A survey of depressive symptoms among South Korean adults after the Korean financial crisis of late 1997: prevalence and correlates

Association between serum vitamin D and depressive symptoms in apparently healthy male adults undergoing routine health check-ups at a single centre

OBJECTIVE

To determine the level of vitamin D and to identify the association between vitamin D and depressive symptoms in apparently healthy Korean male adults.

DESIGN

A retrospective study design. Among 43 513 participants between 1 March and 30 November 2018, after eliminating participants with a history of depression or vitamin D deficiency, 9058 were included. To determine the level of vitamin D, serum 25-hydroxyvitamin D [25(OH)D] was measured. To assess the level of depression, the Korean version of the Center for Epidemiologic Studies Depression Scale (CES-D) was used.

SETTING

South Korea.

PARTICIPANTS

Male adults who underwent routine health check-ups.

RESULTS

The average vitamin D level was 22·31 ± 7·09 ng/ml as 25(OH)D, while the number of subjects in the vitamin D insufficiency group with a finding of <20 ng/ml was 3783 (41·8 %). The mean CES-D score in all subjects was 8·31 ± 5·97 points, and the proportion of the depressive symptoms group with a score of ≥16 was 8·71 %. The OR of patients in the depressive symptoms group also being in the insufficiency group was found to be 1·49 (95 % CI 1·12, 2·00).

CONCLUSIONS

A total of 41·8 % of apparently healthy male adults had vitamin D levels <20 ng/ml. We identified an association between vitamin D insufficiency and depressive symptoms in apparently healthy Korean male adults.

Association between Urban Greenness and Depressive Symptoms: Evaluation of Greenness Using Various Indicators

An increasing number of studies have suggested benefits of greenness exposure on mental health. We examined the association between urban greenness and depressive symptoms in adults in the general population living in the seven major cities in Korea (N = 65,128). Using data from the Korean Community Health Survey 2009, depressive symptoms were measured on the Center for Epidemiological Studies Depression Scale (CES-D). Greenness was assessed using Normalized Difference Vegetation Index (NDVI) and land-use data (forest area and forest volume). Logistic regression models were fitted to adjust for potential confounders. Individuals in regions with the highest NDVI (quartile 4) had the lowest odds for depressive symptoms compared to quartile 1, after adjusting for potential confounders (OR = 0.813; 95% CI: 0.747, 0.884). For all greenness indicators except for forest area per district area (%), the highest rate of depressive symptoms was found for the individuals in the lowest quartile of greenness (quartile 1) and the lowest rate of depressive symptoms for those in the highest quartile of greenness (quartile 4). We found an inverse association between urban greenness and depressive symptoms, which was consistent across a variety of greenness indicators. Our study suggests health benefits of greenness and could provide a scientific basis for policy making and urban planning.

The association between attempted suicide and stock price movements: Evidence from Taiwan

This study is the first comprehensive analysis to investigate the potential association between stock market fluctuations and attempted suicide events as measured by self-inflicted injuries treated in hospitalization. Using nationwide, 15-year population-based data from 1998 through 2012, we observe that the occurrences for the hospitalizations of attempted suicides are apparently predicted by stock price movements. A low stock price index, a daily fall in the stock index, and consecutive daily falls in the stock index have been shown to be associated with increased risk of hospitalization in patients with attempted suicide. More specifically, stock price index is found to be significant impact on attempted suicide in the 45-54 age groups of both genders, whilst daily change is significant for both genders in the 25-34 and 55-64 age groups and accumulated change is only significant in female aged 25-44 and above 65. On the basis of the results, relevant organizations should consider the suicidal factors that relate prime-working-age and near-retirement-age people to better carry out specific suicide prevention measures, and, meanwhile, encourage those people to pay less attention towards daily stock price movements.

Can Psychological, Social and Demographical Factors Predict Clinical Characteristics Symptomatology of Bipolar Affective Disorder and Schizophrenia?

