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The prevalence of and factors associated with depressive symptoms in the Korean adults: the 2014 and 2016 Korea National Health and Nutrition Examination Survey

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Abstract

Purpose

This study was performed to investigate the prevalence of and factors associated with depressive symptoms in the Korean adult population.

Methods

10,710 participants in the 2014 and 2016 Korea National Health and Nutrition Examination Survey (KNHANES) were analyzed in this study. Assessment of depressive symptoms was performed using the self-administered nine-item Patient Health Questionnaire (PHQ–9).

Results

The weighted prevalence of clinically relevant depression (PHQ-9 score ≥ 10) in the Korean adult population was 6.1% [5.5–6.8%]. Female sex, adults aged 19–29 years, elementary school graduation, living alone were significantly associated with clinically relevant depression. Having a household income ≤ 24th percentile was associated with a 2.26 (CI 1.49–3.45, p < 0.001)-fold higher prevalence of clinically relevant depression compared to having a household income ≥ 75th percentile. Regarding occupation, treating managers and professionals as controls, we found that unemployed individuals (OR 2.36, 95% CI 1.52–3.65, p < 0.001) had an increased risk of clinically relevant depression. Alcohol consumption < 30 g/day was reversely associated with clinically relevant depression (OR 0.75, 95% CI 0.62–0.93, p = 0.007), when abstain from alcohol was treated as control. Current smokers (OR 3.42, 95% CI 2.54–4.60, p < 0.001) and ex-smokers (OR 1.73, 95% CI 1.24–2.42, p = 0.001) had a higher risk of clinically relevant depression than never-smokers.

Conclusions

The estimated prevalence of depressive symptoms in a representative sample of the Korean adult population was 6.1%. This study suggests that younger age, female sex, elementary school graduation, living alone, low household income, current smoking, and being unemployed are associated with depressive symptoms.

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References

  1. World Health Organization (2017) Depression

  2. Choi YJ, Lee WY (2017) The prevalence of suicidal ideation and depression among primary care patients and current management in South Korea. Int J Ment Health Syst 11:18

    Article  PubMed  PubMed Central  Google Scholar 

  3. Lee CK, Kwak YS, Yamamoto J, Rhee H, Kim YS, Han JH et al (1990) Psychiatric epidemiology in Korea. Part I: gender and age differences in Seoul. J Nerv Ment Dis 178:242–246

    Article  CAS  PubMed  Google Scholar 

  4. Cho MJ, Kim J, Jeon HJ, Suh T, Chung I, Hong JP et al (2007) Lifetime and 12-month prevalence of DSM-IV psychiatric disorders among Korean adults. J Nerv Ment Dis 195:203–210

    Article  PubMed  Google Scholar 

  5. Spitzer RL, Kroenke K, Williams JB (1999) Validation and utility of a self-report version of PRIME-MD: the PHQ primary care study. Primary care evaluation of mental disorders. Patient Health Questionnaire. JAMA 282:1737–1744

    Article  CAS  PubMed  Google Scholar 

  6. Kroenke K, Spitzer RL, Williams JB (2001) The PHQ-9: validity of a brief depression severity measure. J Gen Intern Med 16:606–613

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  7. Hong JW, Jeon JH, Ku CR, Noh JH, Yoo HJ, Kim D (2015) The prevalence and factors associated with hearing impairment in the Korean adults: the 2010–2012 Korea National Health and Nutrition Examination Survey (observational study). Medicine 94:e611–e611

    Article  PubMed  PubMed Central  Google Scholar 

  8. Manea L, Gilbody S, McMillan D (2015) A diagnostic meta-analysis of the Patient Health Questionnaire-9 (PHQ-9) algorithm scoring method as a screen for depression. Gen Hosp Psychiatry 37:67–75

    Article  PubMed  Google Scholar 

  9. Han C, Jo SA, Kwak JH, Pae CU, Steffens D, Jo I et al (2008) Validation of the Patient Health Questionnaire-9 Korean version in the elderly population: the Ansan Geriatric study. Compr Psychiatry 49:218–223

    Article  PubMed  Google Scholar 

  10. Kim YE, Lee B (2019) The psychometric properties of the Patient Health Questionnaire-9 in a Sample of Korean University Students. Psychiatry Investig 16:904–910

    Article  PubMed  PubMed Central  Google Scholar 

  11. Chang SM, Hahm B, Lee J, Shin MS, Jeon HJ, Hong J et al (2008) Cross-national difference in the prevalence of depression caused by the diagnostic threshold. J Affect Disord 106:159–167

