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Kim C, Jin H, Kang G, Dusing GJ, Chum A. Patterns of follow-up mental health care after hospitalization for suicide-related behaviors among older adults in South Korea. J Affect Disord 2024; 350:313-318. [PMID: 38237869 DOI: 10.1016/j.jad.2024.01.089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Revised: 01/03/2024] [Accepted: 01/05/2024] [Indexed: 01/21/2024]
Abstract
OBJECTIVE This study aimed to investigate the sociodemographic and clinical factors associated with receiving follow-up mental healthcare within 7 days and 30 days after hospitalization for suicide-related behaviors (SRB) among older adults in South Korea. METHODS Data from the Korean National Health Information Database were used, including information on sociodemographic variables and healthcare utilization. The study cohort consisted of individuals born in 1950 or before with a prior hospitalization record for suicide attempts or probable suicide attempts. Logistic regression analysis was conducted to predict the odds of receiving follow-up care within 7 days and 30 days, adjusting for covariates. RESULTS Among the 37,595 older adults discharged from hospitalization for SRB, 29.13 % and 37.86 % received follow-up care within 7 days and 30 days, respectively. Follow-up care was more common among younger individuals, women, those with higher socio-economic status (SES), urban residents, and individuals with comorbidities. CONCLUSION The provision of mental health follow-up care for older adults after hospitalization for suicide attempts is inadequate in South Korea. Increasing access to follow-up care among those with lower income, residing in rural areas, and older age is crucial. Public awareness campaigns, stigma reduction training for healthcare providers, and system-level changes, such as telemedicine and integrated care pathways, can help bridge the healthcare gap and reduce suicide mortality among older adults.
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Affiliation(s)
- Chungah Kim
- School of Kinesiology and Health Science, York University, Toronto, Ontario, Canada
| | - Hyunju Jin
- College of Physical Education and Health Sciences, Zhejiang Normal University, Jinhua, China; Seoul National University Institute of Sport Science, Seoul, South Korea
| | - Goneui Kang
- Department of Economics, Korea University, Seoul, South Korea
| | | | - Antony Chum
- School of Kinesiology and Health Science, York University, Toronto, Ontario, Canada; Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.
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Baek SU, Lee YM, Yoon JH. Association between long working hours and the development of suicidal ideation among female workers: An 8-year population-based study using the Korean Longitudinal Survey of Women & Family (2012-2020). Psychiatry Res 2024; 333:115731. [PMID: 38237536 DOI: 10.1016/j.psychres.2024.115731] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Revised: 01/08/2024] [Accepted: 01/10/2024] [Indexed: 02/17/2024]
Abstract
Long working hours and overwork have recently emerged as pressing public health concerns. We explored the association between long working hours and suicidal ideation in female workers. A total of 8017 women (24,331 observations) from the fourth to eighth waves of the Korean Longitudinal Survey of Women and Families (2012-2020) were analyzed. To address the repeated measurements within each participant, we employed a generalized estimating equation to estimate the odds ratio (OR) and 95% confidence intervals (CIs). The prevalence of suicidal ideation was 1.9% for those working 35-40 h/week and 4.4% for those working ≥55 h/week. Compared to individuals working 35-40 h/week, those working ≥55 h/week were more likely to experience concurrent suicidal ideation (OR [95% CI]:1.85 [1.43-2.39]). The OR (95% CI) of the association between long working hours and onset of suicidal ideation in the subsequent wave was 1.69 (1.20-2.38) for ≥55 h/week. In subgroup analysis, this association was pronounced among workers with low-income levels (OR [95% CI]: 1.97 [1.29-3.02]) and blue-collar occupations (OR [95% CI]: 2.27 [1.41-3.66]). Policy efforts are required to protect the mental health of female workers exposed to long working hours.
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Affiliation(s)
- Seong-Uk Baek
- Department of Occupational and Environmental Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea; The Institute for Occupational Health, Yonsei University College of Medicine, Seoul, Korea; Graduate School, Yonsei University College of Medicine, Seoul, Korea
| | - Yu-Min Lee
- Department of Occupational and Environmental Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea; The Institute for Occupational Health, Yonsei University College of Medicine, Seoul, Korea
| | - Jin-Ha Yoon
- The Institute for Occupational Health, Yonsei University College of Medicine, Seoul, Korea; Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Korea.
