1.8, respectively). In men, depression and perceived severe stress increased significantly from pre-COVID-19 to 2020. There was a 2.4%p (95% CI, 0.8 to 4.0) increase in depression among standard workers and a 2.9%p increase in depression in individuals in the second-highest quintile of household income from 2016 and 2018 to 2020.
CONCLUSIONS
As COVID-19 continued, mental health issues such as suicidal plans, depression, and severe stress increased significantly in young men and people in the second-highest quintile of household income. Proactive community mental health efforts are needed to prevent increases in the suicide rate resulting from prolonged exposure to the COVID-19 pandemic.
Summary
Korean summary
코로나19 이전에 비해 코로나19 유행 첫 해 동안에 전체 인구에서 자살 계획 유병율이 유의하게 증가하였고 특히 20대-40대에서 증가 비율이 높았다. PHQ-9으로 측정한 우울증 유병율은 전체 남성에서 증가하였고 특히 30대 남성에서 증가 비율이 높았다. 코로나19 영향으로 자살 계획과 우울증과 같은 정신 건강 문제가 젊은 성인에서 크게 증가하였기 때문에 이러한 정신건강 문제가 자살률 증가로 이어지는 것을 방지하기 위해 국가적 차원의 체계적인 정책과 적극적인 지역사회 정신건강 중재가 필요하다.
Key Message
There was a significant increase in the prevalence of suicidal plan in the overall population during the first year of COVID-19 pandemic compared to pre-COVID-19. In particular, suicide plans increased among those in their 20s and 40s. The prevalence of PHQ-9 detected depression increased in all men, especially among men in their 30s. As mental health problems such as suicide planning and depression have significantly increased among young adults due to the impact of COVID-19, systematic policies at the national level and active community mental health interventions are needed to prevent these mental health problems from leading to an increase in suicide rates.

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COVID-19: Original Article
Depression, anxiety, and stress in Korean general population during the COVID-19 pandemic
Hooyeon Lee, Dongwoo Choi, Jung Jae Lee
Epidemiol Health. 2022;44:e2022018.   Published online January 18, 2022
DOI: https://doi.org/10.4178/epih.e2022018
  • 33,117 View
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AbstractAbstract AbstractSummary PDF
Abstract
OBJECTIVES
The aim of this study was to investigate the prevalence and risk factors of poor mental health in the general Korean population during the coronavirus disease 2019 (COVID-19) pandemic.
METHODS
This cross-sectional, population-based, online survey-based study was conducted from November 5 to 20, 2020 and included adults aged 20-49 years in Chungnam Province, Korea. A total of 549 adults were included.
RESULTS
In total, 18.8% of the participants had symptoms of depression, 10.6% had symptoms of anxiety, and 5.1% had a high level of perceived stress during the COVID-19 pandemic. Higher levels of stress (odds ratio [OR], 3.13; 95% confidence interval [CI], 1.13 to 8.67), anxiety (OR, 2.33; 95% CI, 1.09 to 4.49), and depression (OR, 3.00; 95% CI, 1.64 to 5.50) were found among never married, widowed, divorced, and separated people than among married/cohabiting/partnered participants. Participants who felt increased stress at home during the COVID-19 outbreak reported more depression (OR, 2.45; 95% CI, 1.49 to 4.05) and anxiety (OR, 2.42; 95% CI, 1.31 to 4.50). Women had higher risks of anxiety (OR, 1.97; 95% CI, 1.09 to 3.58) and stress (OR, 6.40; 95% CI, 2.30 to 17.85) than men. Participants with the highest household income were less likely to report symptoms of stress than those with the lowest household income (OR, 0.24; 95% CI, 0.06 to 0.96).
CONCLUSIONS
The participants in this study exhibited poor mental health index scores, suggesting that some people are at risk for mental health problems during the COVID-19 pandemic. Being married was independently and significantly associated with a lower likelihood of depression, anxiety, and stress.
Summary
Korean summary
이 연구는 코로나-19 유행 기간 동안 정신건강 현황과 위험 요인을 알아보기 위한 단면연구이다. 코로나 19 유행 이후 가정내 스트레스가 증가했다고 응답한 경우 우울증과 불안감의 유병률이 높았다. 반면, 남성인 경우, 결혼했거나 동거인과 같이 살고 있는 경우에는 우울증, 불안 또는 스트레스의 유병률이 통계적으로 유의하게 낮았다. 마스크 착용하기, 비대면 활동 증가, 또는 사회적 거리두기 등 코로나 19의 유행을 통제하기 위한 많은 정책은 개인의 일상생활과 정신건강에 많은 영향을 미쳤다. 이 연구는 취약 집단을 발굴하고, 정신건강 회복을 위한 전략을 개발하는데 기초자료를 제공할 수 있다.
Key Message
This study revealed high prevalence rates of depression, anxiety, and stress in the general population of Korea aged 20-49 years during the COVID-19 pandemic. Participants who felt increased stress at home reported more depression and anxiety. Men and being married were significantly associated with a lower likelihood of depression, anxiety, or stress. The COVID-19 pandemic has been a traumatic event. In addi­tion, the policies created to prevent its spread have disrupted daily living for the general population. Implement­ing strategies to promote resilience and support psychologically vulnerable individuals during the COVID-19 cri­sis is of fundamental importance.

