Depression In South Korea Research Articles

Gender Differences in the Relationship between Coming Out as LGB to Family and Depression in South Korea

Previous studies on the coming out and the mental health of sexual minorities have often overlooked experiences in non-Western societies and the various patterns of coming out within the immediate families. Using the most recent and comprehensive data on 2,381 LGB youths in South Korea, this study examined whether different patterns of coming out to family members are related to different levels of depression and whether these relationships differ between men (gay and bisexual man) and women (lesbian and bisexual woman). Contrary to the prevalent view of coming out as a universally liberating process, our findings indicate that coming out to family is related to increased depressive symptoms in South Korea. Moreover, this coming out stress shows a gendered pattern. Among sexual minority men, compared with those who did not come out, youths who came out to everyone, mother and father, and only siblings report a higher depression level. Being bisexual among men did not provide any protective effect. In contrast, there is no difference observed across coming out patterns among sexual minority women. These findings highlight the importance of considering to whom and in what cultural contexts one comes out to understand the mental health of sexual minorities.

Rheumatoid Arthritis and Risk of Depression in South Korea

Depression is among the most common comorbidities in rheumatoid arthritis (RA). There is a lack of data regarding the association of RA seropositivity and biologic agents with depression risk among individuals with RA. To investigate the risk of depression following RA diagnosis among patients in South Korea. This retrospective cohort study included 38 487 patients with RA and a comparison group of 192 435 individuals matched 1:5 for age, sex, and index date. Data were from the Korean National Health Insurance Service database. Participants were enrolled from 2010 to 2017 and were followed up until 2019. Participants who had previously been diagnosed with depression or were diagnosed with depression within 1 year after the index date were excluded. Statistical analysis was performed in May 2023. Seropositive RA (SPRA) was defined with the International Statistical Classification of Diseases and Related Health Problems, Tenth Revision (ICD-10) codes M05 and enrollment in the Korean Rare and Intractable Diseases program. Seronegative RA (SNRA) was defined with ICD-10 codes M06 (excluding M06.1 and M06.4) and a prescription of any disease-modifying antirheumatic drugs (DMARDs) for 270 days or more. Newly diagnosed depression (ICD-10 codes F32 or F33). The mean (SD) age of the total study population was 54.6 (12.1) years, and 163 926 individuals (71.0%) were female. During a median (IQR) follow-up of 4.1 (2.4-6.2) years, 27 063 participants (20 641 controls and 6422 with RA) developed depression. Participants with RA had a 1.66-fold higher risk of depression compared with controls (adjusted hazard ratio [aHR], 1.66 [95% CI, 1.61-1.71]). The SPRA group (aHR, 1.64 [95% CI, 1.58-1.69]) and the SNRA group (aHR, 1.73 [95% CI, 1.65-1.81]) were associated with an increased risk of depression compared with controls. Patients with RA who used biologic or targeted synthetic DMARDs (aHR, 1.33 [95% CI, 1.20-1.47]) had a lower risk of depression compared with patients with RA who did not use these medications (aHR, 1.69 [95% CI, 1.64-1.74]). This nationwide cohort study found that both SPRA and SNRA were associated with a significantly higher risk of depression. These results suggest the importance of early screening and intervention for mental health in patients with RA.

Association between type 2 diabetes mellitus and depression among Korean midlife women: a cross-sectional analysis study