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Baek SU, Kim MS, Lim MH, Kim T, Won JU, Yoon JH. Working hours and the onset of suicidal ideation and depressive symptoms: A 10-year nationwide longitudinal study in South Korea (2012-2022). Psychiatry Res 2023; 326:115344. [PMID: 37473489 DOI: 10.1016/j.psychres.2023.115344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2023] [Revised: 06/17/2023] [Accepted: 07/12/2023] [Indexed: 07/22/2023]
Abstract
Long working hours are associated with adverse health outcomes. We investigated the association between working hours and suicidal ideation and depressive symptoms. We analyzed a nationally representative sample of 11,116 Korean workers, comprising 64,661 observations from 2012 to 2022, to investigate how working hours were associated with mental health problems. To account for repeated measurements in each participant, we employed a generalized estimating equation to estimate risk ratios (RRs) and 95% confidence intervals (CIs). Of the total observations, 13.1% reported working ≥55 h/week. The RR (95% CI) of the association between long working hours and onset of suicidal ideation in the subsequent year was 1.20 (0.95-1.53) for 41-48 h, 1.35 (1.02-1.78) for 49-54 h, and 1.56 (1.23-1.98) for ≥55 h/week, compared to 35-40 h/week. The RR (95% CI) of the association between long working hours and onset of depressive symptoms in the subsequent year was 1.19 (1.07-1.34) for 41-48 h, 1.11 (0.97-1.28) for 49-54 h, and 1.24 (1.10-1.40) for ≥55 h per week, compared to 35-40 h/week. Those working fewer than 35 h/week also had an increased risk of suicidal ideation and depressive symptoms. Policy interventions are needed to reduce excess working hours and protect workers' mental health.
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Affiliation(s)
- Seong-Uk Baek
- Department of Occupational and Environmental Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea; The Institute for Occupational Health, Yonsei University College of Medicine, Seoul, Korea; Graduate School, Yonsei University College of Medicine, Seoul, Korea
| | - Min-Seok Kim
- Department of Occupational and Environmental Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea; The Institute for Occupational Health, Yonsei University College of Medicine, Seoul, Korea; Department of Public Health, Graduate School of Yonsei University, Seoul, Korea
| | - Myeong-Hun Lim
- Department of Occupational and Environmental Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea; The Institute for Occupational Health, Yonsei University College of Medicine, Seoul, Korea; Department of Public Health, Graduate School of Yonsei University, Seoul, Korea
| | - Taeyeon Kim
- Department of Occupational and Environmental Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea; The Institute for Occupational Health, Yonsei University College of Medicine, Seoul, Korea; Department of Public Health, Graduate School of Yonsei University, Seoul, Korea
| | - Jong-Uk Won
- Department of Occupational and Environmental Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea; The Institute for Occupational Health, Yonsei University College of Medicine, Seoul, Korea; Department of Public Health, Graduate School of Yonsei University, Seoul, Korea
| | - Jin-Ha Yoon
- The Institute for Occupational Health, Yonsei University College of Medicine, Seoul, Korea; Department of Public Health, Graduate School of Yonsei University, Seoul, Korea; Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Korea.
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Vasiliadis HM, Léon C, du Roscoät E, Husky MM. Predisposing, enabling and need factors associated with past-year health service use for mental health reasons in adults with suicidal ideation in France. J Affect Disord 2022; 319:62-69. [PMID: 36126787 DOI: 10.1016/j.jad.2022.09.039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2022] [Revised: 09/12/2022] [Accepted: 09/15/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND We aimed to determine the prevalence of past-year health service use for mental health reasons in a French representative sample of adults overall and in those reporting suicidal ideation in the past year and assess the factors associated with health service use according Andersen's model of healthcare seeking behaviors. METHODS Data were drawn from the 2017 Health Barometer survey a large computer-assisted telephone survey on a representative sample of the general population aged 18-75 years living in France (n = 25,319). Logistic regression analyses were used to study past-year health service use for mental health reasons as a function of predisposing, enabling and need factors. Analyses were stratified according to suicidal ideation and sex. RESULTS Among individuals with suicidal ideation, 45.1 % of adults, 50.4 % of females and 37.6 % of males, reported past-year health service use for a mental health reason. Increased odds of health service use were observed regarding predisposing (female sex, younger age, higher education), enabling (income level), and need factors (prior suicide attempts, role impairment and major depression). Among males, the only significant factors included age 65-75 (aOR = 0.16, 95%CI = 0.03-0.84) and major depression (aOR = 2.79, 95%CI = 1.79-4.36). LIMITATIONS Self-reported service utilization. Cross-sectional survey. CONCLUSIONS In a country with a high level of medical coverage, further research is needed to identify sex-specific socio-demographic, economic and clinical differences in the use of different types of health services as well as perceived need for care, structural and attitudinal barriers to treatment.
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Affiliation(s)
- Helen-Maria Vasiliadis
- Département des sciences de la santé communautaire, Université de Sherbrooke, Canada; Centre de recherche Charles-Le Moyne, Campus de Longueuil Université de Sherbrooke, Canada
| | | | - Enguerrand du Roscoät
- Santé publique France, Saint-Maurice, France; Laboratoire Parisien de Psychologie Sociale (LAPPS), EA 4386, Université Paris Nanterre, France
| | - Mathilde M Husky
- Laboratoire de psychologie EA4139, Université de Bordeaux, Bordeaux, France.
