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Original Articles
Sex differences in the relationship between depression and cardiovascular disease risk: a nationwide study in Korea
Seol-bin Kim, Ihn Sook Jeong
Osong Public Health Res Perspect. 2021;12(2):105-114.   Published online April 29, 2021
DOI: https://doi.org/10.24171/j.phrp.2021.12.2.08
  • 3,452 View
  • 69 Download
AbstractAbstract PDFSupplementary Material
Objectives
This study aimed to identify sex differences in the association between depression and the risk of developing cardiovascular disease (CVD).
Methods
A secondary analysis was conducted of data from the fifth to seventh waves (2010−2018) of the Korea National Health and Nutrition Examination Survey. The participants were adults aged 30−74 years who had no diagnosis of CVD. The CVD risk was calculated using the Framingham Risk Score algorithm. Multiple linear regression analysis was conducted to identify the association between depression and CVD risk using a complex sample design.
Results
The mean CVD risk was higher in males and females with current depression (14.72% vs. 6.35%, respectively) than in males without current depression (11.67% and 4.42%, respectively). Current depression showed a significant association with CVD risk after controlling for only health-related characteristics, but the significance disappeared in both males and females when demographic characteristics were additionally controlled.
Conclusion
The presence of depression was not associated with CVD risk regardless of sex after controlling for confounding factors. Further studies are recommended to investigate the relationship between depression and CVD risk in a larger sample of both males and females with depression.
Gender Difference in the Association Between E-Cigarette Use and Depression among US Adults
Baksun Sung
Osong Public Health Res Perspect. 2021;12(1):13-19.   Published online February 23, 2021
DOI: https://doi.org/10.24171/j.phrp.2021.12.1.03
  • 5,497 View
  • 111 Download
  • 1 Citations
AbstractAbstract PDF
Objectives

The objective of this study was to determine the association between e-cigarette use and depression and examine how this association is different by gender among US adults.

Methods

Data from the 2017 Behavioral Risk Factor Surveillance System and Selected Metropolitan/Micropolitan Area Risk Trends was used, and included 174,351 of 230,875 US adults aged 18 years and older. Data were analyzed using the multivariate logistic regression models.

Results

After adjusting for age, race, education, income, marital status, employment status, smoking status, and physical activity, firstly, “current daily e-cigarette users” (AOR = 2.487, p < 0.001), “current non-daily e-cigarette users” (AOR = 1.623, p < 0.001), and “former e-cigarette users” (AOR = 1.573, p < 0.001) were associated with increased odds of depression compared with “never e-cigarette users.” Secondly, women were associated with increased odds of depression compared with men (AOR = 1.797, p < 0.001). Finally, male “current daily e-cigarette users” (AOR = 1.366, p < 0.01) were associated with increased odds of depression compared with female “never e-cigarette users.”

Conclusion

Thus, even though women tend to be more vulnerable to depression compared with men, e-cigarette use was positively associated with depression among both men and women.

A Study on the Physical Activities, Mental Health, and Health-Related Quality of Life of Osteoarthritis Patients
Deok-Ju Kim
Osong Public Health Res Perspect. 2019;10(6):368-375.   Published online December 31, 2019
DOI: https://doi.org/10.24171/j.phrp.2019.10.6.07
  • 3,528 View
  • 207 Download
  • 1 Citations
AbstractAbstract PDF
Objectives

The purpose of this study was to investigate the physical activities, mental health, and health-related quality of life (HRQOL) of osteoarthritis patients.

Methods

This study was conducted using data from the first year of the 7th Korea National Health and Nutritional Examination Survey. There were 8,150 participants included in the survey, and 665 participants had been diagnosed with osteoarthritis. This study analyzed the measurements of physical activities, depression, and HRQOL in participants with osteoarthritis.

Results

The mean age of the participants was 67 ± 9.9 years and 83.1% were female. Participants rarely engaged in work-related physical activity, and engaged in leisure-related physical activities infrequently. Most of the participants (85.9%) did not do regular exercise, but 1/3 of the participants walked for over 10 minutes a day. “Pain/discomfort” had the least impact upon HRQOL, and among the depression subcategories, “difficult to sleep and tiredness” had the most impact. Multiple logistic regression analysis showed that an adverse HRQOL score was statistically significantly associated with “location changes/physical activities” (p < 0. 01), “depression” (p < 0.001) and “age” (p < 0.001).

