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Original Articles
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
  • 1,004 View
  • 35 Download
AbstractAbstract AbstractSummary PDF
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.
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
  • 1,636 View
  • 88 Download
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.
Changes in mental health service utilization before and during the COVID-19 pandemic: a nationwide database analysis in Korea
Kyoung Hoon Kim, Sang Min Lee, Minha Hong, Kyu-Man Han, Jong-Woo Paik
Epidemiol Health. 2023;45:e2023022.   Published online February 14, 2023
DOI: https://doi.org/10.4178/epih.e2023022
  • 6,290 View
  • 275 Download
  • 3 Web of Science
  • 1 Crossref
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
The present study examined the impact of the coronavirus disease 2019 (COVID-19) pandemic on mental health service utilization through a comparative analysis of nationwide data regarding inpatient care users, outpatient visits, emergency department (ED) visits, and admissions via the ED before and during the pandemic.
METHODS
Data from approximately 350,000 Koreans diagnosed with mental illness were analyzed in terms of hospitalization, outpatient visits, and ED visits between January 2018 and June 2021. An interrupted time series analysis was conducted to determine the significance of changes in mental health service utilization indicators.
RESULTS
The number of hospital admissions per patient decreased by 1.2% at the start of the pandemic and 0.7% afterward. The length of hospital stay increased by 1.8% at the outbreak of the pandemic, and then decreased by 20.2%. Although the number of outpatients increased, the number of outpatient visits per patient decreased; the number of outpatient visits for schizophrenia (3.4%) and bipolar disorder (3.5%) significantly decreased immediately post-outbreak. The number of ED visits per patient decreased both immediately post-outbreak and afterward, and ED visits for schizophrenia (19.2%), bipolar disorder (22.3%), and depression (17.4%) decreased significantly immediately post-outbreak. Admissions via the ED did not show a significant change immediately post-outbreak.
CONCLUSIONS
Mental health service utilization increased during the pandemic, but medical service use decreased overall, with a particularly significant decrease in ED utilization. As the pandemic worsened, the decline in outpatient visits became more pronounced among those with severe mental illness.
Summary
Korean summary
이 연구는 COVID-19 전후 정신질환 의료서비스 이용 변화를 분석하였다. 팬데믹 기간 중에 정신질환 의료서비스는 전반적으로 감소하였고, 특히 중증 정신질환의 외래 방문이 감소하였다. 따라서, 정신질환자의 진료 연속성을 보장하기 위한 조치가 요구된다.
Key Message
This study examined the impact of the COVID-19 pandemic on mental health service utilization. The mental health service utilization decreased overall after the outbreak of COVID-19, especially outpatient visits for severe mental illness significantly decreased. Therefore, countermeasures are needed to maintain the continuity of care.

Citations

Citations to this article as recorded by  
  • Adult Mental Health Presentations to Emergency Departments in Victoria, Australia between January 2018 and October 2020: Changes Associated with COVID-19 Pandemic Public Health Restrictions
    Jackson Newberry-Dupé, Wanyu Chu, Simon Craig, Rohan Borschmann, Gerard O’Reilly, Paul Yates, Glenn Melvin, Kylie King, Harriet Hiscock
    Psychiatric Quarterly.2024; 95(1): 33.     CrossRef
COVID-19: Special Article
Changes in mental health of Korean adolescents before and during the COVID-19 pandemic: a special report using the Korea Youth Risk Behavior Survey
Bomi Park, Jihee Kim, Jieun Yang, Sunhye Choi, Kyungwon Oh
Epidemiol Health. 2023;45:e2023019.   Published online February 14, 2023
DOI: https://doi.org/10.4178/epih.e2023019
  • 5,926 View
  • 357 Download
  • 2 Web of Science
  • 2 Crossref
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
We aimed to study the effects of the coronavirus disease 2019 (COVID-19) pandemic on adolescents’ mental health in Korea.
METHODS
We used data from the Korea Youth Risk Behavior Survey 2018-2021 with 227,139 students aged 12-18 years. We estimated the differences in depressive symptoms, suicidal ideation, and stress perception before (2018-2019) and during (2020-2021) the pandemic, as well as before (2019), the first year (2020) of, and the second year (2021) of the pandemic. We also examined whether COVID-19 is statistically associated with mental health.
RESULTS
In both male and female adolescents, the prevalence of depressive symptoms, suicidal ideation, and stress perception was higher in the “not living with family,” “low household economic status,” and “self-rated unhealthy status” subgroups. The prevalence of depressive symptoms and stress perception was higher in middle school students. Adolescents were less likely to experience depressive symptoms (adjusted odds ratio [aOR], 0.86; 95% confidence interval [CI], 0.83 to 0.89), suicidal ideation (aOR, 0.80; 95% CI, 0.76 to 0.83), and stress perception (aOR, 0.76; 95% CI, 0.74 to 0.79) in 2020 than in 2019. However, there were more depressive symptoms (aOR, 1.06; 95% CI, 1.02 to 1.09), suicidal ideation (aOR, 1.15; 95% CI, 1.10 to 1.21), and stress perception (aOR, 1.19; 95% CI, 1.16 to 1.23) in 2021 than in 2020.
CONCLUSIONS
The COVID-19 pandemic had positive impacts on mental health of adolescents in its early stages but has had negative impacts as the pandemic continues. Attention should be paid to adolescents who are particularly vulnerable to the mental health effects of the pandemic.
Summary
Korean summary
The results from a nationally representative data showed that mental health in adolescents was improved in the first year of the COVID-19 pandemic compared to before the COVID-19 pandemic, but it was deteriorated in the second year of the pandemic compared to the first year.
Key Message
본 연구에서는 대규모 건강조사를 이용하여 코로나19가 장기화됨에 따른 영향을 평가하고자 하였다. 2018년-2021년 청소년건강행태조사에 참여한 만 12-18세 청소년 227,139 명을 대상으로 분석한 결과, 코로나19 유행 첫번째 해(2020년)에는 코로나19 유행 이전에 비해 정신건강이 개선되었으나, 코로나19 유행 두 번째 해(2021년)에는 코로나19 유행 첫 번째 해에 비해 청소년 정신건강이 나빠졌다. 또한 가족과 함께 거주하지 않는 경우, 가정 경제 수준이 낮은 경우, 본인이 건강하지 않다고 인지하는 경우에 더 취약하였다.

