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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
  • 2,764 View
  • 240 Download
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
The present study examined the impact of the coronavirus disease 2019 (COVID-19) pandemic on mental health service utilization through a comparative analysis of nationwide data regarding inpatient care users, outpatient visits, emergency department (ED) visits, and admissions via the ED before and during the pandemic.
METHODS
Data from approximately 350,000 Koreans diagnosed with mental illness were analyzed in terms of hospitalization, outpatient visits, and ED visits between January 2018 and June 2021. An interrupted time series analysis was conducted to determine the significance of changes in mental health service utilization indicators.
RESULTS
The number of hospital admissions per patient decreased by 1.2% at the start of the pandemic and 0.7% afterward. The length of hospital stay increased by 1.8% at the outbreak of the pandemic, and then decreased by 20.2%. Although the number of outpatients increased, the number of outpatient visits per patient decreased; the number of outpatient visits for schizophrenia (3.4%) and bipolar disorder (3.5%) significantly decreased immediately post-outbreak. The number of ED visits per patient decreased both immediately post-outbreak and afterward, and ED visits for schizophrenia (19.2%), bipolar disorder (22.3%), and depression (17.4%) decreased significantly immediately post-outbreak. Admissions via the ED did not show a significant change immediately post-outbreak.
CONCLUSIONS
Mental health service utilization increased during the pandemic, but medical service use decreased overall, with a particularly significant decrease in ED utilization. As the pandemic worsened, the decline in outpatient visits became more pronounced among those with severe mental illness.
Summary
Korean summary
이 연구는 COVID-19 전후 정신질환 의료서비스 이용 변화를 분석하였다. 팬데믹 기간 중에 정신질환 의료서비스는 전반적으로 감소하였고, 특히 중증 정신질환의 외래 방문이 감소하였다. 따라서, 정신질환자의 진료 연속성을 보장하기 위한 조치가 요구된다.
Key Message
This study examined the impact of the COVID-19 pandemic on mental health service utilization. The mental health service utilization decreased overall after the outbreak of COVID-19, especially outpatient visits for severe mental illness significantly decreased. Therefore, countermeasures are needed to maintain the continuity of care.
Original Article
Changes in the prevalence of metabolic syndrome in Korean adults after the COVID-19 outbreak
Ji-Young Kwon, Sang-Wook Song
Epidemiol Health. 2022;44:e2022101.   Published online November 5, 2022
DOI: https://doi.org/10.4178/epih.e2022101
  • 1,498 View
  • 73 Download
AbstractAbstract PDF
Abstract
OBJECTIVES
This study sought to reveal changes in the prevalence of metabolic syndrome (MetS) after the start of the coronavirus disease 2019 (COVID-19) pandemic and to identify the groups showing the greatest changes.
METHODS
We compared the prevalence of MetS between 2017–2019 (i.e., the 3-year period before the COVID-19 pandemic) and soon after the initial outbreak of COVID-19 in 2020 among 24,564 adults ≥ 19 years of age using data from the Korea National Health and Nutrition Examination Survey.
RESULTS
The prevalence of MetS increased steadily between 2017 and 2020 (29.4 to 35.3%, p for trend < 0.001), with annual percent changes of 2.0%p, 2.2%p, and 1.7%p, respectively. Compared to 3 years before the COVID-19 pandemic, the prevalence of MetS significantly increased during the COVID-19 pandemic in males (6.2%p; 95% confidence interval [CI], 3.5 to 8.9) compared to females (1.5%p; 95% CI, -1.2 to 4.1). The age groups with the greatest increases in MetS prevalence after the COVID-19 pandemic were those in their 40s (4.6%p; 95% CI, 0.9 to 8.4) and 50s (5.8%p; 95% CI, 2.2 to 9.4). By educational background, the increase in MetS prevalence was greatest among those with a college degree or higher (5.1%p). The prevalence of MetS in high-income (5.3%p) and low-income (4.6%p) groups significantly increased.
CONCLUSIONS
The increasing trend in the overall prevalence of MetS continued during the COVID-19 pandemic. In particular, the prevalence of MetS among adult males in their 40s and 50s increased significantly after the COVID-19 outbreak in Korea.