BackgroundThe prevalence of depression is higher among midlife women, and they have less control over their diabetes during the menopausal transition. However, there is limited evidence on the association between type 2 diabetes mellitus and depression among Korean women in their midlife. This study aimed to examine the association between type 2 diabetes mellitus and depression and explore the levels of awareness and treatment of depression among Korean midlife women with T2DM.MethodsThis is a cross-sectional analysis study conducted using data from the Korea National Health and Nutrition Examination Surveys of 2014, 2016, and 2018. Korean women aged 40–64 years who randomly participated in the surveys were included, and 4,063 midlife women were selected as study participants. The diabetes progression status of the participants was classified into diabetes, pre-diabetes, and non-diabetes. Furthermore, the Patient Health Questionnaire-9 was used for screening depression. Participants’ awareness rate, treatment rate among incident cases of depression, and treatment rate among awareness cases of depression were also analyzed. For data analysis, the Rao–Scott χ2 test, multiple logistic regression, and linear regression were conducted using SAS 9.4 software program.ResultsThe prevalence of depression significantly differed between diabetes, pre-diabetes, and non-diabetes groups. However, depression awareness, treatment/incident, and treatment/awareness rates did not differ statistically between the diabetes progression status groups. Compared to the non-diabetes group, diabetes group had a higher odds ratio of depression after adjusting for general and health-related factors. Thus, the diabetes group had significantly higher PHQ-9 scores than the non-diabetes group after adjusting for covariates.ConclusionsWomen in their midlife who have type 2 diabetes mellitus tend to have higher levels of depressive symptoms and are at risk of depression. However, we found no significant differences between diabetes and non-diabetes regarding the awareness and treatment rates of depression in South Korea. We recommend that future studies focus on developing clinical practice guidelines aimed at additional screening and intervention for depression in midlife women with type 2 diabetes mellitus to ensure prompt treatment and improved outcomes.

Relationship between Mediterranean diet and depression in South Korea: the Korea National Health and Nutrition Examination Survey.

Several studies have shown that adherence to the Mediterranean diet is associated with a lower risk of depression; however, little is known about the Asian population. This study investigated the relationship between adherence to the Mediterranean diet and depression in a sample of the South Korean population. In total, 5,849 adults from the 2014 and 2016 Korea National Health and Nutrition Examination Surveys were included in the study. The Mediterranean diet adherence was measured using a modified alternate Mediterranean diet score (mMED) developed to adjust for Korean dietary patterns. The mMED scores using the Food Frequency Questionnaire were divided into four categories (0-2, 3-4, 5-6, and 7-9 points). Subjects with depression were defined as having moderate-to-severe depressive symptoms using the Patient Health Questionnaire-9, with a cutoff value of 10. Logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs). A subgroup analysis was performed based on sex. The results of logistic regression analysis indicated that individuals with higher mMED were 42-73% less likely to report depression compared to individuals with the lowest mMED [ORs (95% CIs) =0.58 (0.37-0.90), 0.50 (0.31-0.80), 0.27 (0.15-0.47)] after adjusting for socio-demographic and health-related variables. In women, individuals with mMED of 7-9 had 71% lower odds of depression [ORs (95% CIs): 0.29 (0.13-0.64)]. In men, individuals with mMED of 5-9 had 55% [ORs (95% CIs): 0.45 (0.23-0.91)] to 79% [ORs (95% CIs): 0.21 (0.08-0.57)] lower odds of depression. This study suggests that adherence to the Mediterranean diet is inversely associated with depression in both men and women among Korean adults. This study provides evidence that a Mediterranean diet is crucial in preventing depressive symptoms in Asian populations.

Linking neighbourhood safety and children's internalizing and externalizing problems: Mediating role of maternal depression

AbstractThis study examined the relationship among neighbourhood safety, maternal depression and child behaviour problems among Korean children in South Korea. Using the 2019 Panel Study on Korean Children (N = 1127), we found that residing in less safe neighbourhoods was associated with higher levels of internalizing and externalizing problems. Additionally, results from mediation analysis showed that the relationships between neighbourhood safety and internalizing and externalizing problems were significantly mediated by maternal depression in South Korea. These findings suggest that maternal depression may be an important mechanism linking unsafe neighbourhoods to South Korean children's behaviour problems.

Gender Differences in the Risk of Depression in Community-Dwelling Stroke Survivors Compared to the General Population without Stroke.