Citations

Citations to this article as recorded by  
  • Excess mortality during the Coronavirus disease pandemic in Korea
    Changwoo Han, Hoyeon Jang, Juhwan Oh
    BMC Public Health.2023;[Epub]     CrossRef
  • A Comparison of Changes in Health Behavior, Obesity, and Mental Health of Korean Adolescents Before and During the COVID-19 Pandemic: Online Cross-Sectional Study
    Mi-Sun Lee, Hooyeon Lee
    Psychiatry Investigation.2023; 20(11): 1086.     CrossRef
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
  • 13,782 View
  • 527 Download
  • 15 Web of Science
  • 16 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.

Citations

Citations to this article as recorded by  
  • Mental Health Status of New Police Trainees before and during the COVID-19 Pandemic
    Joungsue Kim, Jiyoung Yoon, Inah Kim, Jeehee Min
    Healthcare.2024; 12(6): 645.     CrossRef
  • The Association of Acute Signs and Symptoms of COVID-19 and Exacerbation of Depression and Anxiety in Patients With Clinically Mild COVID-19: Retrospective Observational Study
    Sumi Sung, Su Hwan Kim, Changwoo Lee, Youlim Kim, Ye Seul Bae, Eui Kyu Chie
    JMIR Public Health and Surveillance.2023; 9: e43003.     CrossRef
  • The Risk of Major Depressive Disorder Due to Cataracts among the Korean Elderly Population: Results from the Korea National Health and Nutrition Examination Survey (KNHANES) in 2016 and 2018
    Min-Jin Kang, Kyung-Yi Do, Nayeon Park, Min-Woo Kang, Kyoung Sook Jeong
    International Journal of Environmental Research and Public Health.2023; 20(2): 1547.     CrossRef
  • Prevalence of Mental Disorders and Associated Factors in Korean Adults: National Mental Health Survey of Korea 2021
    Soo Jung Rim, Bong-Jin Hahm, Su Jeong Seong, Jee Eun Park, Sung Man Chang, Byung-Soo Kim, Hyonggin An, Hong Jin Jeon, Jin Pyo Hong, Subin Park
    Psychiatry Investigation.2023; 20(3): 262.     CrossRef
  • The association mental health of adolescents with economic impact during the COVID-19 pandemic: a 2020 Korean nationally representative survey
    Hanul Park, Kang-Sook Lee
    BMC Public Health.2023;[Epub]     CrossRef
  • Obstructive sleep apnea related to mental health, health-related quality of life and multimorbidity: A nationwide survey of a representative sample in Republic of Korea
    Mee-Ri Lee, Sung Min Jung, Frances Chung
    PLOS ONE.2023; 18(6): e0287182.     CrossRef
  • Comparison of Mental Health between the Older People Living Alone and Older People Not Living Alone before and during the COVID-19 Pandemic: Using the 2019-2020 Korea Community Health Survey
    Kyong Sil Park, Yeojoo Chae
    Journal of Health Informatics and Statistics.2023; 48(2): 132.     CrossRef
  • The risk of obstructive sleep apnea is highly correlated with depressive symptoms among the Korean adults population: results from the 2020 Korea National Health and Nutrition Examination Survey
    Mi-Sun Lee, Hooyeon Lee
    BMC Psychiatry.2023;[Epub]     CrossRef
  • Associations between discrimination experiences and symptoms of depression and anxiety among transgender adults: a nationwide cohort study of 269 transgender adults in South Korea
    Sungsub Choo, Ranyeong Kim, Hyemin Lee, Yun-Jung Eom, Horim Yi, Rockli Kim, Seung-Sup Kim
    Social Psychiatry and Psychiatric Epidemiology.2023;[Epub]     CrossRef
  • 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
  • Mental health status of individuals with diabetes in Korea before and during the COVID-19 pandemic: a comparison of data from the Korean national health and nutrition examination surveys of 2018–2019 and 2020–2021
    Hyejin Jung
    BMJ Open.2023; 13(10): e074080.     CrossRef