Schizophrenia (SCH) is a complex, psychiatric disorder affecting 1 % of population. Its clinical phenotype is heterogeneous with delusions, hallucinations, depression, disorganized behaviour and negative symptoms. Bipolar affective disorder (BD) refers to periodic changes in mood and activity from depression to mania. It affects 0.5-1.5 % of population. Two types of disorder (type I and type II) are distinguished by severity of mania episodes. In our analysis, we aimed to check if clinical and demographical characteristics of the sample are predictors of symptom dimensions occurrence in BD and SCH cases. We included total sample of 443 bipolar and 439 schizophrenia patients. Diagnosis was based on DSM-IV criteria using Structured Clinical Interview for DSM-IV. We applied regression models to analyse associations between clinical and demographical traits from OPCRIT and symptom dimensions. We used previously computed dimensions of schizophrenia and bipolar affective disorder as quantitative traits for regression models. Male gender seemed protective factor for depression dimension in schizophrenia and bipolar disorder sample. Presence of definite psychosocial stressor prior disease seemed risk factor for depressive and suicidal domain in BD and SCH. OPCRIT items describing premorbid functioning seemed related with depression, positive and disorganised dimensions in schizophrenia and psychotic in BD. We proved clinical and demographical characteristics of the sample are predictors of symptom dimensions of schizophrenia and bipolar disorder. We also saw relation between clinical dimensions and course of disorder and impairment during disorder.

EPA guidance on mental health and economic crises in Europe

This European Psychiatric Association (EPA) guidance paper is a result of the Working Group on Mental Health Consequences of Economic Crises of the EPA Council of National Psychiatric Associations. Its purpose is to identify the impact on mental health in Europe of the economic downturn and the measures that may be taken to respond to it. We performed a review of the existing literature that yields 350 articles on which our conclusions and recommendations are based. Evidence-based tables and recommendations were developed through an expert consensus process. Literature dealing with the consequences of economic turmoil on the health and health behaviours of the population is heterogeneous, and the results are not completely unequivocal. However, there is a broad consensus about the deleterious consequences of economic crises on mental health, particularly on psychological well-being, depression, anxiety disorders, insomnia, alcohol abuse, and suicidal behaviour. Unemployment, indebtedness, precarious working conditions, inequalities, lack of social connectedness, and housing instability emerge as main risk factors. Men at working age could be particularly at risk, together with previous low SES or stigmatized populations. Generalized austerity measures and poor developed welfare systems trend to increase the harmful effects of economic crises on mental health. Although many articles suggest limitations of existing research and provide suggestions for future research, there is relatively little discussion of policy approaches to address the negative impact of economic crises on mental health. The few studies that addressed policy questions suggested that the development of social protection programs such as active labour programs, social support systems, protection for housing instability, and better access to mental health care, particularly at primary care level, is strongly needed.

Association between serum vitamin D and depressive symptoms among female workers in the manufacturing industry

Background

Vitamin D has been known to maintain the body’s balance of calcium and phosphorus as well as skeletal health. There has been increasing emphasis on the importance of vitamin D as recent studies have been reporting the specific functions of vitamin D in the cerebral nervous system and the association between the level of serum vitamin D and depressive symptoms. However, there is currently a paucity of research investigating the association between serum vitamin D and depressive symptoms in Korean subjects. Consequently, this study has aimed to determine the level of serum vitamin D and explore the association between serum vitamin D and depressive symptoms in Korean female workers.

Method

A medical examination, questionnaire, anthropometric measurements, and a blood test were conducted between February 3 and March 7, 2014 in 1054 subjects among female workers in the manufacturing industry who underwent physical examinations in a university hospital. From this data, we identified the level of serum vitamin D and investigated the association between serum vitamin D deficiency and depressive symptoms.

Results

The average serum vitamin D level of the 1054 subjects was 9.07 ± 3.25 ng/mL, and the number of subjects in the serum vitamin D deficiency group with less than 10 ng/mL was 721 (68.4 %). The odds ratio of the depressive symptom group with a CES-D score of 16 or above being in the deficiency group with a serum vitamin D level less than 10 ng/mL was found to be 1.55 (95 % CI = 1.15–2.07).

Conclusion

68.4 % of female workers in the manufacturing industry were in the deficiency group with serum vitamin D levels less than 10 ng/mL. Additionally, we identified an association between serum vitamin D deficiency and depressive symptoms. In the future, if serum vitamin D deficiency is checked regularly in workers, we expect to achieve better outcomes in managing their depressive symptoms.