This study examined the gender-specific association between stroke status and depression in South Korea. A total of 5,746 men and 7,608 women aged ≥30 years who participated in the 2014, 2016, and 2018 Korea National Health and Nutrition Examination Survey were included in the analysis. The cross-sectional surveys targeted the general population consisting of nationally representative adults (≥19 years) residing in Korea. A 9-item Patient Health Questionnaire score of 10 or more was regarded as depression. A higher risk of depression in stroke survivors compared to the non-stroke population was not observed in men (odds ratio [OR], 1.51; 95% confidence intervals [CI], 0.82-2.81), while it was observed in women (OR, 2.49; 95% CI, 1.64-3.77). Compared to non-stroke women, women stroke survivors with a younger age at diagnosis (<60 years) (OR, 4.05; 95% CI, 2.28-7.20) and stroke with duration of ≥10 years (OR, 3.12; 95% CI, 1.63-5.97) had a higher risk for depression. Gender aspects should be more intensively considered in the association between stroke status and depression in community settings.

The paradox of protection: association between high community facemask use and increased depression in South Korea

The paradox of protection: association between high community facemask use and increased depression in South Korea

Association between depression and green space before and after the COVID-19: Panel data evidence in South Korea

Green space potentially promotes positive mental health in people. Consequently, the role of green spaces has become increasingly important because of the new coronavirus disease (COVID-19). While the association between green space and depression was explored during the COVID-19 pandemic, population data on this relationship before and after the pandemic are lacking. Furthermore, how different types of green space impact depression needs clarification. Thus, this study investigated the association between two vegetation types of green spaces(forests and grass) and perceived depression in South Korea before and after COVID-19 using population data. The percentage of forest areas had a significant negative effect on perceived depression before and after COVID-19. However, the percentage of grass areas had no significant effect on the perceived depression. A 1% increase in forest area reduced perceived depression by 16 people per 100,000 people. These findings are expected to contribute towards advancing public mental health and natural environment domains, and forests should be prioritized to capture the mental health needs of citizens.

Predicting multicultural adolescents' depression in South Korea: Roles of ego-resilience and social support

PurposeDepressive symptoms among adolescents are a major concern for increased risk of adverse health condition outcomes later in life. Specifically, previous studies have reported that multicultural adolescents experience more depressive symptoms than non-multicultural ones. Using the Korean Children and Youth Panel Survey, this study examined the relationships between ego-resilience, social support, and depression among multicultural adolescents in South Korea, as well as the moderating effect of social support on the association between ego-resilience and depression. Design and methodsA total of 1500 multicultural adolescents were included in the analyses, where generalized estimating equation models were employed. ResultsDepression scores increased slightly from 2012 to 2015. Higher levels of ego-resilience, family support, and friend support were associated with lower levels of depression, while teacher support was not a significant predictor. The moderating effect of friends and family support on the association between ego-resilience and depression was not statistically significant. ConclusionsTo reduce the level of depression among multicultural adolescents, future research should develop interventions that enhance ego-resilience ability, as well as necessary social systems that strengthen family and friend support. Practice implicationsSupportive interventions, such as enhancing ego-resilience to reduce depression should be provided to multicultural adolescents. It is recommended to include family and friends to develop effective intervention programs for multicultural adolescents who are suffering from depression.

COVID-19 and Risk Factors of Anxiety and Depression in South Korea.

ObjectiveThe aims of this study were to explore the prevalence of and identify predictors of anxiety and depression related to coronavirus disease of 2019 (COVID-19) in South Korea. MethodsThe analysis is based on a quota survey design and a sampling frame that permitted recruitment of a national sample of 1,014 individuals between March 17–31, 2020. Several standardized measurements were used, including GAD-7, PHQ-9, COVID-19 related fear, restrictions in deaily life, as well as sociodemographic information and physical and psychosocial needs during the pandemic. Multiple logistic regression was conducted to analyze the influence of sociodemographic factors, fear, and physical/psychosocial needs on anxiety and depression. ResultsSignificant numbers of the respondents were identifiable anxiety (19.0%) and depression group (17.5%), respectively. This indicates that the depression and anxiety prevalence rate after the COVID-19 is substantially high compared to the depression rate of 2.6% in 2020 and 2.8% in 2018 both reported in the Korea Community Health Survey and the anxiety rate of 5.7% reported in 2016 Survey of Mental Disorders in Korea. Multiple logistic regression results showed age, COVID-19 related fear, and the level of restrictions in daily as significant factors in understanding and predicting the anxiety group. Likfewise, the COVID-19 related fear, restrictions in daily life, and need for economic support were important predictors in predicting the depression group. ConclusionFindings on predictors for greater vulnerability to anxiety and depression has important implications for public mental health in the context of the COVID-19 pandemic.