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Tang S, Reily NM, Arena AF, Sheanoda V, Han J, Draper B, Batterham PJ, Mackinnon AJ, Christensen H. Predictors of not receiving mental health services among people at risk of suicide: A systematic review. J Affect Disord 2022; 301:172-188. [PMID: 35032506 DOI: 10.1016/j.jad.2022.01.054] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Revised: 12/12/2021] [Accepted: 01/11/2022] [Indexed: 12/19/2022]
Abstract
BACKGROUND The majority of people who die by suicide are unknown to formal mental health services. The current review identified predictors of non-receipt of mental health services among individuals experiencing suicidal thoughts or behaviours. Such data provides insight into the needs and preferences of these individuals and inform improvements to existing services. METHODS PsycInfo, PubMed/Medline, CINAHL, and Web of Science were systematically searched from 1st January 1980 up to 20th September 2021. Included studies examined predictors of not receiving formal mental health services among people at risk of suicide. Study quality was assessed by adapting the Joanna-Briggs Institute Checklist for Analytical Cross-Sectional Studies. Findings were presented with narrative synthesis. PROSPERO registration: CRD42021256795. RESULTS Included studies (n = 35, sample range = 46-19,243) were predominately conducted in the United States. Non-receipt of services in nationally representative studies was varied (25.7-91.8%). Results indicate that non-receipt of mental health services among people with suicidality is associated with minority ethnicity, better perceived general health, lower psychological distress, lower severity of suicidality, no mental health diagnosis, lower perceived need for treatment and lower use of medical services. LIMITATIONS Limitations included few studies conducted in low-middle income countries, limited literature on key predictors of interest, and exclusion of informal sources of support. CONCLUSION Individuals with suicidality who are unknown to mental health services have diverse attributes. For some, non-use of services may result from low suicidal distress and perceived need for treatment. Further research is needed to understand why these predictors are associated with service non-use.
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Affiliation(s)
| | | | | | | | - Jin Han
- Black Dog Institute, UNSW Sydney, NSW, Australia
| | - Brian Draper
- School of Psychiatry, Faculty of Medicine, UNSW Sydney, NSW, Australia
| | - Philip J Batterham
- Black Dog Institute, UNSW Sydney, NSW, Australia; Centre for Mental Health Research, Research School of Population Health, Australian National University, Canberra, ACT, Australia
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Raschke N, Mohsenpour A, Aschentrup L, Fischer F, Wrona KJ. Socioeconomic factors associated with suicidal behaviors in South Korea: systematic review on the current state of evidence. BMC Public Health 2022; 22:129. [PMID: 35042490 PMCID: PMC8765829 DOI: 10.1186/s12889-022-12498-1] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Accepted: 12/24/2021] [Indexed: 11/16/2022] Open
Abstract
Background The economic and human costs of suicide to individuals, families, communities, and society make suicide a major public health problem around the world. Suicide rates in South Korea are among the highest in the world. This paper is the first systematic review investigating socioeconomic risk factors for suicidal behaviors (suicidal ideation, attempted suicides, and completed suicides) in South Korea. Methods We performed a systematic review in Medline and Web of Science. Empirical studies and peer-reviewed articles on the association between individual socioeconomic factors and suicidal behaviors have been included. A total of 53 studies were included in a descriptive synthesis. Results Overall, 35 studies focused on the association between individual socioeconomic factors and suicidal ideation, 16 were related to suicide attempts, while 10 addressed completed suicides. Low income, unemployment, and financial difficulties were identified as risk factors for all suicidal behaviors. Working in precarious conditions, long working hours, self-employment, changes in employment status, shift work/night-time work, and occupational stress were associated with an increased risk for suicidal ideation. Low educational attainment appears to increase the risk for suicide attempts and completed suicide, but the significance of educational attainment on the reporting of suicidal ideation could not be verified. The primary studies were unable to ascertain whether the place of residence impacts on suicidal behaviors. Conclusions The results highlight the relevance of socioeconomic factors for suicidal behaviors in South Korea. Governmental social spending must be increased and redirected more efficiently so that the economically most vulnerable groups are financially protected and income inequality does not widen. Furthermore, comprehensive prevention strategies at the community level are needed. Future research needs to focus on identifying vulnerable groups for whom the effects of low socioeconomic status may have particularly serious consequences with regard to suicidal behaviors. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-12498-1.
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Cherrie M, Curtis S, Baranyi G, McTaggart S, Cunningham N, Licence K, Dibben C, Bambra C, Pearce J. Use of sequence analysis for classifying individual antidepressant trajectories to monitor population mental health. BMC Psychiatry 2020; 20:551. [PMID: 33228576 PMCID: PMC7684902 DOI: 10.1186/s12888-020-02952-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2020] [Accepted: 11/15/2020] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Over the past decade, antidepressant prescriptions have increased in European countries and the United States, partly due to an increase in the number of new cases of mental illness. This paper demonstrates an innovative approach to the classification of population level change in mental health status, using administrative data for a large sample of the Scottish population. We aimed to identify groups of individuals with similar patterns of change in pattern of prescribing, validate these groups by comparison with other indicators of mental illness, and characterise the population most at risk of increasing mental ill health. METHODS National Health Service (NHS) prescription data were linked to the Scottish Longitudinal Study (SLS), a 5.3% sample of the Scottish population (N = 151,418). Antidepressant prescription status over the previous 6 months was recorded for every month for which data were available (January 2009-December 2014), and sequence dissimilarity was computed by optimal matching. Hierarchical clustering was used to create groups of participants who had similar patterns of change, with multi-level logistic regression used to understand group membership. RESULTS Five distinct prescription pattern groups were observed, indicating: no prescriptions (76%), occasional prescriptions (10%), continuation of prior use of prescriptions (8%), a new course of prescriptions started (4%) or ceased taking prescriptions (3%). Young, white, female participants, of low social grade, residing in socially deprived neighbourhoods, living alone, being separated/divorced or out of the labour force, were more likely to be in the group that started a new course of antidepressant prescriptions. CONCLUSIONS The use of sequence analysis for classifying individual antidepressant trajectories offers a novel approach for capturing population-level changes in mental health risk. By classifying individuals into groups based on their anti-depressant medication use we can better identify how over time, mental health is associated with individual risk factors and contextual factors at the local level and the macro political and economic scale.