    Article  PubMed  Google Scholar 

  12. Weissman MM, Bland RC, Canino GJ, Faravelli C, Greenwald S, Hwu HG et al (1996) Cross-national epidemiology of major depression and bipolar disorder. JAMA 276:293–299

    Article  CAS  PubMed  Google Scholar 

  13. Ferrari AJ, Somerville AJ, Baxter AJ, Norman R, Patten SB, Vos T et al (2013) Global variation in the prevalence and incidence of major depressive disorder: a systematic review of the epidemiological literature. Psychol Med 43:471–481

    Article  CAS  PubMed  Google Scholar 

  14. Yang Y (2007) Is old age depressing? Growth trajectories and cohort variations in late-life depression. J Health Soc Behav 48:16–32

    Article  CAS  PubMed  Google Scholar 

  15. Wang J, Wu X, Lai W, Long E, Zhang X, Li W et al (2017) Prevalence of depression and depressive symptoms among outpatients: a systematic review and meta-analysis. BMJ Open 7:e017173–e017173

    Article  PubMed  PubMed Central  Google Scholar 

  16. Jorm AF (2000) Does old age reduce the risk of anxiety and depression? A review of epidemiological studies across the adult life span. Psychol Med 30:11–22

    Article  CAS  PubMed  Google Scholar 

  17. Rao U, Chen LA (2009) Characteristics, correlates, and outcomes of childhood and adolescent depressive disorders. Dialogues Clin Neurosci 11:45–62

    Article  PubMed  PubMed Central  Google Scholar 

  18. Andersen SL, Teicher MH (2008) Stress, sensitive periods and maturational events in adolescent depression. Trends Neurosci 31:183–191

    Article  CAS  PubMed  Google Scholar 

  19. Alexopoulos GS (2005) Depression in the elderly. Lancet 365:1961–1970

    Article  PubMed  Google Scholar 

  20. Lee WK (2016) Psychological characteristics of self-harming behavior in Korean adolescents. Asian J Psychiatr 23:119–124

    Article  PubMed  Google Scholar 

  21. Kwak CW, Ickovics JR (2019) Adolescent suicide in South Korea: risk factors and proposed multi-dimensional solution. Asian J Psychiatr 43:150–153

    Article  PubMed  Google Scholar 

  22. Kim H, Song YJ, Yi JJ, Chung WJ, Nam CM (2004) Changes in mortality after the recent economic crisis in South Korea. Ann Epidemiol 14:442–446

    Article  CAS  PubMed  Google Scholar 

  23. Yoo KB, Park EC, Jang SY, Kwon JA, Kim SJ, Cho KH et al (2016) Association between employment status change and depression in Korean adults. BMJ Open 6:e008570

    Article  PubMed  PubMed Central  Google Scholar 

  24. Jang SY, Jang SI, Bae HC, Shin J, Park EC (2015) Precarious employment and new-onset severe depressive symptoms: a population-based prospective study in South Korea. Scand J Work Environ Health 41:329–337

    Article  PubMed  Google Scholar 

  25. Bromet E, Andrade LH, Hwang I, Sampson NA, Alonso J, de Girolamo G et al (2011) Cross-national epidemiology of DSM-IV major depressive episode. BMC Med 9:90

    Article  PubMed  PubMed Central  Google Scholar 

  26. Silva MT, Caicedo Roa M, Martins SS, da Silva ATC, Galvao TF (2017) Prevalence and correlates of depressive symptoms among adults living in the Amazon, Brazil: a population-based study. J Affect Disord 222:162–168

    Article  PubMed  Google Scholar 

  27. Meng X, Brunet A, Turecki G, Liu A, D’Arcy C, Caron J (2017) Risk factor modifications and depression incidence: a 4-year longitudinal Canadian cohort of the Montreal Catchment Area Study. BMJ Open 7:e015156–e015156

    Article  PubMed  PubMed Central  Google Scholar 

  28. Solomon MB, Herman JP (2009) Sex differences in psychopathology: of gonads, adrenals and mental illness. Physiol Behav 97:250–258

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  29. Faravelli C, Alessandra Scarpato M, Castellini G, Lo Sauro C (2013) Gender differences in depression and anxiety: the role of age. Psychiatry Res 210:1301–1303

    Article  PubMed  Google Scholar 

  30. Todd M, Teitler J (2019) Darker days? Recent trends in depression disparities among US adults. Am J Orthopsychiatry. 89(6):727