Economic burden of major depression in South Korea

Economic burden of major depression in South Korea

The Health and Productivity Burden of Depression in South Korea.

Major depression in South Korea, which remains under-diagnosed and under-treated, increases the risk of premature death, and reduces quality of life and work productivity. The aim of this study was to quantify the depression-related health and productivity loss in South Korea in terms of life-years lost and productivity-adjusted life-years (PALYs) lost. Age and sex-specific life table models simulated follow-up of South Koreans with depression aged 15 to 54 years, until 55 years. Depression was defined as major depression. Inputs were drawn from national datasets and published sources. Models were constructed for the cohort with depression and repeated assuming they had no depression. Differences in total deaths, years of life, and PALYs represented the impact of depression. PALYs were ascribed a financial value equivalent to total gross domestic product (GDP) divided by the number of equivalent full-time workers (KRW81,507,146 or USD74,748). All outcomes were discounted by 3% per annum. In 2019, there were more than 500,000 people aged 15-54 years with major depression in South Korea. We predicted that until this cohort reached age 55 years, and assuming 22.2% of people with depression are treated, depression led to 12,000 excess deaths, more than 55,000 discounted years of life lost and 1.6 million discounted PALYs lost, equating to KRW133 trillion (USD122 billion) in lost GDP. Applying treatment-related response and remission rates of 11.8% and 42.1%, respectively, and a non-response/non-remission rate of 46.1%, increased the total number of PALYs lost by almost 6.0%. Our study highlights the considerable productivity loss attributable to depression among South Koreans over their working lifetime. Better prevention and treatment of depression is needed for long-term economic gains.

Parental long working hours and adult children’s depression in South Korea: a cross-sectional study

This study investigated the association between parental long working hours and the depression of children living with their parents even after becoming adults in South Korea. Data from two years of the Korean National Health and Nutrition Examination Survey (KNHANES) in 2014 and 2016 were analyzed using a cross-sectional study. Logistic regression analyses were performed to determine the association between parental long working hours and their adult children’s depression. Adult children of mothers who worked more than 60 hours per week were more likely to have depression than 40 hours or less per week. Comprehending aging mothers’ weekly working hours is an important factor for understanding the reason of adult children’s depression.

Low Self-Rated Health as A Risk Factor for Depression in South Korea: A Survey of Young Males and Females.

This is a cross-sectional study aimed to examine whether low self-rated health (SRH) is a risk factor for depression among young males and females. Data from the SRH, quality of life (QoL) and depression questionnaires as well as general information, were collected from 512 males and females aged 20–29 years in South Korea. Chi-square test was used to analyze the distribution of depression between the high and low SRH groups. Logistic regression was used to analyze the relationship between SRH and depression after adjusting for covariates. There were 32.6% males and 30.1% females who were at risk for depression. A significant difference in the distribution of depression between the low and high SRH groups in both males and females was found. The low SRH group had a higher prevalence of depression than the high SRH group in both males and females in the crude analysis. However, when the BMI, economic status, and mental component score were adjusted, the OR of the low SRH group was still significant in males. Low SRH may be a risk factor for depression especially in males. Further studies to improve SRH by developing preventive measures against depression status while considering gender characteristics are needed.