Summary
COVID-19: Special Article
Obesity, hypertension, diabetes mellitus, and hypercholesterolemia in Korean adults before and during the COVID-19 pandemic: a special report of the 2020 Korea National Health and Nutrition Examination Survey
Ga Bin Lee, Yoonjung Kim, Suyeon Park, Hyeon Chang Kim, Kyungwon Oh
Epidemiol Health. 2022;44:e2022041.   Published online April 25, 2022
DOI: https://doi.org/10.4178/epih.e2022041
  • 8,699 View
  • 572 Download
  • 14 Citations
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
We investigated trends in obesity, hypertension, diabetes, and hypercholesterolemia before and during the coronavirus disease 2019 (COVID-19) pandemic in the Korean adult population.
METHODS
Data from 60,098 participants in the Korea National Health and Nutritional Examination Survey between 2011 and 2020 aged ≥19 were used. The age-standardized prevalence and annual percent changes (APCs) were calculated for obesity (body mass index ≥25 kg/m2), hypertension (systolic/diastolic blood pressure ≥140/90 mmHg or under treatment), diabetes (hemoglobin A1c ≥6.5%, fasting glucose ≥126 mg/dL, physician diagnosis, or under treatment), and hypercholesterolemia (total cholesterol ≥240 mg/dL or under treatment).
RESULTS
Over the past decade (2011-2020), the age-standardized APCs (95% confidence intervals) for obesity, hypertension, diabetes and hypercholesterolemia were 3.0% (2.1 to 3.8), 0.1% (-1.3 to 1.5), 1.5% (-1.0 to 4.0) and 8.0% (5.7 to 10.3), respectively, in men; and -0.2% (-1.5 to 1.2), -0.5% (-1.9 to 0.9), -0.1% (-2.3 to 2.2) and 5.9% (3.9 to 8.0), respectively, in women. In 2020 compared to the previous 3 years (2017-2019), obesity, hypertension, diabetes, and hypercholesterolemia increased in men (6.0, 1.8, 1.9, and 2.8%p, respectively), but an increase was not apparent in women (2.5, -1.1, 0.8, and 0.7%p, respectively).
CONCLUSIONS
An increase in major chronic diseases was observed in Korean adults, especially men, during the COVID-19 pandemic. In order to reduce the burden of cardiovascular and metabolic diseases in the future, effective intervention strategies need to be developed according to the characteristics of the target groups.
Summary
Korean summary
한국인의 비만, 고혈압, 당뇨 및 고지혈증 유병률은 지난 10년간 전반적으로 증가하는 경향을 보였다. 특히, 코로나 19가 유행한 2020년에 남성의 주요 만성질환 유병률은 지난 3년 평균치와 비교하였을 때 모두 유의하게 증가하였다. 반면, 여성에서 만성질환 유병률의 뚜렷한 증가는 관찰되지 않았다.
Key Message
During COVID-19 pandemic, the overall increase in major chronic diseases was observed in Korean adults, and this trend was prominent in men. Accordingly, target-specific intervention strategies need to be developed to reduce the burden of cardiovascular and metabolic diseases in the future.

Citations

Citations to this article as recorded by  
  • Sleep Deficit as a Risk Factor for Hypertension in Korean Adults
    Mi-Joon Lee, Bum-Jeun Seo, Inmyung Song
    Sustainability.2023; 15(3): 2586.     CrossRef
  • Gene–Nutrient Interactions in Obesity: COBLL1 Genetic Variants Interact with Dietary Fat Intake to Modulate the Incidence of Obesity
    Junkyung Kwak, Dayeon Shin
    International Journal of Molecular Sciences.2023; 24(4): 3758.     CrossRef
  • Identifying the Associations of Nightly Fasting Duration and Meal Timing with Type 2 Diabetes Mellitus Using Data from the 2016–2020 Korea National Health and Nutrition Survey
    Junkyung Kwak, Kyeong-A Jang, Haeng-Ran Kim, Min-Sook Kang, Kyung Won Lee, Dayeon Shin
    Nutrients.2023; 15(6): 1385.     CrossRef
  • Changes in the Prevalences of Obesity, Abdominal Obesity, and Non-Alcoholic Fatty Liver Disease among Korean Children during the COVID-19 Outbreak
    Kyungchul Song, Juyeon Yang, Hye Sun Lee, Su Jin Kim, Myeongseob Lee, Junghwan Suh, Ahreum Kwon, Ho-Seong Kim, Hyun Wook Chae
    Yonsei Medical Journal.2023; 64(4): 269.     CrossRef
  • Revisiting the Diabetes Crisis in Korea: Call for Urgent Action
    Jun Sung Moon
    The Journal of Korean Diabetes.2023; 24(1): 1.     CrossRef