  • Assessment of burnout level among clinical dental students during the COVID-19 pandemic
    Cumhur Korkmaz, Sibel Dikicier, Arzu Atay
    BMC Medical Education.2023;[Epub]     CrossRef
  • The mechanisms of nature-based therapy on depression, anxiety, stress, and life satisfaction: examining mindfulness in a two-wave mediation model
    Minjung Kang, Yeji Yang, Hyunjin Kim, Songhie Jung, Hye-Young Jin, Kee-Hong Choi
    Frontiers in Psychology.2023;[Epub]     CrossRef
  • Changes in the management of hypertension, diabetes mellitus, and hypercholesterolemia in Korean adults before and during the COVID-19 pandemic: data from the 2010-2020 Korea National Health and Nutrition Examination Survey
    Yoonjung Kim, Suyeon Park, Kyungwon Oh, Hongseok Choi, Eun Kyeong Jeong
    Epidemiology and Health.2023; 45: e2023014.     CrossRef
  • Sadness, counseling for sadness, and sleep time and COVID-19 pandemic in South Korea: Rapid review and a post-hoc analysis
    Jungwoo Choi, Minji Kim, Min Seo Kim, Guillaume Fond, Laurent Boyer, Guillermo F López Sánchez, Elena Dragioti, Samuele Cortese, Ai Koyanagi
    Life Cycle.2023;[Epub]     CrossRef
  • Changes in the prevalence of metabolic syndrome in Korean adults after the COVID-19 outbreak
    Ji-Young Kwon, Sang-Wook Song
    Epidemiology and Health.2022; 44: e2022101.     CrossRef
COVID-19: Perspective
Maternal mental health in Africa during the COVID-19 pandemic: a neglected global health issue
Kobi V. Ajayi, Elizabeth Wachira, Obasanjo Afolabi Bolarinwa, Beulah D. Suleman
Epidemiol Health. 2021;43:e2021078.   Published online October 6, 2021
DOI: https://doi.org/10.4178/epih.e2021078
  • 9,100 View
  • 156 Download
  • 5 Web of Science
  • 3 Crossref
AbstractAbstract AbstractSummary PDF
Abstract
The coronavirus disease 2019 (COVID-19) pandemic has profoundly impacted mental health and well-being around the globe. Public health measures to control the virus’s rapid spread, such as physical distancing, social isolation, lockdown, restricted movements, and quarantine, caused fear and panic in the general population. Although pandemic-related stressors have been reported, changes that occur during the perinatal period compounded by those made to obstetric care guidelines may put pregnant and postpartum mothers at an increased risk of poor mental health. While an abundance of research has examined the impact of the pandemic on maternal mental health in developed nations such as Europe and America, very few studies have done so in the African continent. Considering that Africa has prominently weak health systems, poor mental health policies and infrastructure, high poverty rates, and unreliable maternal care, the pandemic is expected to have dire consequences on maternal mental health in the region. As such, multipronged mental health interventions and strategies that consider the heterogeneity within and between African regions must be developed. Doing so will close existing and widening global health disparities to achieve the United Nations Sustainable Development Goals by 2030.
Summary
Key Message
Despite the adverse psychological impact of the COVID-19 pandemic on maternal mental health globally, little is known about its effect in Africa. As of the time of this study, only four research studies have been conducted in Nigeria, Ethiopia, and Ghana, investigating the psychological sequelae of the pandemic among pregnant and postpartum women in Africa. This study calls for urgent multipronged maternal mental health interventions and psychosocial support that consider the heterogeneity within and between African regions.