Prevalence and correlates of depressive symptoms in korean adults: results of a 2009 korean community health survey

The aim of this study was to investigate the prevalence and correlates of depressive symptoms in the largest number of Korean individuals examined to date. We analyzed cross-sectional data collected from 229,595 Korean adults aged 19 yr and above who participated in a Korean Community Health Survey conducted in 2009. The Center for Epidemiologic Studies Depression Scale (CES-D) was used as the measurement tool for depressive symptoms (CES-D score over 16) and definite depression (CES-D score over 25). Multivariate logistic regression analysis was performed to identify associations between sociodemographic factors and depressive symptoms. The percentages of depressive symptoms and definite depression in the total study population were 11% (7.8% for men, 14.0% for women) and 3.7%, (2.4% for men, 5.0% for women), respectively. Female gender, older age, disrupted marital status, low education and income level, multigenerational household composition and metropolitan residence were associated with greater risk of depressive symptoms. The present study provides a valid prevalence and correlates of depressive symptoms, using the largest representative sample of the Korean general population to date. Various sociodemographic factors contribute to the prevalence and effects of depressive symptoms in Korea.

The measurement of poverty in psychiatric epidemiology in LMICs: critical review and recommendations

PURPOSE

Studies exploring the relationship between poverty and mental health in low and middle income countries (LMICs) have produced somewhat conflicting results. This has partly been attributed to poorly operationalized and oversimplified poverty measures. This paper has two aims: (1) to review how socio-economic outcomes in psychiatric epidemiology in LMICs are measured; (2) based on this review, to provide a set of generic recommendations for measuring poverty in psychiatric epidemiology in LMIC. This is relevant for mental health researchers, and for practitioners and policy makers who use mental health research findings.

METHODS

This review was part of a broader systematic review examining the association between poverty and mental illness. An analytic framework was developed to examine the definition and measurement of poverty in these studies.

RESULTS

The majority of studies provided no definition for the concept of poverty being used, and very few measured poverty through standardized or validated methods. Many poverty indicators were broken down into extremely open-ended and vague categories, with no details on how the parameters were defined or derived, and no documentation of the time period and unit of analysis for which the poverty variable was measured.

CONCLUSIONS

This review revealed that using poverty as an indicator in mental health research in LMIC is still in its infancy, with much room for improvement. The implications of poor measurement of poverty in psychiatric epidemiology are discussed. The recommendations provided will hopefully help researchers in psychiatric epidemiology use the concept of poverty in a much more critical, systematic and appropriate manner.

Depression among the urban poor in Peninsular Malaysia: A community based cross-sectional study

This community based cross-sectional study examined the prevalence and factors associated with depression among urban poor in Peninsular Malaysia. The Patient Health Questionnaire (PHQ-9) was used to determine the presence or absence of depression. The prevalence of depression among the urban poor was 12.3%. Factors significantly associated with depression included respondents under 25 years old, male gender, living in the area for less than four years and those who do not exercise regularly. It is important to identify individuals with depression and its associated factors early because depression can severely affect the quality of life.

Depression: point-prevalence and sociodemographic correlates in a Buenos Aires community sample

BACKGROUND

Since the current epidemiology of depression is not well documented in Latin America, we conducted a community-based survey study in Argentina.

METHODS

The Beck Depression Inventory (BDI) and a general health questionnaire were completed by 1335 adult participants, representing most of the neighborhoods of Buenos Aires.

RESULTS

Prevalence of high total BDI scores (≥13) indicating probable current clinically significant depression was 20.0% (women: 20.6%; men: 19.6%). Probable depression was associated with being unmarried and older, less educated, reporting recent stressors and significant medical illness.

LIMITATIONS

Sampling was cross-sectional and by convenience; probable depression was not verified by clinical assessment.

CONCLUSIONS

Within methodological limits, probable current clinically significant depression was highly prevalent in an urban community sample in Argentina, at rates and with risk factors similar to those found in other world regions.

Association between interpersonal trust, reciprocity, and depression in South Korea: a prospective analysis

BACKGROUND

A growing body of empirical evidence indicates that low-level social capital is related to poor mental health outcomes. However, the prospective association between social capital and depression remains unclear, and no published studies have investigated the association with longitudinal data in East-Asian countries.

METHODS

We analyzed data from the ongoing Korean Welfare Panel Study to prospectively investigate association between social capital and depression. Social capital was measured at the individual level by two items specific to interpersonal trust and reciprocity. Depression was annually assessed as a dichotomous variable using the Center for Epidemiologic Studies Depression Scale. After excluding participants who had depression in 2006, logistic regression models were applied to estimate the association between each social capital indicator and new-onset depression developed in 2007 or long-term depression in both 2007 and 2008. We also examined the association in a subpopulation restricted to healthy participants after excluding individuals with any pre-existing disability, chronic disease, or poor self-rated health condition.