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Original Articles
Elder abuse/mistreatment and associated covariates in India: results from the Longitudinal Aging Study in India wave 1, 2017-2018
Thennavan Sathya, Yesuvadian Selvamani, Rangasamy Nagarajan
Epidemiol Health. 2022;44:e2022017.   Published online January 18, 2022
DOI: https://doi.org/10.4178/epih.e2022017
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AbstractAbstract AbstractSummary PDF
Abstract
OBJECTIVES
Elder abuse has significant adverse consequences for the overall health and well-being of the elderly, including premature mortality. Using cross-sectional data, we assessed the prevalence of elder abuse in India, its variation across states, and associated factors.
METHODS
Nationally representative data from the first wave of the Longitudinal Aging Study in India were analyzed. Bivariate and multivariate analyses were used to study the prevalence, state variations, and associated factors of elder abuse.
RESULTS
Overall, 5.2% of elderly adults (≥60 years) had experienced abuse in the year prior to the survey and 3% had experienced abuse within their own household. Verbal abuse or disrespect was the most common form of abuse. Considerable variation was observed in the prevalence of elder abuse across states and union territories, with the highest prevalence observed in Bihar (11.6%) and Karnataka (10.1%). In regression analysis, education level emerged as a protective factor against elder abuse, particularly among women. Older adults who lived alone, had functional limitations, had multiple morbidities, and had been hospitalized in the past year were more likely to experience abuse. Older adults who experienced abuse were 2 times more likely to experience depressive symptoms.
CONCLUSIONS
Cross-state variation in the prevalence of elder abuse and subgroup differences suggest that state-specific interventions and essential monitoring of older adults with functional limitations, chronic diseases, and recent hospitalization can further reduce the prevalence and consequences of elder abuse in India.
Summary
Key Message
Elder abuse is one of the common forms of violence among the elderly. This study finds a significant proportion (5.2%) of Indian elderly reported elder abuse with considerable state-variations. The prevalence of elder abuse is higher in the states of Bihar (11.6%) and Karnataka (10.1%). Gender differences in elder abuse is notable where women is more likely to experience abuse than men. Education is a key protective factor of abuse. Elderly with multimorbidity and functional limitations are more likely to experience abuse. The elder abuse is positively associated with depressive symptoms.

Citations

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  • Association between Multimorbidity and Psychological Distress among Older Adults in India: The Moderating Role of Elder Abuse
    Sathya Thennavan, Yesuvadian Selvamani, Nagarajan Rangasamy, Mathew Arumai
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    Valatheeswaran Chinnakkannu, Shreyantika Nandi, Vandita Ranjan, Harihar Sahoo
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    Priya Maurya, Aparajita Chattopadhyay, Smitha Rao, Palak Sharma
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    Wenxing Wei, Sarah Balser, Ann W. Nguyen, Weidi Qin
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Independent predictors of depressive symptoms and social isolation on 2-year all-cause mortality among the Korean elderly in a population-based cohort study: gender differences
Hyunsuk Jeong, Hyeon Woo Yim, Beom-Woo Nam
Epidemiol Health. 2022;44:e2022012.   Published online January 8, 2022
DOI: https://doi.org/10.4178/epih.e2022012
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AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
This study examined whether depressive symptoms and social isolation were independent predictors of 2-year all-cause mortality among the elderly using data from a population-based cohort study.
METHODS
In total, 1,033 participants (320 men and 713 women) older than 60 years of age participated in this study. Depressive symptoms, social isolation status, and socio-demographic and health-related covariates were assessed at baseline. The primary outcome measure was 2-year all-cause mortality. Data were collected through in-person interviews by trained interviewers. The GENMOD procedure was used to calculate relative risks (RRs).
RESULTS
Of the 1,033 participants, 102 (40 men and 62 women) died within the follow-up period of 2 years. During the 2-year follow-up period, 17.8% of depressed men and 12.3% of depressed women died, and 29.8% of socially isolated men and 14.9% of socially isolated women died. Social isolation was an independent predictor of mortality in elderly men (adjusted relative risk [aRR], 4.6, 95% confidence interval [CI], 2.0 to 10.2), while depressive symptoms were an independent predictor of mortality in elderly women (aRR, 2.0; 95% CI, 1.2 to 3.6) when controlling for potential confounding factors. However, the depressive symptoms detected using the geriatric depression scale were not associated with mortality in men, and social isolation was not associated with mortality in women.
CONCLUSIONS
The effects of depressive symptoms and social isolation on 2-year all-cause mortality within an elderly population differed according to gender. Gender-specific community-based interventions must be developed to potentially reduce 2-year all-cause mortality among the elderly.
Summary
Korean summary
본 연구는 지역사회 거주하는 저소득층 노인을 대상으로 한 코호트 연구로 2년 추적조사를 수행하여 사망 원인의 예측인자를 분석하였다. 남성노인에서는 사회적 고립이, 여성노인에서는 우울증상이 2년 모든 사망원인의 독립적인 예측인자였다. 노인의 사망율을 줄이기 위한 지역사회 개입 프로그램은 남성에게는 사회적 고립을 해소를, 여성에게는 우울증상 개선을 위한 프로그램이 요구된다.
Key Message
The effects of depressive symptoms and so¬cial isolation on 2-year all-cause mortality among the elderly dif¬fered according to gender. For elderly men, social isolation increased the risk of 2-year all-cause mortality by 4.6 times compared to those who were not socially isolated. However, the depressive symptoms identified by the GDS-15 were not associated with 2-year all-cause mortality in men. From a public health perspective, these findings suggest that gender-specific community-based interventions are needed to mitigate all-cause mortality among the elderly.