Citations

Citations to this article as recorded by  
  • Poor sleep quality and suicidal ideation among pregnant women during COVID-19 in Ethiopia: systematic review and meta-analysis
    Aragaw Asfaw Hasen, Abubeker Alebachew Seid, Ahmed Adem Mohammed
    PeerJ.2023; 11: e16038.     CrossRef
  • Experiences of Perinatal Mental Health Care among Minority Ethnic Women during the COVID-19 Pandemic in London: A Qualitative Study
    Sabrina Pilav, Abigail Easter, Sergio A. Silverio, Kaat De Backer, Sushma Sundaresh, Sara Roberts, Louise M. Howard
    International Journal of Environmental Research and Public Health.2022; 19(4): 1975.     CrossRef
  • Generalized Anxiety Disorder and Its Associated Factors Among Pregnant Women During COVID-19 at Public Health Facilities of East Gojjam Zone, 2020: A Multi-Center Cross-Sectional Study
    Keralem Anteneh Bishaw, Addisu Andalem, Haile Amha, Tirusew wondie
    Frontiers in Global Women's Health.2022;[Epub]     CrossRef
COVID-19: Systematic Review
A closer look at the high burden of psychiatric disorders among healthcare workers in Egypt during the COVID-19 pandemic
Amr Ehab El-Qushayri, Abdullah Dahy, Abdullah Reda, Mariam Abdelmageed Mahmoud, Sarah Abdel Mageed, Ahmed Mostafa Ahmed Kamel, Sherief Ghozy
Epidemiol Health. 2021;43:e2021045.   Published online July 13, 2021
DOI: https://doi.org/10.4178/epih.e2021045
  • 10,431 View
  • 257 Download
  • 9 Web of Science
  • 6 Crossref
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
This study aimed to examine the prevalence of psychiatric disorders among Egyptian healthcare workers (HCWs) during the coronavirus disease 2019 (COVID-19) pandemic.
METHODS
Six databases were searched for relevant papers. The quality of the selected articles was measured using the National Institute of Health quality assessment tool. We used a fixed-effects model when there was no heterogeneity and a random-effects model when there was heterogeneity.
RESULTS
After screening 197 records, 10 studies were ultimately included. Anxiety was the most commonly reported psychiatric disorder among HCWs, with a prevalence of 71.8% (95% confidence interval [CI], 49.4 to 86.9), followed by stress (66.6%; 95% CI, 47.6 to 81.3), depression (65.5%; 95% CI, 46.9 to 80.3), and insomnia (57.9%; 95% CI, 45.9 to 69.0). As measured using the 21-item Depression, Anxiety, and Stress Scale, the most common level of severity was moderate for depression (22.5%; 95% CI, 19.8 to 25.5) and stress (14.5%; 95% CI, 8.8 to 22.9), while high-severity anxiety was more common than other levels of severity (28.2%; 95% CI, 3.8 to 79.6).
CONCLUSIONS
The COVID-19 pandemic has had a negative effect on Egyptian HCWs’ psychological well-being. More psychological support and preventive measures should be implemented to prevent the further development of psychiatric illness among physicians and other HCWs.
Summary
Key Message
The COVID-19 pandemic has had a negative effect on Egyptian HCWs’ psychological well-being with a high burden of anxiety, stress, depression and insomnia. More psychological support and preventive measures should be implemented to prevent the further development of psychiatric illness among physicians and other HCWs.