Conclusion

Exercise programs should be in place which are manageable in everyday life for the elderly (> 65 years). Changes in daily routine so that patients become more active, should be supported by the family and community, together with assistance in managing psychological problems such as depression.

Body Weight Misperception and Psychological Distress Among Children and Adolescents: The CASPIAN-V Study
Roya Riahi, Mohammad Esmaeil Motlagh, Ramin Heshmat, Mostafa Qorbani, Seyede Shahrbanoo Daniali, Roya Kelishadi
Osong Public Health Res Perspect. 2019;10(5):315-324.   Published online October 31, 2019
DOI: https://doi.org/10.24171/j.phrp.2019.10.5.08
  • 2,998 View
  • 155 Download
  • 7 Citations
AbstractAbstract PDF
Objectives

Misperception of weight status is a risk factor that affects psychological health. The aim of this study was to evaluate the association between weight misperception patterns and psychological distress among Iranian children and adolescents.

Methods

This was a cross-sectional nationwide study where data was collected from 14,440 students, aged 7–18 years who participated in the national school-based surveillance program (CASPIAN-V). The students’ weight perception and psychological distress were assessed by validated questionnaires. Weight misperception was classified as misperception of being either underweight or overweight with respect to actual weight.

Results

The rate of weight misperception in all study participants was 59.1%. In groups with a perception of being underweight or overweight, the risks of worthlessness, being worried, experiencing aggression, insomnia, or depression, were significantly higher than groups with an accurate weight perception (p < 0.05). The risk of anxiety in girls of normal weight who perceived themselves as underweight, decreased by 57% compared to girls with an accurate weight perception (OR: 0.43; 95% CI, 0.28–0.66).

Conclusion

Weight misperception is highly prevalent among Iranian children and adolescents and is associated with their psychological health status. Appropriate education intervention needs to be developed to improve the children and adolescents’ perception of their body weight status.

Gender Differences in Harmful Use of Alcohol Among Korean Adults
Eunok Park, Yeon Sook Kim
Osong Public Health Res Perspect. 2019;10(4):205-214.   Published online August 31, 2019
DOI: https://doi.org/10.24171/j.phrp.2019.10.4.02
  • 2,982 View
  • 52 Download
  • 3 Citations
AbstractAbstract PDF
Objectives

Harmful alcohol consumption is associated with considerable social and economic damage to individuals and society. Because gender and ethnic background influence alcohol intake differently, examining gender specific factors influencing harmful drinking is necessary. This study investigated gender differences in alcohol consumption, harmful drinking, and the associated factors among Korean adults.

Methods

We analyzed the data from the 2012–2015 Korean National Health and Nutrition Examination Survey. Data from survey participants aged 20–64 years (N = 18,581) were included. The Alcohol Use Disorders Identification Test was used for alcohol dependence, and pooled weights were used. Chi-squared tests and multiple logistic regression analyses were conducted.

Results

The prevalence of harmful alcohol use (Alcohol Use Disorders Identification Test score ≥ 16) was 10.7% in the total sample; 18.4% in men and 3.4% in women, which constituted a significant difference. Education, marital status, smoking, perceived stress, and depressive feeling were associated with harmful drinking in both genders. However, household income, occupation, and perceived health status were associated with harmful drinking only in men.

Conclusion

Since there are gender differences in harmful drinking and alcohol dependence, gender tailored prevention and intervention strategies for alcohol dependence are necessary including consideration of smoking, stress, and depressive feeling.

Factors Affecting Activity Limitation in the Elderly: Data Processed from the Korea National Health and Nutrition Examination Survey, 2016
Jong-Hoon Moon
Osong Public Health Res Perspect. 2019;10(3):117-122.   Published online June 30, 2019
DOI: https://doi.org/10.24171/j.phrp.2019.10.3.02
  • 3,503 View
  • 32 Download
  • 1 Citations
AbstractAbstract PDF
Objectives

The aim of this study was to compare the sociodemographic characteristics, depression, and the health-related quality of life outcome, among the Korean elderly population, with and without activity limitation.

Methods

The data used was drawn from the raw data of the seventh Korea National Health and Nutrition Examination Survey (N = 8,150). There were 1,632 records for individuals aged 65 or older extracted from the seventh Korea National Health and Nutrition Examination Survey database, 199 of those had missing responses (n = 1,433). Differences within the sociodemographic characteristic, the Patient Health Questionnaire-9, and the EuroQol-5 Dimension were analyzed using logistic regression analysis according to the presence or absence of activity limitation.