Citations

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  • Loneliness, social isolation, and living alone: a comprehensive systematic review, meta-analysis, and meta-regression of mortality risks in older adults
    Agni Nakou, Elena Dragioti, Nikolaos-Stefanos Bastas, Nektaria Zagorianakou, Varvara Kakaidi, Dimitrios Tsartsalis, Stefanos Mantzoukas, Fotios Tatsis, Nicola Veronese, Marco Solmi, Mary Gouva
    Aging Clinical and Experimental Research.2025;[Epub]     CrossRef
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    Wei Ting Foo, Sri Karpageshwary K, Angela Frances Hui Wen Yap
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  • Beyond Treatment Decisions: The Predictive Value of Comprehensive Geriatric Assessment in Older Cancer Patients
    Eleonora Bergo, Marina De Rui, Chiara Ceolin, Pamela Iannizzi, Chiara Curreri, Maria Devita, Camilla Ruffini, Benedetta Chiusole, Alessandra Feltrin, Giuseppe Sergi, Antonella Brunello
    Cancers.2025; 17(15): 2489.     CrossRef
  • Relationship between Cognition, Depression, and Oral health status in Older adults: A longitudinal cross-lagged analysis
    Bo Zhao, Xiaoxu Jiang, Fanlei Kong, Eun Woo Nam
    Journal of Affective Disorders.2023; 330: 158.     CrossRef
  • A systematic review and meta-analysis of 90 cohort studies of social isolation, loneliness and mortality
    Fan Wang, Yu Gao, Zhen Han, Yue Yu, Zhiping Long, Xianchen Jiang, Yi Wu, Bing Pei, Yukun Cao, Jingyu Ye, Maoqing Wang, Yashuang Zhao
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  • Gender Inequalities in Mental Health During the COVID-19 Pandemic: A Population-based Study in Korea
    Minku Kang, Sarah Yu, Seung-Ah Choe, Daseul Moon, Myung Ki, Byung Chul Chun
    Journal of Preventive Medicine and Public Health.2023; 56(5): 413.     CrossRef
Associations of regional-level perceived stress and depression with health-related quality of life in Korean adults: a multilevel analysis of 2017 Korea Community Health Survey data
Eunsu Kim, Min-Ho Shin, Jung-Ho Yang, Soon-Ki Ahn, Baeg-Ju Na, Hae-Sung Nam
Epidemiol Health. 2021;43:e2021062.   Published online September 8, 2021
DOI: https://doi.org/10.4178/epih.e2021062
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AbstractAbstract AbstractSummary PDF
Abstract
OBJECTIVES
We examined the associations of individual and regional-level perceived stress and depression with health-related quality of life (HRQOL) in Korean adults.
METHODS
We used data from the 2017 Korea Community Health Survey, which included 216,713 adults living within 254 municipal districts. As individual-level independent variables, perceived stress (higher vs. lower) and depression (Patient Health Questionnaire-9 ≥10) were defined. Regional-level age-adjusted rates of perceived stress (%) and depression (%) were created for 254 municipal districts and categorized into quartiles to generate regional levels of stress and depression. HRQOL was defined as the individual-level EuroQol 5-dimensional index×100. A multilevel analysis was performed to identify the relationship between individual or regional-level independent variables and individual HRQOL.
RESULTS
In the null model, the proportions of individual variation in the HRQOL explained by region were 1.7% and 2.7% for men and women, respectively. When adjusted with all individual-level variables, regional stress and depression, as well as individual-level perceived stress and depression, were significantly related to HRQOL for both genders. In the full model including all variables, the decrease in HRQOL from the first to the fourth quartile group of regional stress was greater in women (-1.09; 95% confidence interval [CI], -1.87 to -0.31) than in men (-0.65; 95% CI, -1.04 to -0.26).
CONCLUSIONS
Our results suggest that regional-level perceived stress and depression, as well as individual-level perceived stress and depression, are inversely associated with individual HRQOL.
Summary
Korean summary
시군구 단위 스트레스 인지율과 우울 유병률이 개인 단위 건강관련 삶의 질 수준과 연관성을 갖는지 파악하고자 지역사회건강조사 자료를 이용하여 다수준 분석을 수행하였다. 개인 수준에서 인지된 스트레스와 우울은 건강관련 삶의 질 감소와 관련이 있었다. 스트레스와 우울 수준이 높은 시군구일수록 개인의 건강관련 삶의 질은 낮아지는 관계를 보였는데, 이는 남성보다는 여성에서 더 저명하였다.
Key Message
This study examined the associations of regional-level perceived stress and depression with individual HRQOL measured in terms of the EQ-5D using a multilevel model. Individual-level perceived stress and depression were significantly related to individual HRQOL. Regional stress and depression were also significant factors and both had greater negative impacts on HRQOL among women than among men.