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Affiliation(s)
- Mark Cherrie
- School of GeoSciences, The University of Edinburgh, Edinburgh, Scotland, UK. .,Institute of Occupational Medicine, Edinburgh, Scotland, UK.
| | - Sarah Curtis
- grid.4305.20000 0004 1936 7988School of GeoSciences, The University of Edinburgh, Edinburgh, Scotland, UK ,grid.8250.f0000 0000 8700 0572Department of Geography, Durham University, Durham, UK
| | - Gergő Baranyi
- grid.4305.20000 0004 1936 7988School of GeoSciences, The University of Edinburgh, Edinburgh, Scotland, UK
| | | | - Niall Cunningham
- grid.1006.70000 0001 0462 7212School of Geography, Politics & Sociology, Newcastle University, Newcastle upon Tyne, UK
| | - Kirsty Licence
- grid.508718.3Public Health Scotland, Edinburgh, UK ,grid.413893.40000 0001 2232 4338Health Protection Scotland, Glasgow, UK
| | - Chris Dibben
- grid.4305.20000 0004 1936 7988School of GeoSciences, The University of Edinburgh, Edinburgh, Scotland, UK ,grid.4305.20000 0004 1936 7988Scottish Centre for Administrative Data Research, University of Edinburgh, Edinburgh, UK
| | - Clare Bambra
- grid.1006.70000 0001 0462 7212Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Jamie Pearce
- grid.4305.20000 0004 1936 7988School of GeoSciences, The University of Edinburgh, Edinburgh, Scotland, UK
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Factors Influencing Formal and Informal Resource Utilization for Mental Distress Among Korean Americans in Southern California. J Immigr Minor Health 2020; 23:528-535. [PMID: 32681495 DOI: 10.1007/s10903-020-01050-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Despite the high prevalence of mental distress in the Korean American (KA) community, KAs continue to have significantly lower rates of professional mental health utilization than the general U.S. population, making it increasingly critical to study factors related to such utilization. A total of 243 surveys were collected at Korean churches of various denominations in the greater Los Angeles area. This cross sectional study examined KAs' resource utilization using Andersen's Behavioral Model of Health Services Use as a multi-level theoretical framework. Level of education and employment status significantly predicted professional health service utilization. Informal resource utilization was significantly influenced by gender, attitudes toward professional mental health services, acculturation, and views of God and religion. Future studies should further explore which types of interventions or resources would be most effective for KAs to decrease their high levels of mental distress based on their unique intersections and cultural realities.
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An S, Lee H. Suicide Stigma in Online Social Interactions: Impacts of Social Capital and Suicide Literacy. HEALTH COMMUNICATION 2019; 34:1340-1349. [PMID: 29924653 DOI: 10.1080/10410236.2018.1486691] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
This study examined whether and when people are more likely to conform to stigmatizing views on suicide in online social interactions. Two key factors in the study included characteristics of individuals' social capital and suicide literacy. Study 1 analyzed national survey data to explore the relationships, and Study 2 involved a vignette to gauge the extent to which people conform to stigmatizing attitudes toward suicidal people under group pressure. Results showed that those emphasizing social networks demonstrated higher levels of suicide stigma, while those with more interpersonal trust showed lower levels of stigma. However, in relation to interpersonal trust, suicide literacy played a moderating role in that those with lower levels of interpersonal trust showed significantly less conformity when they had high suicide literacy.
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Affiliation(s)
- Soontae An
- Division of Communication and Media, Ewha Womans University
| | - Hannah Lee
- Division of Communication and Media, Ewha Womans University
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Han KM, Jee HJ, An H, Shin C, Yoon HK, Ko YH, Ham BJ, Kim YK, Han C. Intimate partner violence and incidence of depression in married women: A longitudinal study of a nationally representative sample. J Affect Disord 2019; 245:305-311. [PMID: 30419530 DOI: 10.1016/j.jad.2018.11.041] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2018] [Revised: 09/16/2018] [Accepted: 11/03/2018] [Indexed: 11/30/2022]
Abstract
BACKGROUND Intimate partner violence (IPV) has a serious detrimental effect on mental health outcomes. We aimed to investigate the association of verbal or physical IPV with incidence of depressive symptoms in both married women and men according to the victim-perpetrator role. The potential mediating role of verbal or physical IPV in the association between satisfaction level with family relationships or childhood adversity and the incidence of depressive symptoms in married adults was also explored. METHODS The Korea Welfare Panel Study (KOWEPS) in 2006 and 2007 dataset was analyzed for 9217 married respondents aged 19 years or older. Physical and verbal IPV was assessed according to victim-perpetrator role in 2006. Depressive symptoms were evaluated by the Center for Epidemiologic Studies Depression Scale, 11-item version in 2006 and 2007. Association of IPV with incidental depressive symptoms was investigated with logistic regression analysis fully-adjusted for all potential confounding factors. RESULTS The bidirectional role of verbal IPV and victimization by physical IPV led to incidence of depressive symptoms in married women. Verbal IPV significantly mediated the association between satisfaction level with the family relationship and incidental depressive symptoms in women. LIMITATIONS We did not investigate the influence of premorbid depressive symptoms on new-onset IPV. CONCLUSIONS This study is the first to demonstrate that gender and the victim-perpetrator role are critical moderating factors in the association between IPV and depressive symptom incidence using a nationally representative sample.