Results

The prevalence of activity limitation among the elderly individuals surveyed was 19.9%. In the unadjusted regression analysis, the odds ratios of all independent variables (age, gender, education level, type of region, family income, the Patient Health Questionnaire-9, all 5 domains of the EuroQol-5 Dimension) between the elderly individuals with and without activity limitation, were significant. Although, in the adjusted logistic regression analysis, it was observed that the only factors that were significantly associated with activity limitation were the Patient Health Questionnaire-9, EuroQol-5 Dimension, type of region, and family income.

Conclusion

These findings demonstrated that activity limitation in elderly individuals is associated with the sociodemographic characteristics of family income and type of region of residence, as well as depression and the health-related quality of life outcome.

The Effects of Restricted Physical Activity on Health-Related Quality of Life in Adult Patients with Depression
Deok-Ju Kim
Osong Public Health Res Perspect. 2019;10(2):85-92.   Published online April 30, 2019
DOI: https://doi.org/10.24171/j.phrp.2019.10.2.07
  • 2,855 View
  • 63 Download
AbstractAbstract PDF
Objectives

The objective was to identify restricted physical activity in patients with depression, and to determine the effects of that restricted activity, on their health-related quality of life (HRQOL).

Methods

Data was analysed from Year 1 of the 7th Korea National Health and Nutrition Examination Survey (KNHANES VII-1). From a total sample of 8,150 subjects, 277 adults aged ≥19 years who were diagnosed with depression were selected. The results were derived using restricted activity and HRQOL data measured from the subjects.

Results

Most of the participants were females ≥ 50 years old. HRQOL scores were high in the “self-care” dimension and low in the “pain/discomfort” and “anxiety/depression” dimensions. Their restricted activity due to illness in the past year, led to increases in participants being bedridden or absent from work. Many participants reported being bedridden for more than 3 months. A higher number of absences owing to illness in the past year, and longer durations of being bedridden, had a negative impact on HRQOL. Age, marital status, educational level, income level, and occupation were the sociodemographic variables that had an impact on HRQOL.

Conclusion

Patients with depression experiencing stress in their daily lives should take measures to avoid illness and pain that may lead to them becoming bedridden, and employ lifestyle habits with support from families and community health promotion centres, where mental health counselling can be accessed.

Regional Differences of Mental Health Status and Associated Factors: Based on the Community Health Survey
Ji Hye Lim
Osong Public Health Res Perspect. 2018;9(4):175-184.   Published online August 31, 2018
DOI: https://doi.org/10.24171/j.phrp.2018.9.4.06
  • 3,328 View
  • 31 Download
  • 2 Citations
AbstractAbstract PDF
Objectives

The aim of this study was to determine whether there were differences in mental health specific to regions in Korea, and the factors that affected mental health status.

Methods

Data from the 2016 Community Health Survey in Korea were used; 224,421 health survey participants provided responses on mental health issues, demographics, and health behavior, and were included in the study.

Results

A statistically significant difference was observed in the incidence of mental health status between different regions of Korea. Independent variables that affected mental health were sex, age, marital status, household income, economic activity, whether living with dementia patients, self-reported health status, smoking, alcohol drinking, sleep time, and chronic diseases. Risk factors associated with symptoms of depression were gender (female), bereavement or being divorced, low household income, family member with dementia, poor self-reported health status, currently smoking, level of physical activity, insufficient hours of sleep and suffering from chronic diseases.

Conclusion

This study suggests that a standardized healthcare policy is needed to reduce regional variation in mental health. In the future, similar studies that include medical expenses for mental healthcare and relevant variables according to regions of Korea should be conducted.

Effects of Physical Activity on Depression in Adults with Diabetes
Deok-Ju Kim
Osong Public Health Res Perspect. 2018;9(4):143-149.   Published online August 31, 2018
DOI: https://doi.org/10.24171/j.phrp.2018.9.4.02
  • 3,322 View
  • 130 Download
  • 4 Citations
AbstractAbstract PDF
Objectives

The purpose of this study was to identify the current state of physical activity in adults with diabetes and to investigate the effect of physical activity on depression.

Methods

The present study was conducted using data from the 2nd year of the 6th Korea National Health and Nutritional Examination Survey. From the total of 7,550 individuals, 418 adults diagnosed with diabetes were selected as participants, and their physical activity and depression levels were examined.