  • Changes in dietary habits and chronic diseases before and after COVID-19 by regions using data from the 2018-2020 Korea Community Health Survey and Consumer Behavior Survey for Foods: a cross-sectional study
    Surim Park, Eun-hee Jang, Seungmin Lee
    Korean Journal of Community Nutrition.2023; 28(2): 124.     CrossRef
  • Trends in socioeconomic inequalities in obesity among Korean adolescents: the Korea Youth Risk Behavior Web-based Survey (KYRBS) 2006 to 2020
    Eunji Kim, Ga Bin Lee, Dong Keon Yon, Hyeon Chang Kim
    Epidemiology and Health.2023;[Epub]     CrossRef
  • Changes in food and nutrient intakes in Korean adults before and during the coronavirus disease 2019 pandemic : data from the 2011-2020 Korea National Health and Nutrition Examination Survey
    Kyungwon Oh, Suyeon Park, Sihyun Park, Sungha Yun, Hongseok Choi, Eun Kyeong Jeong
    Epidemiology and Health.2023;[Epub]     CrossRef
  • Clinical Features and Visual Prognosis of Retinal Vein Occlusion in Those under 50 Years Old
    Soyeon Jung, Haeeun Shin, Hee Seung Chin
    Journal of the Korean Ophthalmological Society.2023; 64(6): 490.     CrossRef
  • Korea hypertension fact sheet 2022: analysis of nationwide population-based data with a special focus on hypertension in the elderly
    Hyeon Chang Kim, Hokyou Lee, Hyeok-Hee Lee, Gabin Lee, Eunji Kim, Moses Song, Jenny Moon, Yeeun Seo
    Clinical Hypertension.2023;[Epub]     CrossRef
  • Comorbidity in patients with arterial hypertension in therapeutic practice
    D.V. Korsunsky, S.A. Berns, A.R. Novikova, O.M. Drapkina
    Profilakticheskaya meditsina.2023; 26(8): 100.     CrossRef
  • Prevalence and management of hypertension in Korean adults
    Hyeon Chang Kim
    Journal of the Korean Medical Association.2022; 65(10): 633.     CrossRef
  • Association between Mental Health and Hand Hygiene Practices in Adults with Hypertension and Diabetes during the COVID-19 Pandemic: The 2020 Korea Community Health Survey
    Pius Kim, Hae Ran Kim
    Healthcare.2022; 10(10): 1912.     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
The vaccination coverage rate in under-5 children in Nasiriyah, Iraq before and during the COVID-19 pandemic
Ali Rifaat Alhaddad, Elham Ahmadnezhad, Akbar Fotouhi
Epidemiol Health. 2022;44:e2022035.   Published online March 14, 2022
DOI: https://doi.org/10.4178/epih.e2022035
  • 6,057 View
  • 300 Download
  • 2 Citations
AbstractAbstract AbstractSummary PDF
Abstract
providOBJECTIVES: This study compared the vaccination coverage rate (VCR) in children under 5 years old in Nasiriyah, Iraq before and during the coronavirus disease 2019 (COVID-19) pandemic.
METHODS
This cross-sectional study was conducted in the city of Nasiriyah in southeastern Iraq, with data collected from 79 primary healthcare facilities. This study evaluated the VCR in 3 periods (2018, 2019, and 2020) using multi-level random sampling. Pertinent data were extracted from the vaccination records of 598 children for Bacillus Calmette-Guérin (BCG); pentavalent 1, 2, and 3; measles; and activated oral poliovirus vaccine 1 and 2. Missing data were completed by telephone calls to participants’ parents. Logistic regression was applied to compare and estimate the odds ratios (ORs) with 95% confidence intervals (CIs) for the association between VCR and related factors.
RESULTS
The data showed the greatest decline in the studied vaccines in 2020. Among the vaccines studied, BCG had the highest rate in all 3 periods (100% VCR) and measles had the lowest rate (83.7%), reaching 63.6% in 2020 (p<0.001). The highest OR among all types of vaccine were found for the pentavalent-3 vaccine among city dwellers and those born in 2020 (OR, 2.67; 95% CI, 1.39 to 5.10 and OR, 2.34; 95% CI, 1.28 to 4.28, respectively).
CONCLUSIONS
The VCR for children decreased during the COVID-19 pandemic in Iraq, and new health policies are needed to increase the coverage rate. Improving the knowledge and attitudes of parents, as well as removing barriers or risk factors, can also be effective in improving the VCR.
