Epidemiology and Health

Original Articles

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

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Abstract Summary PDF Supplementary 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.

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

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Abstract Summary PDF Supplementary 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.

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

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9 Citations

Abstract Summary PDF Supplementary 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

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
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Sungsub Choo, Ranyeong Kim, Hyemin Lee, Yun-Jung Eom, Horim Yi, Rockli Kim, Seung-Sup Kim
Social Psychiatry and Psychiatric Epidemiology.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: 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

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12 Citations

Abstract Summary 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.

Citations

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Differences in Functional Level and Central Symptom of Network Structures in the Patients Seeking Treatment for Panic Disorder Before and During the COVID-19 Pandemic
Hyun-Ju Kim, Minji Bang, Chun Il Park, Chongwon Pae, Sang-Hyuk Lee
Psychiatry Investigation.2023; 20(3): 245. 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
Physical activity and mental health in Brazilian university students: An analysis in different sexes during the COVID-19 pandemic
Gabriela Carvalho Jurema Santos, Mateus Jurema Rino, Victor Luiz da Silva Lima, José Adilson Santos, Débora Eduarda da Silva Fidelis, Tiago Lacerda Ramos, Adelmo José de Andrade, Camila Tenório Calazans de Lira, Matheus Santos de Souza Fernandes
Biomedical Human Kinetics.2023; 15(1): 113. CrossRef
Risk and protective factors of mental health during the COVID-19 pandemic: A cross-sectional study in Singapore
Mythily Subramaniam, Edimansyah Abdin, Saleha Shafie, Peizhi Wang, Shazana Shahwan, Pratika Satghare, Boon Yiang Chua, Michael Y Ni, Phyllis Lun, Wen Lin Teh, Janhavi Ajit Vaingankar, Siow Ann Chong
Annals of the Academy of Medicine, Singapore.2023; 52(5): 249. CrossRef
Is social support associated with postpartum depression, anxiety and perceived stress among Korean women within the first year postpartum?
Mi-Sun Lee, Jung Jae Lee, Soyeon Park, Seongju Kim, Hooyeon Lee
Journal of Psychosomatic Obstetrics & Gynecology.2023;[Epub] CrossRef
Pandemic stressors and mental health indicators in eight countries
Salma M Abdalla, Shaffi Fazaludeen Koya, Samuel B. Rosenberg, Isaac B. Stovall, Olivia Biermann, Zahra Zeinali, Gregory H. Cohen, Catherine K. Ettman, Sandro Galea
Social Psychiatry and Psychiatric Epidemiology.2023;[Epub] CrossRef
Assessing Knowledge, Preventive Practices, and Depression Among Chinese International Students and Local Korean Students in South Korea During the COVID-19 Pandemic: An Online Cross-Sectional Study
Xiaoxu Jiang, Bo Zhao, Eun Woo Nam, Fanlei Kong
Frontiers in Psychiatry.2022;[Epub] CrossRef
Association of compliance with COVID-19 public health measures with depression
Ju An Byun, Tae Jun Sim, Tae Yoon Lim, Sung-In Jang, Seung Hoon Kim
Scientific Reports.2022;[Epub] CrossRef
Factors associated with depressive symptomatology during the COVID-19 pandemic in Mexico: A 2021 national survey
Pablo D. Valencia, Maria A. Torres-Quispe, Sofía Sánchez-Cayo, Ricardo F. Reyes-Aguilar, Alexander G. Acevedo-Cahuana
Journal of Affective Disorders.2022; 317: 212. CrossRef
Depression and anxiety in later COVID-19 waves across Europe: New evidence from the European COvid Survey (ECOS)
André Hajek, Sebastian Neumann-Böhme, Iryna Sabat, Aleksandra Torbica, Jonas Schreyögg, Pedro Pita Barros, Tom Stargardt, Hans-Helmut König
Psychiatry Research.2022; 317: 114902. CrossRef
Socio-economic factors associated with mental health outcomes during the COVID-19 pandemic in South Korea
Seo Yoon Lee, Jung Jae Lee, Hooyeon Lee
Frontiers in Public Health.2022;[Epub] CrossRef
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
Epidemiology and Health.2022; 44: e2022042. CrossRef

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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2 Citations

Abstract Summary 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

Citations to this article as recorded by

Elder Mistreatment as a Risk Factor for Depression and Suicidal Ideation in Korean Older Adults
Min-So Paek, Mi Jin Lee, Yu-Seon Shin
International Journal of Environmental Research and Public Health.2022; 19(18): 11165. CrossRef
Understanding Elder Abuse in India: Contributing Factors and Policy Suggestions
Priya Maurya, Aparajita Chattopadhyay, Smitha Rao, Palak Sharma
Journal of Population Ageing.2022;[Epub] CrossRef

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

7,732 View
485 Download
2 Citations

Abstract Summary PDF Supplementary 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

Citations to this article as recorded by

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
Nature Human Behaviour.2023;[Epub] 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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2 Citations

Abstract Summary 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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Depression before and during-COVID-19 by Gender in the Korean Population
Won-Tae Cha, Hye-Jin Joo, Yu-Shin Park, Eun-Cheol Park, Soo-Young Kim
International Journal of Environmental Research and Public Health.2022; 19(6): 3477. CrossRef
Association Between Regional Levels of Particulate Matter and Recurrent Falls in Korea
Jung-Ho Yang, Ji-An Jeong, Sun-Seog Kweon, Min-Ho Shin
Journal of Korean Medical Science.2022;[Epub] CrossRef

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

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Abstract Summary PDF Supplementary 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.