RESULTS

Compared to the high interpersonal trust group, the odds ratios of developing new-onset and long-term depression among the low interpersonal trust group were 1.22 (95% CI: 1.08∼1.38) and 1.23 (95% CI: 1.03∼1.50), respectively, and increased to 1.32 (95% CI: 1.10∼1.57) and 1.47 (95% CI: 1.05∼2.08) in the subpopulation analyses restricted to healthy individuals. Although the low and intermediate reciprocity group also had significantly higher odds of developing new-onset depression compared to the high reciprocity group, the effects were attenuated and statistically non-significant in the subpopulation analyses.

CONCLUSION

Low interpersonal trust appears to be an independent risk factor for new-onset and long-term depression in South Korea.

Employed women with depression in Korea

Korean women have been reported to be more susceptible to depressive symptoms than men. In this study we explored the important predictors of depression among employed Korean women using modified Hauenstein's Nursing Practice Paradigm for Depressed Rural Women, focusing on the relationship of stressful life events and three resources (physiological, social, and psychological). In particular, we examined the moderating effects of resources on the stress-depression relationship among a community-based sample of employed Korean women. In this cross-sectional study, survey data were collected with 767 employed women in Korea over a 2-month period in 2006. Of these respondents, 286 depressed participants' data were analysed to test moderating effects of the three resources on depression. Our hierarchical multiple regression results revealed that stressful life events directly affected depression. However, after including the product terms of the three resources (i.e. regular exercise, self-efficacy, and closeness) and stressful life events, the main effect of stressful life events disappeared, confirming significant moderating effects of the resources. The findings would contribute to development of a body of culturally sensitive knowledge for clinical practice with depressed employed Korean women.

Was the economic crisis 1997-1998 responsible for rising suicide rates in East/Southeast Asia? A time-trend analysis for Japan, Hong Kong, South Korea, Taiwan, Singapore and Thailand

In 1997-1998 a widespread economic crisis hit the economies of many East/Southeast Asian countries; its impact on suicide rates across the region has not been systematically documented. We investigated the impact of the Asian economic crisis (1997-1998) on suicide in Japan, Hong Kong, South Korea, Taiwan, Singapore and Thailand. Suicide and population data for the period 1985-2006 were extracted from the World Health Organisation's mortality database and Taiwanese mortality statistics. Sex-specific age-standardised suicide rates for people aged 15years or above were analysed using joinpoint regression. Trends in divorce, marriage, unemployment, gross domestic product (GDP) per capita and alcohol consumption were compared with trends in suicide rates graphically and using time-series analysis. Suicide mortality decreased in the late 1980s and early 1990s but subsequently increased markedly in all countries except Singapore, which had steadily declining suicide rates throughout the study period. Compared to 1997, male rates in 1998 rose by 39% in Japan, 44% in Hong Kong and 45% in Korea; rises in female rates were less marked. Male rates also rose in Thailand, but accurate data were incomplete. The economic crisis was associated with 10,400 more suicides in 1998 compared to 1997 in Japan, Hong Kong and Korea. Similar increases in suicide rates were not seen in Taiwan and Singapore, the two countries where the economic crisis had a smaller impact on GDP and unemployment. Time-series analyses indicated that some of the crisis's impact on male suicides was attributable to increases in unemployment. These findings suggest an association of the Asian economic crisis with a sharp increase in suicide mortality in some, but not all, East/Southeast Asian countries, and that these increases were most closely associated with rises in unemployment.

Socio-economic status over the life-course and depressive symptoms in men and women in Eastern Europe

OBJECTIVE

Research into social inequalities in depression has studied western populations but data from non-western countries are sparse. In this paper, we investigate the extent of social inequalities in depression in Eastern Europe, the relative importance of social position at different points of the life-course, and whether social patterning of depression differs between men and women.

METHOD

A cross-sectional study examined 12,053 men and 13,582 women in Russia, Poland and the Czech Republic. Depressive symptoms (16 or above on the CESD-20) were examined in relation to socio-economic circumstances at three phases of the life-course: childhood (household amenities and father's education); own education; current circumstances (financial difficulties and possession of household items).