Differential risk factors for prenatal and postpartum depression in South Korea

IntroductionIncidence for depression increases during the perinatal period. Risk factors for depression may differentially affect each time period.ObjectivesTo assess demographic, psychological and obstetric risk factors that differentially affect prenatal and postpartum depressionMethodsA total of 169 subjects participated. Assessment was conducted during the first trimester, second trimester, third trimester, within a month after childbirth, and a month after childbirth. Demographic and obstetric measures, as well as psychological measures, including the Edinburgh Postnatal Depression Scale were conducted. Multiple regression and the Mann-Whitney U test were performed to examine the association between variables and depression scores.ResultsDepression score was higher during the postpartum period than the prenatal period. Younger age was associated with depression during the first trimester. In the second trimester, less education, a history of depression and having stress within a year significantly affected depression scores. Smoking, artificial abortion and lack of support from family and parents correlated with depression during the third trimester. Within a month after childbirth, psychiatric and depression history, smoking, stress level within a year and lack of family support were associated with depression. At a month after childbirth, those who were primiparous and not breastfeeding had significantly higher depression scores.ConclusionsThis study identifies various risk factors for each gestational and postpartum period and suggests differential interventions for different perinatal periods.

Formal Volunteering and Mental Health in South Korea: Does Age Matter?

Extensive research shows a positive association between formal volunteering and mental health and this association is stronger for older adults compared to their younger peers. The purpose of our study is to re-examine the link between formal volunteering, age, and mental health in a non-western society, South Korea. We employ two recent waves—years 2012-13 -- of nationally representative data from the Korea Welfare Panel Survey to test the extent to which the relationship between formal volunteering and mental health, as measured by depression, varies across two non-elderly age groups—young adults (18–35) and those middle-aged (36–55). Findings reveal that being a formal volunteer is psychologically more beneficial to young adults compared to their middle-aged counterparts. Understanding the age differential in the link between formal volunteering and depression in South Korea is crucial, given the different economic and sociocultural contexts, at current time, for young adults and their middle-aged peers.

Increased prevalence of depression in South Korea from 2002 to 2013

South Korea has one of the highest suicide rates among countries. However, the prevalence of depression in South Korea has been reported to be much lower than in other countries. The current study aims to estimate the prevalence of major depressive disorder using a large representative sample of the South Korean population. The prevalence of depression in a sampled population of one million individuals increased from 2.8% in 2002 to 5.3% in 2013; it was found to increase with the age of the population, and was higher in females than in males for most age groups. A Cox’s proportional hazard model showed that suicide risk was significantly higher in people with depression (hazard ratio [HR] 3.79, 95% CI 3.14–4.58) than those without depression. It was also significantly higher in older people (HR 1.52, 95% CI 1.36–1.70) than in younger people, and in males (HR 2.45, 95% CI 2.02–2.96) than in females. Furthermore, higher income groups were at lower suicide risk as compared to lower income groups (HR 0.88, 95% CI 0.80–0.95). This study using the large representative sample data provided evidence that increased prevalence of depression contributed to the increased risk of suicide in South Korea during the recent decade.

Correlation between private education costs and parental depression in South Korea

BackgroundIn Korea, higher education has rapidly grown influenced by sociocultural tradition. Parents invest a significant portion of their household income in their children’s education. Private education has been considered to greatly affect students’ psychology and behavior. However, past research has largely neglected to study parents who pay these costs. Since household income and education level are important determinants of socioeconomic status (SES), education expenditures are likely to cause depressive symptoms. Therefore, the study aimed to investigate the correlation between private education costs and parental depression in South Korea.MethodsData were collected from the Korean Welfare Panel Study (KoWePS, 2015, 2018). The sample analyzed consisted of 397 and 337 fathers and 403 and 370 mothers in 2015 and 2018, respectively. The independent variable in this study was the proportion of private education cost. This proportion was calculated by dividing each household’s private education costs by its equivalized household disposable income (EHDI) and multiplying this number by 100. The main dependent variable was parental responses to the Center for Epidemiologic Studies Depression Scale-11 (CESD-11). Using a generalized linear model, we investigated the effects of the proportion of private education cost on parental depression.ResultsThe results showed that fathers with higher proportions of private education cost exhibited higher CESD-11 scores compared to fathers with lower proportions cost (moderate: β = 0.419, S. E = 0.164, p = 0.0105; high: β = 0.476, S. E = 0.178, p = 0.0076), indicating that a higher ratio of private education cost may negatively affect depression in fathers. However, there was no discernable correlation between mothers’ CESD-11 scores and the proportion of private education cost (moderate: β = − 0.078, S. E = 0.250, p = 0.7555; high: β = 0.003, S. E = 0.215, p = 0.9882).ConclusionsThese results may be explained by the tendency for fathers to experience greater economic burdens than mothers in patriarchal Korean society.