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Affiliation(s)
- Kyu-Man Han
- Department of Psychiatry, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Republic of Korea
| | - Hee-Jung Jee
- Department of Biostatistics, Korea University College of Medicine, Seoul, Republic of Korea
| | - Hyonggin An
- Department of Biostatistics, Korea University College of Medicine, Seoul, Republic of Korea
| | - Cheolmin Shin
- Department of Psychiatry, Korea University Ansan Hospital, Korea University College of Medicine, Ansan, Republic of Korea
| | - Ho-Kyoung Yoon
- Department of Psychiatry, Korea University Ansan Hospital, Korea University College of Medicine, Ansan, Republic of Korea
| | - Young-Hoon Ko
- Department of Psychiatry, Korea University Ansan Hospital, Korea University College of Medicine, Ansan, Republic of Korea
| | - Byung-Joo Ham
- Department of Psychiatry, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Republic of Korea
| | - Yong-Ku Kim
- Department of Psychiatry, Korea University Ansan Hospital, Korea University College of Medicine, Ansan, Republic of Korea
| | - Changsu Han
- Department of Psychiatry, Korea University Ansan Hospital, Korea University College of Medicine, Ansan, Republic of Korea.
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Han KM, Ko YH, Yoon HK, Han C, Ham BJ, Kim YK. Relationship of depression, chronic disease, self-rated health, and gender with health care utilization among community-living elderly. J Affect Disord 2018; 241:402-410. [PMID: 30145510 DOI: 10.1016/j.jad.2018.08.044] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2018] [Revised: 07/17/2018] [Accepted: 08/12/2018] [Indexed: 11/15/2022]
Abstract
BACKGROUND We investigated the interactive effects of depressive symptoms and chronic diseases on health care utilization among elderly people and explored the potential moderating effect of gender and the mediating effect of self-rated health (SRH) on the association between depressive symptoms and health care utilization. METHOD We analyzed data from 5223 people aged 60 years or older living in the community from the Korea Welfare Panel Study in 2015. Depressive symptoms were measured using an 11-item version of the Center for Epidemiologic Studies Depression (CES-D-11) Scale and morbidity within 28 disease categories was assessed. Health care utilization was evaluated as the number of outpatient visits (OV), number of hospitalizations (NH), and number of days spent in the hospital (DH) during past year. Hierarchical moderated regression analyses were applied to investigate the interactive effects. We also adopted the mediation analysis method by Hayes and Preacher. RESULTS A significant interactive effect of CES-D-11 score and chronic disease on OV was found. A positive correlation between CES-D-11 score and OV was only observed in those with chronic disease. Gender had a moderating effect on the association of depression symptoms with OV, NH, and DH among elderly people with chronic disease. SRH had mediating effects on the association of CES-D-11 with OV, NH, and DH only among those with chronic disease. LIMITATIONS The severity or multimorbidity of chronic diseases, which could affect health care utilization among elderly were not considered. CONCLUSIONS We elucidated the complex aspects of the relationship between depressive symptoms and chronic disease and their interactive effects on health care utilization among elderly people, and identified important roles of gender and SRH.
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Affiliation(s)
- Kyu-Man Han
- Department of Psychiatry, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Republic of Korea
| | - Young-Hoon Ko
- Department of Psychiatry, Korea University Ansan Hospital, Korea University College of Medicine, 123 Jeokgeum-ro, Danwon-gu, Ansan, Republic of Korea.