Citations

Citations to this article as recorded by  
  • Anxiety and stress among healthcare professionals during COVID-19 in Ethiopia: systematic review and meta-analysis
    Aragaw Asfaw Hasen, Abubeker Alebachew Seid, Ahmed Adem Mohammed
    BMJ Open.2023; 13(2): e070367.     CrossRef
  • COVID-19 and common mental health symptoms in the early phase of the pandemic: An umbrella review of the evidence
    Anke B. Witteveen, Susanne Y. Young, Pim Cuijpers, José Luis Ayuso-Mateos, Corrado Barbui, Federico Bertolini, Maria Cabello, Camilla Cadorin, Naomi Downes, Daniele Franzoi, Michael Gasior, Brandon Gray, Maria Melchior, Mark van Ommeren, Christina Palantz
    PLOS Medicine.2023; 20(4): e1004206.     CrossRef
  • Effectiveness of mindfulness-based interventions on burnout and self-compassion among critical care nurses caring for patients with COVID-19: a quasi-experimental study
    Sahar Younes Othman, Nagia I. Hassan, Alaa Mostafa Mohamed
    BMC Nursing.2023;[Epub]     CrossRef
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COVID-19: Systematic Review
Mental health outcomes of quarantine and isolation for infection prevention: a systematic umbrella review of the global evidence
Md Mahbub Hossain, Abida Sultana, Neetu Purohit
Epidemiol Health. 2020;42:e2020038.   Published online June 2, 2020
DOI: https://doi.org/10.4178/epih.e2020038
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AbstractAbstract PDFSupplementary Material
Abstract
Objectives
Transmission of infectious diseases is often prevented by quarantine and isolation of the populations at risk. These approaches restrict the mobility, social interactions, and daily activities of the affected individuals. In recent coronavirus disease 2019 (COVID-19) pandemic, quarantine and isolation are being adopted in many contexts, which necessitates an evaluation of global evidence on how such measures impact the mental health outcomes among populations. This umbrella review aimed to synthesize the available evidence on mental health outcomes of quarantine and isolation for preventing infectious diseases.
Methods
We searched nine major databases and additional sources and included articles if they were systematically conducted reviews, published as peer-reviewed journal articles, and reported mental health outcomes of quarantine or isolation in any population.
Results
Among 1,364 citations, only eight reviews met our criteria. Most of the primary studies in those reviews were conducted in high-income nations and in hospital settings. These articles reported a high burden of mental health problems among patients, informal caregivers, and healthcare providers who experienced quarantine or isolation. Prevalent mental health problems among the affected individuals include depression, anxiety, mood disorders, psychological distress, posttraumatic stress disorder, insomnia, fear, stigmatization, low self-esteem, lack of self-control, and other adverse mental health outcomes.
Conclusions
This umbrella review found severe mental health problems among individuals and populations who have undergone quarantine and isolation in different contexts. This evidence necessitates multipronged interventions including policy measures for strengthening mental health services globally and promoting psychosocial wellbeing among high-risk populations.
Summary

Citations

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    Serena Petrocchi, Annalisa Levante, Federica Bianco, Ilaria Castelli, Flavia Lecciso
    Frontiers in Public Health.2020;[Epub]     CrossRef
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    Daniel Fellman, Liisa Ritakallio, Otto Waris, Jussi Jylkkä, Matti Laine
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    Eva-Lotta Brakemeier, Janine Wirkner, Christine Knaevelsrud, Susanne Wurm, Hanna Christiansen, Ulrike Lueken, Silvia Schneider
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    Maximilian Andreas Storz
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    Giuseppina Lo Moro, Emma Soneson, Peter B. Jones, Julieta Galante
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Original Article
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
  • 13,381 View
  • 295 Download
  • 8 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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    Jiwon Choi, Sun-Kyung Hwang
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    Yeong Mi Seo, Eun Sook Lee
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    Vanessa Koh, David B. Matchar, Angelique Chan
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    Matt C. Smith, Jessica O’Loughlin, Vasileios Karageorgiou, Francesco Casanova, Genevieve K. R. Williams, Malcolm Hilton, Jessica Tyrrell
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    Sadaya Misaki, Hiroshi Murayama, Mika Sugiyama, Hiroki Inagaki, Tsuyoshi Okamura, Chiaki Ura, Fumiko Miyamae, Ayako Edahiro, Keiko Motokawa, Shuichi Awata
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Cohort Profile
Health Effects of Underground Workspaces cohort: study design and baseline characteristics
Gerard Dunleavy, Thirunavukkarasu Sathish, Nuraini Nazeha, Michael Soljak, Nanthini Visvalingam, Ram Bajpai, Hui Shan Yap, Adam C. Roberts, Thuan Quoc Thach, André Comiran Tonon, Chee Kiong Soh, Georgios Christopoulos, Kei Long Cheung, Hein de Vries, Josip Car
Epidemiol Health. 2019;41:e2019025.   Published online August 16, 2019
DOI: https://doi.org/10.4178/epih.e2019025
  • 15,786 View
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  • 14 Web of Science
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AbstractAbstract PDFSupplementary Material
Abstract
The development of underground workspaces is a strategic effort towards healthy urban growth in cities with ever-increasing land scarcity. Despite the growth in underground workspaces, there is limited information regarding the impact of this environment on workers’ health. The Health Effects of Underground Workspaces (HEUW) study is a cohort study that was set up to examine the health effects of working in underground workspaces. In this paper, we describe the rationale for the study, study design, data collection, and baseline characteristics of participants. The HEUW study recruited 464 participants at baseline, of whom 424 (91.4%) were followed-up at 3 months and 334 (72.0%) at 12 months from baseline. We used standardized and validated questionnaires to collect information on socio-demographic and lifestyle characteristics, medical history, family history of chronic diseases, sleep quality, health-related quality of life, chronotype, psychological distress, occupational factors, and comfort levels with indoor environmental quality parameters. Clinical and anthropometric parameters including blood pressure, spirometry, height, weight, and waist and hip circumference were also measured. Biochemical tests of participants’ blood and urine samples were conducted to measure levels of glucose, lipids, and melatonin. We also conducted objective measurements of individuals’ workplace environment, assessing air quality, light intensity, temperature, thermal comfort, and bacterial and fungal counts. The findings this study will help to identify modifiable lifestyle and environmental parameters that are negatively affecting workers’ health. The findings may be used to guide the development of more health-promoting workspaces that attempt to negate any potential deleterious health effects from working in underground workspaces.
Summary