Citations

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  • Gender-specific secular trends and related factors of high perceived stress level among Korean older adults: a nation-wide serial cross-sectional study
    Eunjeong Choi, Hyun-Ju Seo, Kye Ha Kim, Sun-Young Jung
    BMC Public Health.2025;[Epub]     CrossRef
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    Myung-Ock Chae
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Association between weekly fruit and vegetable consumption and depressive symptoms: results from the Korean Elderly Environmental Panel study
Youjeong Yuk, Chae-Rin Han, Yoonyoung Jang, Yun-Chul Hong, Yoon-Jung Choi
Epidemiol Health. 2021;43:e2021029.   Published online April 20, 2021
DOI: https://doi.org/10.4178/epih.e2021029
  • 22,279 View
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AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
Although previous studies have investigated the correlation between fruit and vegetable consumption and depression, the results remain inconclusive. The present study aimed to investigate the association between weekly fruit and vegetable consumption and depressive symptoms in elderly Koreans.
METHODS
A multiple covariate linear regression analysis was performed using the data of 1,226 elderly individuals ≥ 60 years of age who participated in the Korean Elderly Environmental Panel II study from 2012 to 2014. Depressive symptoms were evaluated using the Korean version of the Short form Geriatric Depression Scale (SGDS-K). Generalized linear mixed-effects models were constructed to analyze the repeated measurements of 305 people who participated in the survey every year.
RESULTS
After adjusting for confounders, SGDS-K scores were negatively associated with the frequency of weekly fruit consumption as follows (β [95% confidence interval; CI]: -0.17 [-0.28 to -0.05], -0.17 [-0.27 to -0.07], -0.42 [-0.54 to 0.29], and -0.33 [-0.44 to -0.21]) for less than 1 time/wk, 1-3 times/wk, 4-6 times/wk, and daily, respectively, compared to no consumption. The SGDS-K scores were also negatively associated with the frequency of vegetable consumption (β [95% CI]: -0.86 [-1.18 to -0.55], -0.18 [-0.35 to -0.01], -0.36 [-0.53 to -0.18], and -0.15 [-0.29 to 0.00]) in the above order, respectively.
CONCLUSIONS
Fruit consumption was inversely associated with depression levels in a dose-dependent manner. Although there was no dose-response relationship between vegetable consumption and the level of depression, it was negatively associated with SGDS-K scores.
Summary
Korean summary
KEEP-II 데이터를 활용하여 한국 노년층의 주간 과일 및 채소 섭취 빈도와 우울증상 간의 상관관계를 알아보았다. 주중 과일을 섭취하는 빈도와 우울증상의 정도 및 우울증 이환 간에서 음의 상관관계가 있었으며 양반응관계가 나타났다. 채소 섭취 빈도의 경우에는 양반응관계가 나타나지 않았으나 채소 섭취 빈도와 우울증상의 정도 간에 음의 상관관계가 있었다.
Key Message
Weekly fruit consumption frequency was inversely associated with the level of depression in a dose-dependent manner in Korean elderly population who participated in KEEP-II study. Although there was no dose-response relationship between vegetable consumption and the level of depression, vegetable consumption frequency was negatively associated with the level of depression.

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  • Digital village construction and depressive symptoms in rural middle-aged and older adults: Evidence from China
    Shenwei Wan, Pengfei Zhang, Song Chen, Yue Yang
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    Xiaoqian Dong, Ying Li, Xingxing Wang, Yinglong Duan, Min Liu, Sha Wang, Xue He, Pingting Yang, Yaqin Wang, Jianfei Xie, Andy S.K. Cheng
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    Annabel P. Matison, Anbupalam Thalamuthu, Victoria M. Flood, Julian N. Trollor, Vibeke S. Catts, Margaret J. Wright, David Ames, Henry Brodaty, Perminder S. Sachdev, Simone Reppermund, Karen A. Mather
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The effects of mental health on recurrent falls among elderly adults, based on Korean Community Health Survey data
Kyung Hee Jo, Jong Park, So Yeon Ryu
Epidemiol Health. 2020;42:e2020005.   Published online February 2, 2020
DOI: https://doi.org/10.4178/epih.e2020005
  • 26,517 View
  • 322 Download
  • 15 Web of Science
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AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
This study aimed to identify the effect of mental health on frequency of falls (single and recurrent falls) among elderly adults.
METHODS
Data were drawn from the 2015 Korean Community Health Survey. A chi-square test was conducted to compare differences in fall frequency according to health-related behaviors, chronic diseases, and mental health. Subsequently, multinomial logistic regression analysis was used to identify the effects of mental health on single and recurrent falls based on variables found to be significant in the chi-square test.
RESULTS
Recurrent falls were found to be more risky than single falls. Depression was significantly related to single falls (odds ratio [OR], 1.27; 95% confidence interval [CI], 1.12 to 1.44). Depression (OR, 1.56; 95% CI, 1.38 to 1.76), sleep disorder (5 hours or less: OR, 1.12; 95% CI, 1.02 to 1.23; more than 9 hours: OR, 1.24; 95% CI, 1.07 to 1.44, respectively), and subjective stress (OR, 2.30; 95% CI, 1.90 to 2.78) were significantly related to recurrent falls.
CONCLUSIONS
The study’s findings suggest that specialized fall prevention programs are needed to address different types of falls in elderly adults. To prevent recurrent falls, systematic treatment strategies and rehabilitation training must improve physical function and mental health.
Summary
Korean summary
우리나라 노인에서 정신건강이 낙상에 미치는 영향을 확인하였고, 그 결과 단순낙상은 우울감 경험을 한 경우 낙상발생 위험이 증가했으며, 반복낙상은 우울감을 경험하고, 수면장애가 있으며(수면시간 6시간 미만, 9시간 이상), 주관적 스트레스가 커질수록 낙상 위험이 증가하였다. 최종적으로 노인의 정신건강이 반복낙상에 미치는 영향이 더 큰 것을 확인하였다. 본 연구결과를 통해 낙상 예방 및 관리를 위한 보건사업을 제시하고, 반복낙상자의 정신적/신체적 기능 증진을 위한 치료전략과 재활훈련 계획의 근거자료로 활용할 수 있을 것으로 생각된다.