Summary
Key Message
Vaccination is one of the most important essential health services. COVID-19 pandemic has reduced the coverage of vaccination among under five.

Citations

Citations to this article as recorded by  
  • Current Impact and Long-Term Influence of the COVID-19 Pandemic on Iraqi Healthcare Systems: A Case Study
    Taysir Al Janabi, Sunny Chung
    Epidemiologia.2022; 3(4): 412.     CrossRef
  • Dropout of Vaccination Among Iraqi Children
    Maha. A. Kadim, Anees Flayyih Abdulhasan, Zainab Abdulameer Abdulrasol, Ali Fadhil Obaid
    South Asian Journal of Social Sciences and Humanities.2022; 3(6): 163.     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
  • 9,551 View
  • 599 Download
  • 12 Citations
AbstractAbstract AbstractSummary PDF
Abstract
OBJECTIVES
The aim of this study was to investigate the prevalence and risk factors of poor mental health in the general Korean population during the coronavirus disease 2019 (COVID-19) pandemic.
METHODS
This cross-sectional, population-based, online survey-based study was conducted from November 5 to 20, 2020 and included adults aged 20-49 years in Chungnam Province, Korea. A total of 549 adults were included.
RESULTS
In total, 18.8% of the participants had symptoms of depression, 10.6% had symptoms of anxiety, and 5.1% had a high level of perceived stress during the COVID-19 pandemic. Higher levels of stress (odds ratio [OR], 3.13; 95% confidence interval [CI], 1.13 to 8.67), anxiety (OR, 2.33; 95% CI, 1.09 to 4.49), and depression (OR, 3.00; 95% CI, 1.64 to 5.50) were found among never married, widowed, divorced, and separated people than among married/cohabiting/partnered participants. Participants who felt increased stress at home during the COVID-19 outbreak reported more depression (OR, 2.45; 95% CI, 1.49 to 4.05) and anxiety (OR, 2.42; 95% CI, 1.31 to 4.50). Women had higher risks of anxiety (OR, 1.97; 95% CI, 1.09 to 3.58) and stress (OR, 6.40; 95% CI, 2.30 to 17.85) than men. Participants with the highest household income were less likely to report symptoms of stress than those with the lowest household income (OR, 0.24; 95% CI, 0.06 to 0.96).
CONCLUSIONS
The participants in this study exhibited poor mental health index scores, suggesting that some people are at risk for mental health problems during the COVID-19 pandemic. Being married was independently and significantly associated with a lower likelihood of depression, anxiety, and stress.
Summary
Korean summary
이 연구는 코로나-19 유행 기간 동안 정신건강 현황과 위험 요인을 알아보기 위한 단면연구이다. 코로나 19 유행 이후 가정내 스트레스가 증가했다고 응답한 경우 우울증과 불안감의 유병률이 높았다. 반면, 남성인 경우, 결혼했거나 동거인과 같이 살고 있는 경우에는 우울증, 불안 또는 스트레스의 유병률이 통계적으로 유의하게 낮았다. 마스크 착용하기, 비대면 활동 증가, 또는 사회적 거리두기 등 코로나 19의 유행을 통제하기 위한 많은 정책은 개인의 일상생활과 정신건강에 많은 영향을 미쳤다. 이 연구는 취약 집단을 발굴하고, 정신건강 회복을 위한 전략을 개발하는데 기초자료를 제공할 수 있다.
Key Message
This study revealed high prevalence rates of depression, anxiety, and stress in the general population of Korea aged 20-49 years during the COVID-19 pandemic. Participants who felt increased stress at home reported more depression and anxiety. Men and being married were significantly associated with a lower likelihood of depression, anxiety, or stress. The COVID-19 pandemic has been a traumatic event. In addi­tion, the policies created to prevent its spread have disrupted daily living for the general population. Implement­ing strategies to promote resilience and support psychologically vulnerable individuals during the COVID-19 cri­sis is of fundamental importance.

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
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    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
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    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
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    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
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    Mi-Sun Lee, Jung Jae Lee, Soyeon Park, Seongju Kim, Hooyeon Lee
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    Salma M Abdalla, Shaffi Fazaludeen Koya, Samuel B. Rosenberg, Isaac B. Stovall, Olivia Biermann, Zahra Zeinali, Gregory H. Cohen, Catherine K. Ettman, Sandro Galea
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    Hyunsuk Jeong, Suyeon Park, Jihee Kim, Kyungwon Oh, Hyeon Woo Yim
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