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  • Integrated lighting ergonomics: A review on the association between non-visual effects of light and ergonomics in the enclosed cabins
    Zhiming Gou, Bingchen Gou, Wenyi Liao, Yuxue Bao, Yongqi Deng
    Building and Environment.2023; 243: 110616.     CrossRef
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    Kar Fye Alvin Lee, Eun Hee Lee, Adam Charles Roberts, Josip Car, Chee Kiong Soh, Georgios Christopoulos
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  • A Comparative Study of International and Asian Criteria for Overweight or Obesity at Workplaces in Singapore
    Nuraini Nazeha, Thirunavukkarasu Sathish, Michael Soljak, Gerard Dunleavy, Nanthini Visvalingam, Ushashree Divakar, Ram Chandra Bajpai, Chee Kiong Soh, George Christopoulos, Josip Car
    Asia Pacific Journal of Public Health.2021; 33(4): 404.     CrossRef
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    Nanthini Visvalingam, Thirunavukkarasu Sathish, Michael Soljak, Ai-Ping Chua, Gerard Dunleavy, Ushashree Divakar, Nuraini Nazeha, Ram Bajpai, Chee Kiong Soh, Kwok Kian Woon, Georgios Christopoulos, Josip Car
    Sleep Health.2020; 6(3): 277.     CrossRef
  • Activity Tracker–Based Metrics as Digital Markers of Cardiometabolic Health: Cross-Sectional Study
    Yuri Rykov, Thuan-Quoc Thach, Gerard Dunleavy, Adam Charles Roberts, George Christopoulos, Chee Kiong Soh, Josip Car
    JMIR mHealth and uHealth.2020; 8(1): e16409.     CrossRef
  • Prevalence of psychological distress and its association with perceived indoor environmental quality and workplace factors in under and aboveground workplaces
    Gerard Dunleavy, Ram Bajpai, André Comiran Tonon, Kei Long Cheung, Thuan-Quoc Thach, Yuri Rykov, Chee-Kiong Soh, Hein de Vries, Josip Car, Georgios Christopoulos
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    Vinita Venugopal, Adam Charles Roberts, Kian-Woon Kwok, George I. Christopoulos, Chee-Kiong Soh
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    Thuan‐Quoc Thach, Dhiya Mahirah, Charlotte Sauter, Adam Charles Roberts, Gerard Dunleavy, Nuraini Nazeha, Yuri Rykov, Yichi Zhang, George I. Christopoulos, Chee‐Kiong Soh, Josip Car
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    Ying Su, Adam C. Roberts, Hui Shan Yap, Josip Car, Kian Woon Kwok, Chee-Kiong Soh, George I. Christopoulos
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    Thuan-Quoc Thach, Dhiya Mahirah, Gerard Dunleavy, Nuraini Nazeha, Yichi Zhang, Christina En Hui Tan, Adam Charles Roberts, George Christopoulos, Chee Kiong Soh, Josip Car
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    Gerard Dunleavy, André Comiran Tonon, Ai Ping Chua, Yichi Zhang, Kei Long Cheung, Thuan-Quoc Thach, Yuri Rykov, Chee-Kiong Soh, Georgios Christopoulos, Hein de Vries, Josip Car
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    Thirunavukkarasu Sathish, Gerard Dunleavy, Michael Soljak, Nanthini Visvalingam, Nuraini Nazeha, Ushashree Divakar, Ram Bajpai, Thuan-Quoc Thach, Kei Cheung, Hein Vries, Chee-Kiong Soh, Georgios Christopoulos, Josip Car
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    Dunleavy, Bajpai, Tonon, Chua, Cheung, Soh, Christopoulos, Vries, Car
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    Ushashree Divakar, Thirunavukkarasu Sathish, Michael Soljak, Ram Bajpai, Gerard Dunleavy, Nanthini Visvalingam, Nuraini Nazeha, Chee Kiong Soh, Georgios Christopoulos, Josip Car
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Original Article
The relationship between maternal mental health and communication skills in children in Shiraz, Iran
Najmeh Maharlouei, Hossein Alibeigi, Abbas Rezaianzadeh, Pedram Keshavarz, Hadi Raeisi Shahraki, Hamid Nemati, Kamran B. lankarani
Epidemiol Health. 2019;41:e2019035.   Published online July 19, 2019
DOI: https://doi.org/10.4178/epih.e2019035
  • 12,586 View
  • 238 Download
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AbstractAbstract PDF
Abstract
OBJECTIVES
Child development is a significant issue in global public health, and maternal mental health (MMH) can have a remarkable effect on children’s development of communication skills. We aimed to investigate the association between MMH and communication skills in a sample of Iranian children.
METHODS
This study was conducted in Shiraz, Iran during 2016. In total, 640 mothers who lived in Shiraz and were registered in the Fars Birth Cohort (FBC) study were invited to attend the FBC clinic with their children. A trained physician evaluated MMH using the General Health Questionnaire (GHQ). Additionally, a trained nurse assessed the children’s communication development status using the Ages and Stages Questionnaire for 60-month old children.
RESULTS
The majority of the mothers were homemakers (82.8%) and had high school diplomas (38.9%). The mothers’ mean age was 33.7±4.6 years. Seventy-nine (12.3%) children had delayed communication skills, but no significant association was found between children’s communication skills and the mothers’ total GHQ score (p=0.43). In total, 493 mothers (77.0%) had abnormal somatic symptoms, 497 (77.7%) had abnormal anxiety/insomnia, 337 (52.7%) had social dysfunction, and 232 (36.3%) suffered from depression. Logistic regression indicated that after adjusting for confounders, the odds of delayed communication skills were 3-fold higher among the children of mothers with abnormal somatic symptoms than among other children (p=0.01).
CONCLUSIONS
The study results confirmed that MMH had a significant impact on children’s communication skills. Moreover, maternal abnormal somatic symptoms exerted the strongest impact on the development of communication skills in 5-yearold children.
Summary