    Article  PubMed  Google Scholar 

  31. Miech RA, Eaton WW, Brennan K (2005) Mental health disparities across education and sex: a prospective analysis examining how they persist over the life course. J Gerontol B Psychol Sci Soc Sci 60(Spec No 2):93–98

    Article  PubMed  Google Scholar 

  32. Quesnel-Vallee A, Taylor M (2012) Socioeconomic pathways to depressive symptoms in adulthood: evidence from the National Longitudinal Survey of Youth 1979. Soc Sci Med 74:734–743

    Article  PubMed  Google Scholar 

  33. Guralnik JM, Land KC, Blazer D, Fillenbaum GG, Branch LG (1993) Educational status and active life expectancy among older blacks and whites. N Engl J Med 329:110–116

    Article  CAS  PubMed  Google Scholar 

  34. Domenech-Abella J, Mundo J, Leonardi M, Chatterji S, Tobiasz-Adamczyk B, Koskinen S et al (2018) The association between socioeconomic status and depression among older adults in Finland, Poland and Spain: a comparative cross-sectional study of distinct measures and pathways. J Affect Disord 241:311–318

    Article  PubMed  Google Scholar 

  35. Freeman A, Tyrovolas S, Koyanagi A, Chatterji S, Leonardi M, Ayuso-Mateos JL et al (2016) The role of socio-economic status in depression: results from the COURAGE (aging survey in Europe). BMC Public Health 16:1098

    Article  PubMed  PubMed Central  Google Scholar 

  36. Lorant V, Deliège D, Eaton W, Robert A, Philippot P, Ansseau M (2003) Socioeconomic inequalities in depression: a meta-analysis. Am J Epidemiol 157:98–112

    Article  CAS  PubMed  Google Scholar 

  37. Zimmerman FJ, Katon W (2005) Socioeconomic status, depression disparities, and financial strain: what lies behind the income-depression relationship? Health Econ 14:1197–1215

    Article  PubMed  Google Scholar 

  38. Osafo Hounkpatin H, Wood AM, Brown GD, Dunn G (2015) Why does income relate to depressive symptoms? Testing the income rank hypothesis longitudinally. Soc Indic Res 124:637–655

    Article  PubMed  Google Scholar 

  39. Hoebel J, Maske UE, Zeeb H, Lampert T (2017) Social inequalities and depressive symptoms in adults: the role of objective and subjective socioeconomic status. PLoS ONE 12:e0169764–e0169764

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  40. Awaworyi Churchill S, Farrell L (2017) Alcohol and depression: evidence from the 2014 health survey for England. Drug Alcohol Depend 180:86–92

    Article  CAS  PubMed  Google Scholar 

  41. Bellos S, Skapinakis P, Rai D, Zitko P, Araya R, Lewis G et al (2013) Cross-cultural patterns of the association between varying levels of alcohol consumption and the common mental disorders of depression and anxiety: secondary analysis of the WHO Collaborative Study on Psychological Problems in General Health Care. Drug Alcohol Depend 133:825–831

    Article  PubMed  Google Scholar 

  42. Boden JM, Fergusson DM (2011) Alcohol and depression. Addiction 106:906–914

    Article  PubMed  Google Scholar 

  43. World Health Organization World: Total alcohol per capita consumption, in litres of pure alcohol, projected estimates, 2015. World Health Statistics 2016

  44. Lee HK, Chou SP, Cho MJ, Park JI, Dawson DA, Grant BF (2010) The prevalence and correlates of alcohol use disorders in the United States and Korea–a cross-national comparative study. Alcohol 44:297–306

    Article  PubMed  PubMed Central  Google Scholar 

  45. Boden JM, Fergusson DM, Horwood LJ (2010) Cigarette smoking and depression: tests of causal linkages using a longitudinal birth cohort. Br J Psychiatry 196:440–446

    Article  PubMed  Google Scholar 

  46. Flensborg Madsen T, von Scholten MB, Flachs EM, Mortensen EL, Prescott E, Tolstrup JS (2011) Tobacco smoking as a risk factor for depression. A 26-year population-based follow-up study. J Psychiatr Res 45:143–149

    Article  PubMed  Google Scholar 

Download references

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Correspondence to Dong-Jun Kim.

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Hong, J.W., Noh, J.H. & Kim, DJ. The prevalence of and factors associated with depressive symptoms in the Korean adults: the 2014 and 2016 Korea National Health and Nutrition Examination Survey. Soc Psychiatry Psychiatr Epidemiol 56, 659–670 (2021). https://doi.org/10.1007/s00127-020-01945-2

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  • DOI: https://doi.org/10.1007/s00127-020-01945-2

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