| | - Ho-Kyoung Yoon
- Department of Psychiatry, Korea University Ansan Hospital, Korea University College of Medicine, 123 Jeokgeum-ro, Danwon-gu, Ansan, Republic of Korea
| | - Changsu Han
- Department of Psychiatry, Korea University Ansan Hospital, Korea University College of Medicine, 123 Jeokgeum-ro, Danwon-gu, Ansan, Republic of Korea
| | - Byung-Joo Ham
- Department of Psychiatry, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Republic of Korea
| | - Yong-Ku Kim
- Department of Psychiatry, Korea University Ansan Hospital, Korea University College of Medicine, 123 Jeokgeum-ro, Danwon-gu, Ansan, Republic of Korea
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12
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Han KM, Shin C, Yoon HK, Ko YH, Kim YK, Han C. Emotional labor and depressive mood in service and sales workers: Interactions with gender and job autonomy. Psychiatry Res 2018; 267:490-498. [PMID: 29980129 DOI: 10.1016/j.psychres.2018.06.044] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2017] [Revised: 05/22/2018] [Accepted: 06/16/2018] [Indexed: 01/16/2023]
Abstract
Emotional labor is strongly correlated with negative consequences in psychological well-being and mental health status in workers. We investigated the associations of emotional labor with depressive mood and perceived usual stress level according to gender and its interactions with job autonomy in service and sales workers. The data from 2,055 service and sales workers from the Korea National Health and Nutrition Examination Surveys (KNHANES) conducted from 2007 to 2009 were analyzed. High emotional labor was associated with increased risk for depressive mood in female workers (adjusted odds ratio [aOR] = 2.19, 95%, confidence interval [CI] = 1.56-3.07). Emotional labor and job autonomy showed interactive effects on depressive mood in that high emotional labor was associated with depressive mood only in the presence of low job autonomy in male workers (aOR = 2.85, 95% CI = 1.13-7.17). A significant mediation pathway between high emotional demand and prevalence of depressive mood through higher stress level was observed in female workers. In conclusion, female workers had high vulnerability to depressive symptoms due to emotional labor, and high job autonomy can act as a buffer against the detrimental effect of emotional labor in male workers.
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Affiliation(s)
- Kyu-Man Han
- Department of Psychiatry, Korea University Ansan Hospital, Korea University College of Medicine, Ansan, Republic of Korea
| | - Cheolmin Shin
- Department of Psychiatry, Korea University Ansan Hospital, Korea University College of Medicine, Ansan, Republic of Korea
| | - Ho-Kyoung Yoon
- Department of Psychiatry, Korea University Ansan Hospital, Korea University College of Medicine, Ansan, Republic of Korea
| | - Young-Hoon Ko
- Department of Psychiatry, Korea University Ansan Hospital, Korea University College of Medicine, Ansan, Republic of Korea
| | - Yong-Ku Kim
- Department of Psychiatry, Korea University Ansan Hospital, Korea University College of Medicine, Ansan, Republic of Korea
| | - Changsu Han
- Department of Psychiatry, Korea University Ansan Hospital, Korea University College of Medicine, Ansan, Republic of Korea.
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Tinnitus, depression, and suicidal ideation in adults: A nationally representative general population sample. J Psychiatr Res 2018; 98:124-132. [PMID: 29406247 DOI: 10.1016/j.jpsychires.2018.01.003] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2017] [Revised: 01/09/2018] [Accepted: 01/09/2018] [Indexed: 11/24/2022]
Abstract
Tinnitus is strongly associated with psychiatric symptoms, including depression and suicidality. We aimed to further investigate the association of tinnitus with depressive mood and/or suicidal ideation, and explore the shared risk factors for these within a representative sample of the adult general population. We also investigated potential mediation pathways among tinnitus, suicidal ideation, depression, shared risk factors, and perceived stress levels. We analysed data from 28,930 adults (aged ≥19 years) from the fourth and fifth Korea National Health and Nutrition Examination Surveys (KNHANES) conducted from 2008 to 2012 in South Korea. We investigated the presence and severity of tinnitus, depressive mood, suicidal ideation, perceived usual stress level, and socioeconomic and health-related variables. We conducted logistic regression and mediation analyses. Tinnitus and its severity were significantly associated with depressive mood and suicidal ideation. Tinnitus, depressive mood, and suicidal ideation shared common socioeconomic and health-related risk factors. Tinnitus significantly mediated the association of shared risk factors for depressive mood and suicidal ideation. Perceived usual stress level mediates the association of tinnitus with depressive mood and suicidal ideation. The correlation of perceived usual stress levels with depression and suicidal ideation was also mediated by tinnitus. Our findings implicate that tinnitus may contribute substantially to the development of depressive symptom and suicidal ideation in adults via apparent interactions with shared risk factors and stress levels.
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Kim M, Lee YH. Gender-specific factors associated with the use of mental health services for suicidal ideation: Results from the 2013 Korean Community Health Survey. PLoS One 2017; 12:e0189799. [PMID: 29253031 PMCID: PMC5734709 DOI: 10.1371/journal.pone.0189799] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2017] [Accepted: 12/02/2017] [Indexed: 11/19/2022] Open
Abstract
This study examined gender-specific factors associated with the use of mental health services (MHS) for suicidal ideation (SI). We included data on 6,768 males and 12,475 females who had experienced SI over the past year from the nationwide 2013 Korean Community Health Survey. These individuals were grouped as MHS users for SI if they had received professional counseling at medical institutions, professional counseling agencies, or community health centers for SI-related problems. Their information on sociodemographic factors, socio-familial relationships, health behaviors, and health status were included as exposures in a logistic regression analysis. Of the 19,243 individuals, 7.0% of the males and 10.5% of the females used MHS for SI treatment. For males with SI, living in an urban area, being a widower, and having unhealthy behaviors (frequent alcohol consumption and infrequent walking) were associated with underuse of MHS. For females with SI, frequent contact with friends, low level of religious activity, and good self-rated health were associated with underuse of MHS. For both males and females, those who were younger, completed higher education, and experienced depression/suicide attempts in the past year were more likely to use MHS for SI. These findings suggest that gender-specific factors should be used to inform suicide prevention strategies.