Citations

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Anti-Inflammatory, Antioxidant, and Neuroprotective Effects of Polyphenols—Polyphenols as an Element of Diet Therapy in Depressive Disorders
Anna Winiarska-Mieczan, Małgorzata Kwiecień, Karolina Jachimowicz-Rogowska, Janine Donaldson, Ewa Tomaszewska, Ewa Baranowska-Wójcik
International Journal of Molecular Sciences.2023; 24(3): 2258. CrossRef
Genetic and environmental influences on fruit and vegetable consumption and depression in older adults
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
BMC Geriatrics.2023;[Epub] CrossRef
Longitudinal correlates of fruit and vegetable consumption with depressive symptoms among middle-aged and older adults in South Africa
Supa Pengpid, Karl Peltzer
BMC Psychology.2022;[Epub] CrossRef

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

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7 Citations

Abstract Summary PDF Supplementary 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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The understanding and experience of falls among community-dwelling adults aged 50 and over living with mental illness: A qualitative study
Ling Koh, Lynette Mackenzie, Mandy Meehan, Diane Grayshon, Meryl Lovarini
Aging & Mental Health.2023; 27(4): 789. CrossRef
Factors Associated with Fear of Falling by Fall Experience in the Community-dwelling Elderly
Yeong Mi Seo, Eun Sook Lee
Research in Community and Public Health Nursing.2023; 34: 12. CrossRef
Physical strength and mental health mediate the association between pain and falls (recurrent and/or injurious) among community-dwelling older adults in Singapore
Vanessa Koh, David B. Matchar, Angelique Chan
Archives of Gerontology and Geriatrics.2023; 112: 105015. CrossRef
Joinpoint Regression About Injury Mortality and Hospitalization in Korea
Hyun Jin Park, Ui Jeong Kim, Won kyung Lee, Bohyun Park, Yoonhee Shin, Seonhwa Lee, Eun Jeong Choi, Nam-eun Kim, Ju Ok Park, Hyesook Park
Journal of Korean Medical Science.2022;[Epub] CrossRef
Association between falls in elderly and the number of chronic diseases and health-related behaviors based on CHARLS 2018: health status as a mediating variable
Shaoliang Tang, Meixian Liu, Tongling Yang, Chaoyu Ye, Ying Gong, Ling Yao, Yun Xu, Yamei Bai
BMC Geriatrics.2022;[Epub] CrossRef
Comparison of factors influencing fall recurrence in the young-old and old-old: a cross-sectional nationwide study in South Korea
Mi Young Kim, Yujeong Kim
BMC Geriatrics.2022;[Epub] CrossRef
A Machine Learning Approach for the Classification of Falls and Activities of Daily Living in Agricultural Workers
Hyunmok Son, Jae Woon Lim, Sangbae Park, Byeongjoo Park, Jinsub Han, Hong Bae Kim, Myung Chul Lee, Kyoung-Je Jang, Ghiseok Kim, Jong Hoon Chung
IEEE Access.2022; 10: 77418. CrossRef

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

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Abstract PDF Supplementary 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

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5 Citations

Abstract Summary PDF Supplementary 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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Analysis of Quality of Life and Mental Health in Patients With Atopic Dermatitis, Asthma and Allergic Rhinitis Using a Nation-wide Database, KNHANES VII
Gyu Na Lee, Ha Yeh Rin Koo, Kyungdo Han, Young Bok Lee
Allergy, Asthma & Immunology Research.2022; 14(2): 273. CrossRef
Eczema is a shared risk factor for anxiety and depression: A meta-analysis and systematic review
Qing Long, Hongxia Jin, Xu You, Yilin Liu, Zhaowei Teng, Yatang Chen, Yun Zhu, Yong Zeng, Dong Keon Yon
PLOS ONE.2022; 17(2): e0263334. CrossRef
Impairment of Quality of Life and Mental Health Status in Adult-Onset Atopic Dermatitis
Juhwan Yoo, Ha Yeh Rin Koo, Kyungdo Han, Young Bok Lee
Annals of Dermatology.2022; 34(4): 278. CrossRef
Combined Oral and Topical Application of Pumpkin (Cucurbita pepo L.) Alleviates Contact Dermatitis Associated With Depression Through Downregulation Pro-Inflammatory Cytokines
Maha Jameal Balgoon, Maryam H. Al-Zahrani, Soad Al Jaouni, Nasra Ayuob
Frontiers in Pharmacology.2021;[Epub] CrossRef
Association of atopic dermatitis with suicide risk among 788,411 adolescents
Yechan Kyung, Min Hwan Choi, Yoo Jung Jeon, Ju Suk Lee, Jun Hwa Lee, Seon Hui Jo, Sung Hoon Kim
Annals of Allergy, Asthma & Immunology.2020; 125(1): 55. CrossRef

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

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Abstract 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

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Abstract Summary PDF Supplementary 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.

Citations

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A geographically weighted artificial neural network
Julian Hagenauer, Marco Helbich
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Taewan Kim, Hee-Jung Jun
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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

15,868 View
235 Download
16 Citations

Abstract 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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Differences in Oral Health and Generalized Anxiety Disorder According to Secondhand Smoke Exposure in Public Places
Yu-Rin Kim, Kyeung-Ae Jang
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Ruotong Yang, Yunting Zheng, Huan Yu, Junhui Wu, Siyue Wang, Hongbo Chen, Mengying Wang, Xueying Qin, Tao Wu, Chun Chang, Yiqun Wu, Yonghua Hu
International Journal of Mental Health and Addiction.2023;[Epub] CrossRef
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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

13,229 View
88 Download
8 Citations

Abstract PDF

Abstract

OBJECTIVES

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.

METHODS

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.

RESULTS

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).

CONCLUSION

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.

Summary

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