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  • Prevalence and Risk Factors Associated With Self-reported Psychological Distress Among Children and Adolescents During the COVID-19 Pandemic in China
    Zuguo Qin, Lei Shi, Yaqing Xue, Huang Lin, Jinchan Zhang, Pengyan Liang, Zhiwei Lu, Mengxiong Wu, Yaguang Chen, Xiao Zheng, Yi Qian, Ping Ouyang, Ruibin Zhang, Xuefeng Yi, Chichen Zhang
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    Kathryn Mishkin, Shaymaa Samir Maqsood, Hamdia Mirkhan Ahmed
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Editorial
Lessons from radiation epidemiology
Won Jin Lee
Epidemiol Health. 2018;40:e2018057.   Published online November 14, 2018
DOI: https://doi.org/10.4178/epih.e2018057
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AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
Radiation epidemiology has developed as a specialized field and has unique characteristics compared to the other fields of epidemiology. Radiation exposure assessment is highly quantified and health risk assessment can yield precise risks per unit dose in each organ. At the same time, radiation epidemiology also emphasizes the uncertainty of the estimated doses and risks. More radiation epidemiologists work in radiation societies rather than those of epidemiology. This specialization deepens the research of radiation studies but also results in fragmentation from general epidemiology. In addition to continued involvement with radiation-related sciences, therefore, more efforts to communicate with the other fields of epidemiology are necessary for radiation epidemiology.
Summary
Korean summary
방사선 역학은 역학의 세부 전공분야로서 다른 역학 분야와 구별되는 특성들이 있다. 노출 및 건강영향 평가에서의 정량화된 접근방법을 비롯하여 방사선 역학의 많은 장점들은 다른 역학분야에서도 응용될 필요가 있다. 이러한 전문화는 역학 연구의 내용을 깊게 발전시키는데 큰 역할을 하고 있는 반면, 일반 역학 분야와 분열되는 단점도 있다. 따라서 기존 방사선 관련 학문들과의 지속적인 교류뿐 아니라 다른 역학분야와의 활발한 교류를 통해 방사선 역학 및 전체 역학분야를 발전시키는 것이 중요하다.