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Affiliation(s)
- Mina Kim
- Department of Nursing, Graduate School, Chonnam National University, Dong-gu, Gwangju, Republic of Korea
- Department of Counseling Psychology, Graduate School of Dongshin University, Naju, Jeonnam, Republic of Korea
| | - Young-Hoon Lee
- Department of Preventive Medicine & Institute of Wonkwang Medical Science, Wonkwang University School of Medicine, Iksan, Jeonbuk, Republic of Korea
- Regional Cardiocerebrovascular Center, Wonkwang University Hospital, Iksan, Jeonbuk, Republic of Korea
- * E-mail:
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Watanabe T, Ueda M, Ishiguro S, Hayashi Y, Aoki A, Shinozaki M, Kato K, Akiyama K, Shimoda K. Early Improvement and Marriage Are Determinants of the 12-Month Treatment Outcome of Paroxetine in Outpatients with Panic Disorder. CLINICAL PSYCHOPHARMACOLOGY AND NEUROSCIENCE 2017; 15:382-390. [PMID: 29073750 PMCID: PMC5678480 DOI: 10.9758/cpn.2017.15.4.382] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/02/2017] [Revised: 02/22/2017] [Accepted: 03/18/2017] [Indexed: 01/06/2023]
Abstract
Objective In this study, we investigated the determinants of remission and discontinuation of paroxetine pharmacotherapy in outpatients with panic disorder (PD). Methods Subjects were 79 outpatients diagnosed with PD who took 10-40 mg/day of paroxetine for 12 months. The candidate therapeutic determinants included the serotonin transporter gene-linked polymorphic region and the -1019C/G promoter polymorphism of the serotonin receptor 1A as genetic factors, educational background and marital status as environmental factors, and early improvement (EI) at 2 weeks as a clinical factor were assessed. The Clinical Global Impression scale was used to assess the therapeutic effects of the pharmacotherapy. Results Cox proportional hazards regression was performed to investigate the significant predictive factors of remission and discontinuation. EI was only a significant predictive factor of remission. EI was a significant predictive factor of remission (hazard ratio [HR], 2.709; 95% confidence interval [CI], 1.177-6.235). Otherwise, EI and marital status were significant predictive factors of the discontinuation. EI (HR, 0.266; 95% CI, 0.115-0.617) and being married (HR, 0.437; 95% CI, 0.204-0.939) were considered to reduce the risk of treatment discontinuation. In married subjects, EI was a significant predictive factor of the discontinuation (HR, 0.160; 95% CI, 0.045-0.565). However, in unmarried subjects, EI was not a significantly predictive factor for the discontinuation. Conclusion EI achievement appears to be a determinant of PD remission in paroxetine treatment. In married PD patients, EI achievement also appears to reduce a risk of discontinuation of paroxetine treatment.
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Affiliation(s)
- Takashi Watanabe
- Department of Psychiatry, Dokkyo Medical University School of Medicine, Shimotsuga, Japan
| | - Mikito Ueda
- Department of Psychiatry, Dokkyo Medical University School of Medicine, Shimotsuga, Japan
| | - Shin Ishiguro
- Department of Psychiatry, Dokkyo Medical University School of Medicine, Shimotsuga, Japan
| | - Yuki Hayashi
- Department of Psychiatry, Dokkyo Medical University School of Medicine, Shimotsuga, Japan
| | - Akiko Aoki
- Department of Psychiatry, Dokkyo Medical University School of Medicine, Shimotsuga, Japan
| | - Masataka Shinozaki
- Department of Psychiatry, Dokkyo Medical University School of Medicine, Shimotsuga, Japan
| | - Kazuko Kato
- Mental Health Clinic SAKURA-RA, Utsunomiya, Japan
| | - Kazufumi Akiyama
- Department of Biological Psychiatry and Neuroscience, Dokkyo Medical University School of Medicine, Shimotsuga, Japan
| | - Kazutaka Shimoda
- Department of Psychiatry, Dokkyo Medical University School of Medicine, Shimotsuga, Japan
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16
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Han KM, Kim KH, Lee M, Lee SM, Ko YH, Paik JW. Increase in the prescription rate of antidepressants after the Sewol Ferry disaster in Ansan, South Korea. J Affect Disord 2017; 219:31-36. [PMID: 28505500 PMCID: PMC7112638 DOI: 10.1016/j.jad.2017.05.026] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2017] [Revised: 04/29/2017] [Accepted: 05/09/2017] [Indexed: 01/30/2023]
Abstract
BACKGROUND Previous pharmaco-epidemiological studies have reported increases in the prescription of psychotropic medications after a disaster, reflecting post-disaster changes in psychiatric conditions and mental health service utilization. We investigated changes in the prescription of psychotropic medications in the Danwon district of Ansan city (Ansan Danwon) compared to a control community before and after the Sewol Ferry disaster on April 16, 2014. METHODS Data was collected from the Korean Health Insurance Review and Assessment Service database. We analyzed the prescription rates of psychotropic medications including antidepressants, anxiolytics, and sedatives/hypnotics, and investigated whether the time-series pattern of monthly prescriptions per 100,000 people was different in Ansan Danwon compared to that in Cheonan city after the Sewol Ferry disaster through difference-in-differences regression analysis. RESULTS Ansan Danwon showed a significantly greater increase (5.6%) in the prescription rate of antidepressants compared to Cheonan city following the Sewol Ferry disaster. There were no significant differences in changes in the prescription rates of anxiolytics or sedatives/hypnotics. In the secondary analysis, a significantly greater increase in the prescription rate of antipsychotics was observed in Ansan Danwon compared to a control community after the disaster. LIMITATIONS We could not exclude the possibility that other events influenced changes in the prescription rates of psychotropic medications during the study period. CONCLUSIONS Pharmaco-epidemiological studies on psychotropic medication prescription after a disaster provide important information about population-level mental health. Our results suggest that the Sewol Ferry disaster exerted a harmful effect on the mental health status of the affected community.