Results

The physical activity status of the participants showed that they did not usually engage in physical activities at work, and only a few participants were involved in moderate intensity physical leisure activity. Apart from walking for 10 minutes each day, which accounted for 1/3 of the participants, most of the participants did not engage in specific forms of exercise. An examination of the effects of physical activity on depression revealed that moderate intensity physical activity at work and leisure influenced depression. In terms of demographic characteristics, gender, occupation, income quintile, and subjective health status were all found to affect depression.

Conclusion

For elderly (60 years or older) patients with diabetes, which accounted for the majority of the diabetic population, a systematic leisure program and professional education are necessary to help them to manage stress and depression in daily life. Additionally, provision of community and family support should encourage regular, moderate intensity exercise and promote lifestyle changes to encourage increased physical activity.

Sex-based Association between Depression and Metabolic Syndrome in Korean Middle-aged and Older Adults
Jin Suk Ra, Hye Sun Kim
Osong Public Health Res Perspect. 2017;8(2):130-137.   Published online April 30, 2017
DOI: https://doi.org/10.24171/j.phrp.2017.8.2.05
  • 2,511 View
  • 44 Download
  • 9 Citations
AbstractAbstract PDF
Objectives

This study aimed to identify the sex-based association between depression and the development of metabolic syndrome (Mets) among middle-aged and older Korean adults.

Methods

A cross-sectional design was used for the secondary analysis of the 2010–2014 Korean National Health and Nutrition Examination Survey. Data from 1,938 men and 2,404 women were analyzed. Mets was defined in accordance with the criteria used for clinical diagnosis. Depression was assessed with a question about having clinical depression. The association between depression and the development of Mets with or without adjustment for covariates was identified by conducting logistic regression analysis on weighted data using a complex sample procedure.

Results

More women than men had depression. Before covariate adjustment, depression was significantly associated with the development of Mets among women (odds ratio [OR], 1.586; 95% confidence interval [CI], 1.152–2.183) and with a higher triglyceride level among men (OR, 1.679; 95% CI, 1.001–2.818). After covariate adjustment; depression was significantly associated with higher waist circumference among women (adjusted OR [AOR], 1.532; 95% CI, 1.046–2.245) and higher triglyceride level (AOR, 1.511; 95% CI, 1.029–2.219) than was Mets. Conversely, depression did not have significant effects on the development of Mets among men.

Conclusion

Depression was associated with the development of Mets among middle-aged and older Korean women. Healthcare providers in communities should assess women with depression for the presence of Mets components. Interventions for relieving depressive symptoms should also be provided to women at risk for Mets.