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Review
Meta-analysis of the prevalence of depression among breast cancer survivors in Iran: an urgent need for community supportive care programs
Hassan Ahmadi Gharaei, Mostafa Dianatinasab, Seyyed Mostafa Kouhestani, Mohammad Fararouei, Hossein Moameri, Reza Pakzad, Reza Ghaiasvand
Epidemiol Health. 2019;41:e2019030.   Published online July 4, 2019
DOI: https://doi.org/10.4178/epih.e2019030
  • 25,980 View
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  • 18 Web of Science
  • 22 Crossref
AbstractAbstract PDFSupplementary Material
Abstract
OBJECTIVES
Depression, which is the most common comorbidity in breast cancer (BC) patients, has adverse effects on patients’ quality of life, disease progress, and survival.
METHODS
The protocol of this study was registered in PROSPERO (registration No. CRD42019121494). We electronically searched published studies through January 2019 with the aim of finding articles that investigated the prevalence of depression among BC survivors. Web of Science, Scopus, PubMed/MEDLINE, Science Direct, and Google Scholar were searched to obtain relevant published studies. This review included 14 cross-sectional and 4 cohort studies published from 2000 to 2018. We used a random-effects model to conduct the meta-analysis and generated a summary estimate for the pooled prevalence with 95% confidence intervals (CIs). A subgroup analysis was also conducted based on the depression assessment tool used and the study design.
RESULTS
The total sample size of the studies contained 2,799 women with BC, including 1,228 women who were diagnosed with depression. The pooled prevalence of depression among Iranian women with BC was 46.83% (95% CI, 33.77 to 59.88) with significant heterogeneity (I2 =98.5%; p<0.001). The prevalence of depression ranged from 14.00% (95% CI, 4.91 to 23.09) to 95.90% (95% CI, 91.97 to 99.83). The results of the subgroup analyses suggested that the depression assessment tool, year of publication, and study design were sources of heterogeneity.
CONCLUSIONS
Our findings indicate a high prevalence of depression among BC patients, underscoring the urgent need for clinicians and health authorities to provide well-defined social and psychological supportive care programs for these patients.
Summary

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Original Articles
Estimating causal associations of atopic dermatitis with depression using the propensity score method: an analysis of Korea Community Health Survey data, 2010-2013
Hayon Michelle Choi, Dahye Kim, Whanhee Lee, Ho Kim
Epidemiol Health. 2018;40:e2018059.   Published online November 29, 2018
DOI: https://doi.org/10.4178/epih.e2018059
  • 22,793 View
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  • 9 Web of Science
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AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
Numerous studies have reported associations between atopic dermatitis (AD) and depression, but the causal relationship between the 2 diseases has not been established. Therefore, this study used the propensity score method to investigate whether there was a positive causal effect of AD on depression in 16 regions (cities and provinces) in Korea.
METHODS
The study analyzed 16 regions (cities and provinces) in Korea, using data obtained from the Korea Community Health Survey for the years 2010-2013. Propensity score matching was used to estimate the causal influence of AD on depression in Korea.
RESULTS
After propensity score matching, the standardized difference for each covariate among the 16 regions (cities and provinces) was less than 1, indicating a balance between the case and control groups. At the national level, those diagnosed with AD had a 2.31 times higher risk for being diagnosed with depression than those who had not been diagnosed with AD. In particular, the risk was highest in North Jeolla Province (odds ratio [OR], 4.87; 95% confidence interval [CI], 2.28 to 10.43) and lowest in Gwangju (OR, 1.82; 95% CI, 0.87 to 3.79), and the OR for Seoul was 2.23 (95% CI, 1.66 to 2.99).
CONCLUSIONS
This study provides insights into how causal inferences can be derived from observational studies, through an analysis of Korea Community Health Survey data. Furthermore, the study results have implications for region-specific guidelines for preventive health policies targeting depression.
Summary
Korean summary
성향 점수 매칭을 이용하여 전국 및 16개 시/도 별 아토피 피부염과 우울증 사이의 인과성을 추정한 결과, 전국에서 아토피 피부염을 진단 받은 사람이 진단 받지 않은 사람들에 비해 우울증 위험도가 2.38배 높았다(CI: 1.29-4.38).