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Affiliation(s)
- Kyu-Man Han
- Department of Psychiatry, Korea University Ansan Hospital, Korea University College of Medicine, Ansan, Republic of Korea
| | - Kyoung-Hoon Kim
- Healthcare Data Analysis Division, Health Insurance Review and Assessment Service, Wonju, Republic of Korea
| | - Mikyung Lee
- Department of Psychiatry, College of Medicine, Kyung Hee University, Seoul, Republic of Korea
| | - Sang-Min Lee
- Department of Psychiatry, College of Medicine, Konyang University, Daejeon, Republic of Korea
| | - Young-Hoon Ko
- Department of Psychiatry, Korea University Ansan Hospital, Korea University College of Medicine, Ansan, Republic of Korea
| | - Jong-Woo Paik
- Department of Psychiatry, College of Medicine, Kyung Hee University, Seoul, Republic of Korea.
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Precarious employment associated with depressive symptoms and suicidal ideation in adult wage workers. J Affect Disord 2017; 218:201-209. [PMID: 28477498 DOI: 10.1016/j.jad.2017.04.049] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2016] [Revised: 03/01/2017] [Accepted: 04/23/2017] [Indexed: 11/22/2022]
Abstract
BACKGROUND Precarious employment is one of the most important indicators of social disadvantage and is associated with poor mental health. This study aimed to investigate the association of precarious employment with depressive mood and suicidal ideation in adult wage workers, and the possible mediating or moderating effect of socioeconomic factors in the association between precarious work and mental health status. METHOD Data from the Fifth Korea National Health and Nutrition Examination Survey (KNHANES V) conducted between 2010 and 2012 were analyzed. Among the 24,173 participants, 6266 adult wage workers (3206 precarious and 3060 non-precarious workers) aged ≥19 years were included. Socioeconomic and health-related characteristics as well as depressive mood and suicidal ideation were investigated. RESULTS Precarious employment was significantly associated with depressive mood in the logistic regression analyses adjusting for all potential confounding factors as covariates. The socioeconomic variables including age, gender, education level, marital status, household income, and occupation type were significantly related with depressive mood and suicidal ideation in adult wage workers. We also found that gender and household income had possible moderating effects on the association between precarious employment and suicidal ideation. Precarious work was associated with suicidal ideation only for male workers and worker with low or middle-lower income levels. LIMITATIONS Our study is based on a cross-sectional design, thus, we could not elucidate the causal relationship between the variables. CONCLUSIONS Our study suggested that precarious employment plays a pivotal role in the mental health status of adult wage workers.
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Utilization of professional mental health services according to recognition rate of mental health centers. Psychiatry Res 2017; 250:204-209. [PMID: 28167434 DOI: 10.1016/j.psychres.2017.01.051] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2016] [Revised: 11/28/2016] [Accepted: 01/20/2017] [Indexed: 01/14/2023]
Abstract
BACKGROUND Despite the positive effect of community-based mental health centers, the utilization of professional mental health services appears to be low. Therefore, we analyzed the relationship between regional recognition of mental health centers and utilization of professional mental health services. METHODS We used data from the Community Health Survey (2014) and e-provincial indicators. Only those living in Seoul, who responded that they were either feeling a lot of stress or depression, were included in the study. Multiple logistic regression analysis using generalized estimating equations was performed to examine both individual- and regional-level variables associated with utilization of professional mental health services. RESULTS Among the 7338 participants who reported depression or stress, 646 (8.8%) had consulted a mental health professional for their symptoms. A higher recognition rate of mental health centers was associated with more utilization of professional mental health services (odds ratio [OR]=1.05, 95% confidence interval [CI]=1.03-1.07). CONCLUSIONS Accessibility to professional mental health services could be improved depending on the general population's recognition and attitudes toward mental health centers. Therefore, health policy-makers need to plan appropriate strategies for changing the perception of mental health services and informing the public about both the benefits and functions of mental health centers.
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