How do Sexual Identity, and Coming Out Affect Stress, Depression, and Suicidal Ideation and Attempts Among Men Who Have Sex With Men in South Korea?
Byonghee Cho, Aeree Sohn
Osong Public Health Res Perspect. 2016;7(5):281-288.   Published online October 31, 2016
DOI: https://doi.org/10.1016/j.phrp.2016.09.001
  • 1,743 View
  • 24 Download
  • 9 Citations
AbstractAbstract PDF
Objectives
This study investigated the status of sexual identity, perceived stigma, stress, depression, and suicidal ideation and attempts. It also examined how sexual identity and “coming out” affect stress, depression, and suicidal ideation and attempts.
Methods
Suicidal ideation, psychological health status, and health-related behaviors were assessed using the Internet to maximize the confidentiality of the participants, men who have sex with men (MSM). The data were collected from a total of 873 MSM aged between 19 years and 59 years in 2014.
Results
Only 20.9% of the MSM had come out (18.0% voluntarily and 2.9% by others). The prevalences of perceived stress and depression among MSM were 46.7% and 42.7%, respectively, compared with 20.1% and 7.4% among general men. Approximately 32% of the MSM reported any suicidal ideation, and 3.3% had attempted suicide in the past year. The likelihood of suicidal ideation was significantly associated with being age 30–39 years [odds ratio (OR) = 1.8], high school or less (OR = 1.6), having been outed (OR = 5.2), feeling stressed (OR = 1.8), and feeling depressed (OR = 12.4) after sociodemographic factors and other perceptions were controlled for.
Conclusion
The present study provides evidence that MSM are at an elevated risk for suicidal ideation and attempts with high stress and depression. Some risk factors were specific to being gay or bisexual in a hostile environment.
Depression among Korean Adults with Type 2 Diabetes Mellitus: Ansan-Community-Based Epidemiological Study
Chan Young Park, So Young Kim, Jong Won Gil, Min Hee Park, Jong-Hyock Park, Yeonjung Kim
Osong Public Health Res Perspect. 2015;6(4):224-232.   Published online August 31, 2015
DOI: https://doi.org/10.1016/j.phrp.2015.05.004
  • 1,557 View
  • 12 Download
  • 22 Citations
AbstractAbstract PDF
Objectives
There are an increasing number of studies being carried out on depression in patients with diabetes. Individuals with diabetes have been reported as having a higher prevalence of depression compared to those without diabetes. However, only a few studies involving Korean patients have been conducted. The aims of this study were to examine the prevalence of depression and to find various risk factors according to the degree of depression among Korean patients with Type 2 diabetes mellitus (T2DM).
Methods
An Ansan-community-based epidemiological study was conducted from 2005 to 2012. The total number of participants in this study was 3,540, from which patients with diabetes (n = 753) have been selected. The presence of depression was evaluated using the Beck Depression Inventory total score.
Results
The prevalence of depression was 28.8%. The mean age of participants was 55.5 ± 8.2 years. We divided the participants into three groups (without-depression, moderate-depression, and severe-depression groups) to examine the depression prevalence among Korean T2DM patients. The unemployed participants had 2.40 [95% confidence interval (CI) 1.21–4.76], the low-income participants had 2.57 (95% CI 1.52–4.35), the participants using an oral diabetes medicine or insulin had 2.03 (95% CI 1.25–3.32), the participants who are currently smoking had 2.03 (95% CI 1.10–3.73), and those without regular exercise had 1.91 (95% CI 1.17–3.14) times higher odds of depression in the severe-depression group, compared with the without-depression group.
Conclusion
There was a significant association between depression prevalence and diabetes, and we found various risk factors according to the degree of depression in Korean patients with T2DM.
Exposure–Response Relationship Between Aircraft Noise and Sleep Quality: A Community-based Cross-sectional Study
Soo Jeong Kim, Sang Kug Chai, Keou Won Lee, Jae-Beom Park, Kyoung-Bok Min, Hyun Gwon Kil, Chan Lee, Kyung Jong Lee
Osong Public Health Res Perspect. 2014;5(2):108-114.   Published online April 30, 2014
DOI: https://doi.org/10.1016/j.phrp.2014.03.004
  • 1,840 View
  • 25 Download
  • 17 Citations
AbstractAbstract PDF
Objectives
Exposure to aircraft noise has been shown to have adverse health effects, causing annoyance and affecting the health-related quality of life, sleep, and mental states of those exposed to it. This study aimed to determine sleep quality in participants residing near an airfield and to evaluate the relationship between the levels of aircraft noise and sleep quality.
Methods
Neighboring regions of a military airfield were divided into three groups: a high exposure group, a low exposure group, and a control group. A total of 1082 participants (aged 30–79 years) completed a comprehensive self-administered questionnaire requesting information about demographics, medical history, lifestyle, and the Pittsburgh Sleep Quality Index.
Results
Of the 1082 participants, 1005 qualified for this study. The prevalence of sleep disturbance was 45.5% in the control group, 71.8% in the low exposure group, and 77.1% in the high exposure group (p for trend < 0.001). After adjusting for potential confounding factors, we determined the exposure–response relationship between the degree of aircraft noise and sleep quality. Of the participants with a normal mental status, the prevalence of sleep disturbance was 2.61-fold higher in the low exposure group and 3.52-fold higher in the high exposure group than in the control group.
Conclusion
The relationship between aircraft noise and health should be further evaluated through a large-scale follow-up study.
The Impact of Emergency Room Utilization by Depression Patients on Medical Treatment Expense in Korea
Hyun Sook Lee
Osong Public Health Res Perspect. 2013;4(5):240-245.   Published online October 31, 2013
DOI: https://doi.org/10.1016/j.phrp.2013.09.007
  • 1,464 View
  • 13 Download
  • 2 Citations
AbstractAbstract PDF
Objectives
To investigate the determinants of total medical expense for depression patients admitted through the emergency room (ER).
Methods
Data were selected from the Korean National Health Insurance sample data for 2009. SPSS version 18 was used for the statistical analysis such as descriptive analysis, correlation analysis, and multiple regression analysis. Data included 1203 cases admitted through the ER with ICD-10 codes (F31–F39).
Results
In the multiple regression analysis, significant variables affecting total payment were gender (p < 0.001), age (p < 0.001), main illness (p < 0.001), course of admission to the ER (p < 0.05), and length of stay (p < 0.001).
Conclusion
It is necessary to build a long-term program and system for high-risk depression groups.

PHRP : Osong Public Health and Research Perspectives