RESULTS

Pronounced social differences in depression exist in men and women throughout Eastern Europe. Depression was largely influenced by current circumstances rather than by early life or education, with effects stronger in Poland and Russia. Odds ratios in men for current disadvantage were 3.16 [95% CI: 2.57-3.89], 3.16 [2.74-3.64] and 2.17 [1.80-2.63] in Russia, Poland and the Czech Republic respectively. Social variables did not explain the female excess in depression, which varied from 2.91 [2.58-3.27] in Russia to 1.90 [1.74-2.08] in Poland. Men were more affected by adult disadvantage than women, leading to narrower sex differentials in the presence of disadvantage.

LIMITATIONS

Cross-sectional data with recall of childhood conditions were used.

CONCLUSION

Current social circumstances are the strongest influence on increased depressive symptoms in countries which have recently experienced social changes.

The prevalence of anxiety symptoms and depressive symptoms in patients with somatic disorders in urban China: a multi-center cross-sectional study

OBJECTIVE

To assess the prevalence of anxiety and depressive symptoms among patients with somatic diseases in urban China.

METHOD

A hospital-based cross-sectional study was carried out in four major cities of China from June to August in 2004. There were 2111 eligible subjects with Stroke, Parkinson's Disease, Epilepsy, Irritable Bowel Syndrome, Functional Dyspepsia, and Menopausal Syndrome, and 317 Post-natal women were recruited from general hospitals. Self-completed hospital anxiety and depression scale (HAD) questionnaire was used for screening anxiety and/or depressive symptoms. Subjects with a HAD score of > = 9 were further assessed with Hamilton anxiety scale (HAMA) and Hamilton depression scale (HAMD) by certified psychologists or psychiatrists.

RESULTS

The prevalence of "screened" depressive and anxiety symptoms using HAD were 11-19% and 11-22% respectively in patients with above somatic diseases and post-natal women. Assessed by HAMA/HAMD scale, the prevalence of "definite" depressive symptoms was 30%-59% in subjects with "screened" depressive symptoms, and 44%-84% in subjects with "screened" anxiety symptoms. About half of the subjects had co-morbidity depressive and anxiety symptoms. Less than one-fourth of these subjects had ever been diagnosed as depressive/anxiety disorders and been treated prior to the investigation.

CONCLUSION

There is a high prevalence and low diagnosis and treatment rate of depressive and anxiety symptoms in patients with these somatic diseases in China.

Depressive symptoms in urban population samples in Russia, Poland and the Czech Republic

BACKGROUND

Relatively little is known about depression in countries that were formerly part of the Soviet Union, especially Russia.

AIMS

To investigate the rates and distribution of depressive symptoms in urban population samples in Russia, Poland and the Czech Republic.

METHOD

A cross-sectional study was conducted in randomly selected men and women aged 45-64 years (n=2151 in total, response rate 69%) in Novosibirsk (Russia), Krakow (Poland) and Karvina (Czech Republic). The point prevalence of depressive symptoms in the past week was defined as a score of at least 16 on the Center for Epidemiological Studies Depression scale.

RESULTS

In men the prevalence of depressive symptoms was 23% in Russia, 21% in Poland and 19% in the Czech Republic; in women the rates were 44%, 40% and 34% respectively. Depressive symptoms were positively associated with material deprivation, being unmarried and binge drinking. The association between education and depression was inverse in Poland and the Czech Republic but positive in Russia.

CONCLUSIONS

The prevalence of depressive symptoms in these eastern European urban populations was relatively high; as in other countries, it was associated with alcohol and several sociodemographic factors.

Self-reported sleep quality in family caregivers of gastric cancer patients who are receiving chemotherapy in Korea

BACKGROUND

Shifting of cancer care from inpatient to outpatient in Korea can lead to negative outcomes for family caregivers. Little research has been performed on Korean family caregivers' sleep quality and its related symptoms: fatigue and depression.

METHODS

We obtained data from a convenient sample of 103 family caregivers. Family caregivers completed sleep, depression, fatigue, and quality of life questionnaires.

RESULTS

Of family caregivers, 80% had poor sleep quality. Positive correlation existed among symptoms, but symptoms were negatively correlated with quality of life.

CONCLUSIONS

Health professionals need to include family caregivers in the overall patient care plan.