Epidemiology and Health

COVID-19: Original Article

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

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Abstract Summary PDF Supplementary 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.

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

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Abstract Summary PDF Supplementary 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

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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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

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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
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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
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Changes in the prevalence of metabolic syndrome in Korean adults after the COVID-19 outbreak
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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

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Abstract Summary 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

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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

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Abstract Summary PDF Supplementary 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

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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
COVID‐19 outcomes in paediatric cancer: A large scale pooled meta‐analysis of 984 cancer patients
Amr Ehab El‐Qushayri, Amira Yasmine Benmelouka, Abdullah Dahy, Mohammad Rashidul Hashan
Reviews in Medical Virology.2022;[Epub] CrossRef
Mental health symptoms during the COVID-19 pandemic in developing countries: A systematic review and meta-analysis
Jiyao Chen, Stephen X Zhang, Allen Yin, Jaime A Yáñez
Journal of Global Health.2022;[Epub] CrossRef
Scientific evidence on mental health in key regions under the COVID-19 pandemic – meta-analytical evidence from Africa, Asia, China, Eastern Europe, Latin America, South Asia, Southeast Asia, and Spain
Stephen X. Zhang, Jiyao Chen
European Journal of Psychotraumatology.2021;[Epub] CrossRef

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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Abstract PDF Supplementary 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

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The Increased Alcohol and Marijuana Use Associated with the Quality of Life and Psychosocial Aspects: a Study During the Covid-19 Pandemic in a Brazilian University Community
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Lower Back Pain Caused by the Impact of COVID-19 Quarantine on Physical Activity and Daily Sitting Among Adult Saudi Arabian Populations in Jeddah: A Cross-Sectional Study
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Exercise and Use of Enhancement Drugs at the Time of the COVID-19 Pandemic: A Multicultural Study on Coping Strategies During Self-Isolation and Related Risks
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Psychological impact of infection with SARS-CoV-2 on health care providers: A qualitative study
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Suicide and Suicidal Behaviors in the Context of COVID-19 Pandemic in Bangladesh: A Systematic Review
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Impact of COVID-19 Institutional Isolation Measures on Postnatal Women in Level 3 COVID Facility in Northern India
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MENTAL HEALTH CHALLENGES, RESILIENCE AND COPING STYLE CONTRIBUTING TO THE WELL BEING OF PATIENTS RECOVERED FROM COVID - 19.
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Towards an In-Depth Understanding of Physical Activity and Eating Behaviours during COVID-19 Social Confinement: A Combined Approach from a Portuguese National Survey
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ՀԱՄԱՎԱՐԱԿԻ ԸՆԹԱՑՔՈՒՄ ԱՆՁԻ ՀՈԳԵԲԱՆԱԿԱՆ ԱՆՎՏԱՆԳՈՒԹՅՈՒՆԸ ԵՒ ՀՈԳԵԿԱՆ ԱՌՈՂՋՈՒԹՅՈՒՆԸ. ՏԵՍԱԿԱՆ ԱՍՊԵԿՏ / A PERSON’S PSYCHOLOGICAL SAFETY AND MENTALHEALTH DURING A PANDEMIC: THE THEORETICAL ASPECT
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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

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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.

Citations

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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
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Comparison of factors influencing fall recurrence in the young-old and old-old: a cross-sectional nationwide study in South Korea
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A Machine Learning Approach for the Classification of Falls and Activities of Daily Living in Agricultural Workers
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IEEE Access.2022; 10: 77418. CrossRef

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

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14 Citations

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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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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

10,701 View
233 Download
3 Citations

Abstract 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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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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Shiraz E-Medical Journal.2020;[Epub] CrossRef

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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Abstract Summary PDF Supplementary 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

14,716 View
272 Download
9 Citations

Abstract 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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Mohammad Zamani, Shaghayegh Alizadeh‐Tabari, Vahid Zamani
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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

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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

Citations

Citations to this article as recorded by

Differences in Oral Health and Generalized Anxiety Disorder According to Secondhand Smoke Exposure in Public Places
Yu-Rin Kim, Kyeung-Ae Jang
Behavioral Sciences.2023; 13(6): 455. CrossRef
Impact of a Comprehensive Tobacco Control Package on Trends in Hospital Admissions for Depression in Beijing, China: Interrupted Time Series Study
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
Residential secondhand smoke in a densely populated urban setting: a qualitative exploration of psychosocial impacts, views and experiences
Grace Ping Ping Tan, Odelia Teo, Yvette van der Eijk
BMC Public Health.2022;[Epub] CrossRef
Passive exposure to e-cigarette emissions is associated with worsened mental health
Kayla Rae Farrell, Michael Weitzman, Emma Karey, Teresa K. Y. Lai, Terry Gordon, Shu Xu
BMC Public Health.2022;[Epub] CrossRef
Secondhand Smoke in the Workplace Is Associated With Depression in Korean Workers
Seunghan Kim, Juyeon Oh, Byungyoon Yun, Ara Cho, Juho Sim, Jin-Ha Yoon
Frontiers in Public Health.2022;[Epub] CrossRef
Is exposure to indoor secondhand smoke associated with poor mental health? Results from non-conflict and post-conflict setting
Marija Milic, Hagai Levine, Tatjana Pekmezovic, Darija Kisic-Tepavcevic, Gorica Maric, Aleksandra Popovic, Jasmina Stevanovic, Karamchand Hukumchand Patil, Tatjana Gazibara
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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

16,181 View
238 Download
20 Citations

Abstract Summary PDF Supplementary 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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