Examining Regional Differences of Dietary Inflammatory Index and Its Association with Depression and Depressive Symptoms in Korean Adults.

The relationship between the dietary inflammatory index (DII®) and depression and depressive symptoms in South Korean adults remains unclear. This study aimed to examine the overall relationship between the DII and depression in South Korea and to evaluate the association between the DII and depressive symptoms and depression across regions among Korean adults aged ≥19 years. A total of 15,929 study participants were selected from the Korea National Health and Nutrition Examination Survey (KNHANES) 2014–2017. Energy-adjusted (E-DII) scores were calculated using 24-h dietary recall data. Depression and depressive symptoms were measured on the basis of the Korean version of the Patient Health Questionnaire 9-item scale, a doctor’s diagnosis of depression, and self-reported depressive symptom-related questionnaire. Overall, 4.2% of the participants had depression, with notable gender differences (i.e., 2.4% in men and 6.2% in women). Korean adults residing in the Capital area, Chungcheong-do and Jeju-do, and with diets in the highest tertile of the E-DII (most pro-inflammatory diet) had significantly increased odds of having depression and depressive symptoms compared with those in the lowest tertile of the E-DII (most anti-inflammatory diet) after controlling for covariates (adjusted odds ratio (AOR): 1.44, 95% confidence interval (CI): 1.04–1.99; AOR 2.97, 95% CI 1.36–6.52; AOR 4.06, 95% CI 1.56–10.53, respectively). No association between the E-DII and depression/depressive symptoms was found in other regions of South Korea. A pro-inflammatory diet is associated with greater odds of depression and depressive symptoms, with distinct regional differences. The present study provides evidence regarding existing regional differences in the association of the E-DII with depression and depressive symptoms.

Epidemiology of pharmaceutically treated depression and treatment resistant depression in South Korea.

BackgroundThe epidemiology of pharmaceutically treated depression (PTD) and treatment resistant depression (TRD) is largely unknown in South Korea. The aim of this study was to develop a greater understanding of the characteristics of PTD and TRD in nearly the entire adult population in South Korea using the Health Insurance Review and Assessment Service (HIRA).MethodDiagnostic codes and prescription data for South Korean adults were extracted from the HIRA. Subjects were included in the PTD cohort if they received at least one prescription for antidepressants and were diagnosed with depression. TRD was defined as PTD having two or more regimen failures of antidepressants or antipsychotics.ResultsIn 2012, there were 41,256,396 adults in South Korea with 834,694 meeting the criteria for PTD (2.0%). Among subjects with PTD, 57% stopped treatment in less than 28 days of antidepressant supply. Tricyclic and tetracyclic antidepressants were the most frequently used antidepressants as a first-line regimen for PTD (44.3% of PTD) followed by selective serotonin reuptake inhibitors (32.1% of PTD). Results also indicated that 34,812 subjects developed TRD (4.2% of PTD). Median PTD and TRD durations were 28 and 623 days respectively. Proportions of psychiatric and non-psychiatric comorbidities were higher in TRD cases than in PTD cases that were not treatment resistant.ConclusionsDespite a small proportion of patients with TRD, the prolonged duration of illness and higher comorbidity implies the need for better treatment.