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Sleep quality and associated factors among the elderly living in rural Chiang Rai, northern Thailand
Weerakorn Thichumpa, Nopporn Howteerakul, Nawarat Suwannapong, Visasiri Tantrakul
Epidemiol Health. 2018;40:e2018018.   Published online May 14, 2018
DOI: https://doi.org/10.4178/epih.e2018018
  • 30,616 View
  • 461 Download
  • 42 Web of Science
  • 56 Crossref
AbstractAbstract PDF
Abstract
OBJECTIVES
This study aimed to characterize the prevalence of poor sleep quality and to identify associated factors among community-dwelling elderly individuals in northern Thailand.
METHODS
A cross-sectional study was conducted among 266 randomly selected elderly people in a sub-district in rural Chiang Rai Province, northern Thailand. The participants were interviewed using the Thai version of the Pittsburgh Sleep Quality Index (PSQI).
RESULTS
Roughly 44.0% of the participants had poor sleep quality (PSQI score, >5), 9.4% used sleep medication, 27.1% had poor family relationships, and 12.0% had mild depression. Multiple logistic regression analysis indicated that being female (odds ratio [OR], 1.74; 95% confidence interval [CI], 1.10 to 3.02), a higher education level (OR, 3.03; 95% CI, 1.34 to 6.86 for primary school; OR, 2.48; 95% CI, 1.31 to 5.44 for higher than primary school), mild depression (OR, 2.65; 95% CI, 1.11 to 6.36), and poor family relationships (OR, 3.65; 95% CI, 1.98 to 6.75) were significantly associated with poor sleep quality.
CONCLUSIONS
The prevalence of poor sleep quality among the elderly was moderately high. Healthcare providers should regularly conduct screenings for sleep quality and depression; provide sleep health education; and conduct interventions to encourage participating in family activities, resolving conflicts, sharing ideas, and making compromises within the family.
Summary

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Analysis of the relationship between community characteristics and depression using geographically weighted regression
Hyungyun Choi, Ho Kim
Epidemiol Health. 2017;39:e2017025.   Published online June 21, 2017
DOI: https://doi.org/10.4178/epih.e2017025
  • 24,036 View
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  • 2 Web of Science
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AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
Achieving national health equity is currently a pressing issue. Large regional variations in the health determinants are observed. Depression, one of the most common mental disorders, has large variations in incidence among different populations, and thus must be regionally analyzed. The present study aimed at analyzing regional disparities in depressive symptoms and identifying the health determinants that require regional interventions.
METHODS
Using health indicators of depression in the Korea Community Health Survey 2011 and 2013, the Moran’s I was calculated for each variable to assess spatial autocorrelation, and a validated geographically weighted regression analysis using ArcGIS version 10.1 of different domains: health behavior, morbidity, and the social and physical environments were created, and the final model included a combination of significant variables in these models.
RESULTS
In the health behavior domain, the weekly breakfast intake frequency of 1-2 times was the most significantly correlated with depression in all regions, followed by exposure to secondhand smoke and the level of perceived stress in some regions. In the morbidity domain, the rate of lifetime diagnosis of myocardial infarction was the most significantly correlated with depression. In the social and physical environment domain, the trust environment within the local community was highly correlated with depression, showing that lower the level of trust, higher was the level of depression. A final model was constructed and analyzed using highly influential variables from each domain. The models were divided into two groups according to the significance of correlation of each variable with the experience of depression symptoms.
CONCLUSIONS
The indicators of the regional health status are significantly associated with the incidence of depressive symptoms within a region. The significance of this correlation varied across regions.
Summary
Korean summary
정신질환 중 가장 흔한 우울증의 경우 집단의 특성 간 발생 현황에 차이를 보이고 있어 지역별 접근을 통한 연구가 요구됨에 따라 본 연구에서는 우울증의 지역적 변이요인을 분석하여 지역별 중재가 필요한 건강결정요인을 파악하고자 지역사회건강조사 자료를 이용하여 공간적 지리가중회귀분석을 시행하였다. 본 연구를 통해 지역단위보건관련지표는 지역의 우울증 발생과 유의미한 연관성이 있으며 연관성 우선순위는 지역별 차이가 있음이 밝혀졌다. 지역적 특성에 따른 우선순위를 제시하였음에 본 연구의 의의가 있으며 공중 보건 영역의 다른 사례에 본 연구방법론 및 연구결과 제시 방안을 적용함에 따라 지역의 건강수준향상 프로그램 개발에 유용한 기초자료의 제공을 기대할 수 있다.

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Secondhand smoke exposure and mental health problems in Korean adults
Na Hyun Kim, Hansol Choi, Na Rae Kim, Jee-Seon Shim, Hyeon Chang Kim
Epidemiol Health. 2016;38:e2016009.   Published online March 14, 2016
DOI: https://doi.org/10.4178/epih.e2016009
  • 28,376 View
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  • 18 Web of Science
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AbstractAbstract PDF
Abstract
OBJECTIVES
To evaluate the association between secondhand smoke exposure (SHSE) and mental health problems among Korean adults.
METHODS
We analyzed data from the 2011 Korean Community Health Survey. From the total of 229,226 participants aged 19 years or above, we excluded 48,679 current smokers, 36,612 former smokers, 3,036 participants with a history of stroke, 2,264 participants with a history of myocardial infarction, 14,115 participants who experienced at least one day in bed per month due to disability, and 855 participants for whom information regarding SHSE or mental health problems was not available. The final analysis was performed with 22,818 men and 100,847 women. Participants were classified into four groups according to the duration of SHSE: none, <1 hr/d, 1-<3 hr/d, and ≥3 hr/d. The presence of depressive symptoms, diagnosed depression, and high stress were measured by questionnaire.
RESULTS
After adjusting for demographic factors, lifestyle, and chronic disease, the odds ratio (OR) and 95% confidence interval (CI) of depressive symptoms with 1-<3 hr/d and ≥3 hr/d SHSE were 1.44 (95% CI, 1.14 to 1.82) and 1.59 (95% CI, 1.46 to 1.74), respectively. However, SHSE ≥3 hr/d had a higher OR of 1.37 (95% CI, 1.20 to 1.58) for diagnosed depression. SHSE was also associated with high stress (1-<3 hr/d: OR, 1.56; 95% CI, 1.38 to 1.76; ≥3 hr/d: OR, 1.33 95% CI, 1.28 to 1.40). However, the association between SHSE and symptoms of depression and stress did not differ significantly by region.
CONCLUSIONS
SHSE may be associated with mental health problems such as depression and stress in Korean adults.
Summary