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Original Articles
Irritable bowel syndrome is concentrated in people with higher educations in Iran: an inequality analysis
Asieh Mansouri, Mostafa Amini Rarani, Mosayeb Fallahi, Iman Alvandi
Epidemiol Health. 2017;39:e2017005.   Published online February 1, 2017
DOI: https://doi.org/10.4178/epih.e2017005
  • 16,412 View
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  • 15 Web of Science
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AbstractAbstract PDF
Abstract
OBJECTIVES
Like any other health-related disorder, irritable bowel syndrome (IBS) has a differential distribution with respect to socioeconomic factors. This study aimed to estimate and decompose educational inequalities in the prevalence of IBS.
METHODS
Sampling was performed using a multi-stage random cluster sampling approach. The data of 1,850 residents of Kish Island aged 15 years or older were included, and the determinants of IBS were identified using a generalized estimating equation regression model. The concentration index of educational inequality in cases of IBS was estimated and decomposed as the specific inequality index.
RESULTS
The prevalence of IBS in this study was 21.57% (95% confidence interval [CI], 19.69 to 23.44%). The concentration index of IBS was 0.20 (95% CI, 0.14 to 0.26). A multivariable regression model revealed that age, sex, level of education, marital status, anxiety, and poor general health were significant determinants of IBS. In the decomposition analysis, level of education (89.91%), age (−11.99%), and marital status (9.11%) were the three main contributors to IBS inequality. Anxiety and poor general health were the next two contributors to IBS inequality, and were responsible for more than 12% of the total observed inequality.
CONCLUSIONS
The main contributors of IBS inequality were education level, age, and marital status. Given the high percentage of anxious individuals among highly educated, young, single, and divorced people, we can conclude that all contributors to IBS inequality may be partially influenced by psychological factors. Therefore, programs that promote the development of mental health to alleviate the abovementioned inequality in this population are highly warranted.
Summary

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    Joanna Palma, Justyna Antoniewicz, Krzysztof Borecki, Karol Tejchman, Karolina Skonieczna-Żydecka, Dominika Maciejewska-Markiewicz, Karina Ryterska, Natalia Komorniak, Maja Czerwińska-Rogowska, Anna Wolska, Honorata Mruk-Mazurkiewicz, Anna Gudan, Tomasz M
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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
  • 17,884 View
  • 239 Download
  • 17 Web of Science
  • 17 Crossref
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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Community mental health status six months after the Sewol ferry disaster in Ansan, Korea
Hee Jung Yang, Hae Kwan Cheong, Bo Youl Choi, Min-Ho Shin, Hyeon Woo Yim, Dong-Hyun Kim, Gawon Kim, Soon Young Lee
Epidemiol Health. 2015;37:e2015046.   Published online October 23, 2015
DOI: https://doi.org/10.4178/epih/e2015046
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AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
The disaster of the Sewol ferry that sank at sea off Korea’s southern coast of the Yellow Sea on April 16, 2014 was a tragedy that brought grief and despair to the whole country. The aim of this study was to evaluate the mental health effects of this disaster on the community of Ansan, where most victims and survivors resided.
METHODS
The self-administered questionnaire survey was conducted 4 to 6 months after the accident using the Korean Community Health Survey system, an annual nationwide cross-sectional survey. Subjects were 7,076 adults (≥19 years) living in two victimized communities in Ansan, four control communities from Gyeonggi-do, Jindo and Haenam near the accident site. Depression, stress, somatic symptoms, anxiety, and suicidal ideation were measured using the Center for Epidemiologic Studies-Depression Scale, Brief Encounter Psychosocial Instrument, Patient Health Questionnaire-15, and Generalized Anxiety Disorder 7-Item Scale, respectively.
RESULTS
The depression rate among the respondents from Ansan was 11.8%, and 18.4% reported suicidal ideation. Prevalence of other psychiatric disturbances was also higher compared with the other areas. A multiple logistic regression analysis revealed significantly higher odds ratios (ORs) in depression (1.66; 95% confidence interval [CI], 1.36 to 2.04), stress (1.37; 95% CI, 1.10 to 1.71), somatic symptoms (1.31; 95% CI, 1.08 to 1.58), anxiety (1.82; 95% CI, 1.39 to 2.39), and suicidal ideation (1.33; 95% CI, 1.13 to 1.56) compared with Gyeonggi-do. In contrast, the accident areas of Jindo and Haenam showed the lowest prevalence and ORs.
CONCLUSIONS
Residents in the victimized area of Ansan had a significantly higher prevalence of psychiatric disturbances than in the control communities.
Summary
Korean summary
본 연구는 2014년 4월 16일 발생한 세월호 침몰 사고가 지역사회의 정신건강 수준에 미친 영향을 평가하기 위해 실시하였다. 2014년 지역사회건강조사를 활용, 사고 후 6개월 시점에 조사를 시행하였다. 대부분의 희생자가 발생한 안산시 대상자의 11.8%가 우울군으로 분류되었으며, 18.4%가 자살생각을 호소하였고, 그 밖의 유병률도 대조 지역에 비해 높았다.

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Epidemiol Health : Epidemiology and Health