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Association of Subway Driver's Depressive Symptoms and Experience of Work-Related Problems
Sun-Jin Jo, Hyeon Woo Yim, Hyoung-Ryoul Kim, Kang Sook Lee, Jong-Ik Park, Sung Man Chang
Epidemiol Health. 2010;32:e2010010.   Published online December 3, 2010
DOI: https://doi.org/10.4178/epih/e2010010
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AbstractAbstract PDF
Abstract
<sec><title>OBJECTIVES</title><p>Subway drivers experience various types of work-related problems during their driving, and those experiences can act as risk factors for depressive symptoms. This study was conducted to investigate the association between work-related problems and subway driver's depressive symptoms.</p></sec><sec><title>METHODS</title><p>We recruited all of the 961 current subway drivers of a subway company located in Seoul, South Korea and conducted a survey of their socio-demographic and vocational characteristics, hospital visits as an outpatient or inpatient, and work-related problem experiences during the last year. Work-related problems included an accident resulting in death or injury, a conflict with a customer, a sudden stop from an emergency bell, or a near accident. Depressive symptoms were measured with the Center for Epidemiologic Studies-Depression (CES-D) instrument. The survey was performed using a self-report questionnaire from April 16 to July 13, 2007. The data of 827 drivers (86.2%) were analyzed.</p></sec><sec><title>RESULTS</title><p>Experience of a conflict with a passenger (p=0.011), a sudden stop from an emergency bell (p=0.001), or a near accident (p=0.001) increased the prevalence of depressive symptoms among subway drivers. A multiple logistic regression analysis revealed that a sudden stop from an emergency bell increased the risk of depressive symptoms significantly (OR=2.59, p=0.026). Near accidents were marginally associated with a higher risk for depressive symptoms (OR=1.62, p=0.062).</p></sec><sec><title>CONCLUSION</title><p>The experience of a sudden stop from an emergency bell increased subway driver's depressive symptoms, and near accidents may increase the risk of depressive symptoms. Therefore, interventions for the drivers who had experienced these work-related problems are needed.</p></sec>
Summary

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The Associations between Social Support, Health-Related Behaviors, Socioeconomic Status and Depression in Medical Students
Yoolwon Jeong, Jin Young Kim, Jae Seon Ryu, Ko eun Lee, Eun Hee Ha, Hyesook Park
Epidemiol Health. 2010;32:e2010009.   Published online November 24, 2010
DOI: https://doi.org/10.4178/epih/e2010009
  • 29,552 View
  • 162 Download
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AbstractAbstract PDF
Abstract
<sec><title>OBJECTIVES</title><p>The objective of this study was to estimate the prevalence of depression in medical students and to evaluate whether interpersonal social support, health-related behaviors, and socio-economic factors were associated with depression in medical students.</p></sec><sec><title>METHODS</title><p>The subjects in this study were 120 medical students in Seoul, Korea who were surveyed in September, 2008. The subjects were all women and over the age of 20. Their age, body mass index (BMI), quality of sleep, diet, household income, smoking, alcohol consumption, exercise levels, and self-reported health status were surveyed. The degree of perceived social support was measured using the interpersonal support evaluation list (ISEL). Depression was evaluated using the center for epidemiology studies depression scale (CES-D).</p></sec><sec><title>RESULTS</title><p>The mean CES-D score was 14.1±8.6 and 37.1% of the participants appeared to suffer from depression. Low levels of perceived interpersonal support increased the risk of depression by more than 10 times and having higher household income did not necessarily decrease the risk of depression.</p></sec><sec><title>CONCLUSION</title><p>Medical students have a relatively high level of depression. Efforts should be made to encourage social support in order to promote mental health in medical students.</p></sec>
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Hebei Spirit oil spill exposure and acute neuropsychiatric effects on residents participating in clean-up work.
Jin Hee Eum, Hae Kwan Cheong, Mina Ha, Ho Jang Kwon, Eun Hee Ha, Yun Chul Hong, Ye Yong Choi, Woo Chul Jeong, Jong Il Hur, Seungmin Lee, Eun Jung Kim, Eun Hee Lee, So Young Lee Ahn, Jong Hun Kim
Korean J Epidemiol. 2008;30(2):239-251.   Published online December 31, 2008
DOI: https://doi.org/10.4178/kje.2008.30.2.239
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AbstractAbstract PDF
Abstract
OBJECTIVES
Hebei Spirit oil spill accident has brought about the worst coastal oil contamination in Korean history. Following the accident, residents and volunteers, number exceeding a million from nationwide, were exposed to chemicals from the crude oil itself and dispersants, including volatility organic compounds (VOCs), polycyclic aromatic hydrocarbons (PAHs), and heavy metals through the clean-up works over months. This study was undertaken to investigate the effect of clean-up work on the peripheral nerve function and psychologic status of the residents after a prolonged exposure to clean-up work after the oil spill exposure.
METHODS
We performed a study on the residents of Jango-do Island, Chungnam, on 5 and 12 January 2008, six to eight weeks after the accident. A questionnaire on general characteristics, Korean Beck Depression Inventory (K-BDI), color vision test (Lanthony desaturated D-15 test), and vibration perception threshold test were done. Among 210 residents with 30 years or older, 63 (30%) finished questionnaires and completed at least one among K-BDI, color vision test, or vibration perception threshold test. Descriptive statistics was done on the residents.
RESULTS
The residents participated in clean-up work for average 20 days, max 30 days, during 6 weeks following the accident. Average work hours were 7.4 hours per day, max 10 hours. On K-BDI, 21 (33.3%) had a severe depressive state. Mean color confusion index was 1.29 in the right and 1.20 in the left. Mean vibration perception threshold was 3.69 VU (right) and 3.55 VU (left), respectively.
DISCUSSIONS
AND CONCLUSIONS: Compared to literature report, the residents had higher depression scale. Color vision threshold was not higher compared to general population near an industrial complex. Vibration perception threshold was significantly higher than the residents of similar age living near an abandoned mine in southern coastal area only in the age group of forties. These suggests there is some evidence of neuropsychiatric effect related to oil cleaning work and a mid- and long-term study of the oil exposure health effects with continuous monitoring should be done for the exposed residents in the affected area.
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Prevalence and risk factors of irritable bowel syndrome in Korean high school students.
Kyung Tae Lee, Jaehyun Yoo, Bo Kyoung Kim, Hae Kwan Cheong
Korean J Epidemiol. 2007;29(1):21-33.
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Abstract
BACKGROUND
AND OBJECTIVES: Irritable bowel syndrome (IBS) is prevalent in the general population, but there are few reports on bowel habits and IBS in high school students in Korea. This study aims to describe the prevalence of IBS in high school students in Korea and to investigate the influence of lifestyle factors including dietary habits, on the IBS. This study also investigates relationship between anxiety, depression and IBSprevalence. SUBJECTS AND METHODS: This study is a cross-sectional study on 1,018 students (451 males and 567 females) form freshman to senior of a high schools in Seoul. All students were requested to fill in a self-reported questionnaire. IBS was diagnosed based on the Rome II criteria. Those having past medical history of organic gastrointestinal disorders and any one of the 'alarm factors'(e.g. continuous hematochezia, weight loss, or anemic symptom) were excluded from the IBS group. For the evaluation of risk factors on the IBS, we surveyed dietary habit, health behavior, past medical history, the Hollingshed index for the measurement of socioeconomic status, Beck's Anxiety Inventory for the anxiety, and the Children's Depression Inventory for the depression.
RESULTS
The prevalence of IBS was 19.1%. Family history of abdominal discomfort (odds ratio 2.07, 95% 1.46-2.92) and having night snack (odds ratio 1.46, 95% CI 1.09-1.94) were significantly different between the IBS group and non-IBS group. There was a linear trend towards the higher prevalence of IBS with fewer hours of exercise (odds ratio 0.99, 95% CI 0.95-1.04). Menstruation, stress, and irregular eating were the significant provocation factors of IBS. Anxiety and depression was not significantly higher in in the IBS group.
CONCLUSIONS
Prevalence of the IBS in high school students from this study was higher compared with those reported in college students in Korea. This study shows that family history, dietary factors, lifestyle, and grade were significantly related to IBS. From our study, we found that there are multifaceted health aspects required to reduce symptoms, such as dietary education and encouragement to change lifestyle for controlling stress.
Summary
A study on the addicted use of mobile phone among the high school students.
Jin young Jeong, Dong Hyun Kim
Korean J Epidemiol. 2005;27(1):140-153.
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Abstract
BACKGROUND
As there are many teenagers being addicted to the Internet ever since the computer became one of the communication channels, similar addictive phenomena are expected to occur for mobile phone usage as it rapidly positions itself as a means of communication among teenagers. OBJECTIVE: This study was performed to describe the pattern of mobile phone usage among high school students and to examine the association with psychological characteristics related to addiction such as depression, self-esteem and impulsiveness.
METHOD
OLOGY: A survey was conducted for 501 high school students(254 males and 247 females), currently using mobile phones, in the Metropolitan Seoul area. The Questionnaire by Young for the evaluation of internet addiction was modified and supplemented incorporating the circumstances in Korea. For the psychological characteristics, following were used: Korean translation of the depression scale CES-D, the self-esteem scale and Barratt Impulsiveness Scale. Based on the total score on the mobile phone survey, the top 25% were categorized as the addicted user group (n=129) and the bottom 25% as the non-addicted user group(n=126).
RESULTS
The addicted user group started using the mobile phone earlier, used their phones for longer durations and displayed higher purchasing frequencies than the non-addicted user group. Furthermore, the addicted group members scored higher in terms of average daily usage time, voice call duration, SMS exchanges, the number of contacts stored in the phone, experiences of using the phone during classes, and average monthly charges. Multiple logistic regression analysis was performed to assess associated factors of addicted mobile phone use. In terms of psychological characteristics, addicted mobile phone use was 10.2 times(OR=10.2, 95% CI 2.1~49.2) greater if the depression point is 51 or higher compared to 35 or less, and 6.3 times(OR=6.4, 95% CI 2.0~20.5) greater if the impulsiveness point is 61 or higher compared to 50 or less.
CONCLUSION
These finding showed that there were differences between the addicted mobile phone user group and the non-addicted counterpart in terms of mobile phone usage patterns and psychological characteristics such as depression and impulsiveness. Further studies on the association between addicted use of mobile phone and psychological factors are needed.
Summary

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