Depression before and during-COVID-19 by Gender in the Korean Population

Association between depression, anemia and physical activity using isotemporal substitution analysis

BACKGROUND

Depression is a leading cause of disability and mortality, with estimated number of deaths exceeding 2.2 million worldwide. We examined depression in relation to anemia and physical activity, both of which have an impact on depression mechanisms.

METHODS

This cross-sectional study used data from the Korean National Health and Nutrition Examination Survey, including 18,622 participants. Depression was measured by The Patient Health Questionnaire-9, and physical activity was assessed by the Global Physical Activity Questionnaire. Anemia was defined by World Health Organization criteria for blood hemoglobin levels. Isotemporal substitution model for physical activity was used to assess the effect of replacing sedentary behavior to each intensity level of physical activity. Logistic regression was applied to estimate the association on depression.

RESULTS

Replacing sedentary behavior with moderate or vigorous physical activity was associated with a lower risk of depression in the anemic (OR: 0.875, 95% CI: 0.782-0.978) and non-anemic groups (OR: 0.943, 95% CI: 0.919-0.967). Depression risk was significantly reduced by replacing walking with moderate to vigorous physical activity in both anemic (OR: 0.877, 95% CI: 0.784-0.982) and non-anemic groups (OR: 0.951, 95% CI: 0.927-0.976).

CONCLUSIONS

Moderate to vigorous physical activity had a protective association against depression in both anemic and non-anemic groups. Anemic patients are recommended to perform physical activity for any duration acceptable to them to prevent depression.

Post-COVID-19 Syndrome and Related Dysautonomia: Reduced Quality of Life, Increased Anxiety and Manifestation of Depressive Symptoms: Evidence from Greece

Background

Post-COVID-19 syndrome affects a significant number of SARS-CoV-2 infected individuals, even in asymptomatic cases causing several neurological and neuropsychiatric symptoms and signs.

Materials and Methods

An online cross-sectional study with a convenience sample was conducted in Greece from November 2022 to January 2023. We measured the demographic and clinical characteristics of patients with post-COVID-19 dysautonomia in terms of the quality of life with the EQ-5D-3L, and anxiety and depressive symptoms by employing Patient Health Questionnaire-4.

Results

The study population included 122 patients with post-COVID-19 syndrome. One out of four patients (27.8%) manifested post-COVID-19 dysautonomia, while the mean duration of COVID-19 symptoms was 11.6 months. Anxiety and depressive symptoms were worse after the post-COVID-19 syndrome (p<0.001 in both cases). A statistically significant reduction in quality of life was observed among patients after the post-COVID-19 syndrome (p<0.001 for both EQ-5D-3L index value and EQ-5D-3L VAS). Post-COVID-19 dysautonomia increased depression symptoms after developing the post-COVID-19 syndrome (p=0.02). We found a negative relationship between the duration of COVID-19 symptoms and the quality of life (p<0.001). Moreover, our results showed that depressive symptoms were more common among females after the post-COVID-19 syndrome (p=0.01). Also, the quality of life was lower among females than males (p=0.004 for EQ-5D-3L index value, and p=0.007 for EQ-5D-3L VAS).

Conclusions

Our results suggest that post-COVID-19 syndrome causes a tremendous impact on the patients' quality of life and mental health. In addition, we found that the groups most psychologically affected were patients with post-COVID-19 dysautonomia, females, and patients with a longer duration of symptoms. Policy makers should assign priority rights to vulnerable groups in future psychiatric planning. Policy measures should focus on the mental health of post-COVID-19 patients who seem to be particularly vulnerable.

Perceived household financial decline and physical/mental health among adolescents during the COVID-19 crisis: Focusing on gender differences

COVID-19 has worsened adolescents' mental and physical health. Several studies have reported that the effect may be greater in girls; however, relevant socio-ecological factors have not been examined. This study aimed to examine the factors associated with physical and mental health status among adolescents and the moderating role of gender on the relationship between physical and mental health status and perceived household financial decline. We analyzed the cross-sectional 2020 Korea Youth Risk Behavior Web-based Survey (KYRBS) collected between August and November 2020 in South Korea. It included 54,809 adolescents (28,269 males and 26,540 females), on average aged 15.1. We conducted ordinary least squares (OLS) regressions to examine the factors associated with physical and mental health outcomes. Gender differences were observed in associated factors. Then, we tested the moderating effect of gender by including an interaction term between gender and perceived household financial decline due to the COVID-19 pandemic. Perceived household financial decline due to COVID-19 negatively affected both groups. Perceiving moderate and severe financial decline due to COVID-19 is negatively associated with self-rated health among female adolescents than male counterparts. Female adolescents were also more vulnerable to mental health outcomes (i.e., distress, anxiety, and loneliness) when they perceived severe or moderate household financial decline due to COVID-19 compared to their male peers. Our findings suggest that female adolescents are more vulnerable to household financial shocks due to COVID-19, especially in households that have experienced a severe decline. We suggest the need for gender-sensitive policy interventions for adolescent mental health.

Age at onset of alcohol consumption and its association with alcohol misuse in adulthood

OBJECTIVE

This study aimed to explore the association between early age onset of alcohol consumption and alcohol misuse in adulthood.

METHODS

The study sample consisted of 16 829 individuals' (8349 males, 8435 females) survey responses obtained from the Korea National Health and Nutrition Examination Survey (KNHANES) from 2016 through 2019. Alcohol dependence was measured using the AUDIT-C (Alcohol Use Disorder Identification Test-Consumption), and the ages at which alcohol consumption began were grouped into four categories: under 16, 16 to 18, 19 to 23, and over 24. Multiple logistic regression was used to examine the association between current alcohol misuse and age at onset of alcohol consumption.

RESULTS

Compared to individuals who started drinking alcohol after the age of 24, those who began drinking alcohol before the age of 16 were more likely to score 8 or more on AUDIT-C questions (under 16: males, odds ratio [OR] 2.50, confidence interval [CI] 1.97-3.17; females, OR: 1.66, CI: 1.18-2.33). Similar to the main analysis, the earlier the onset of alcohol assumption starts, the more likely one is to develop alcohol misuse in adulthood according to subgroup analysis stratified by independent variables in both gender.

CONCLUSION

The lower the age at the onset of alcohol consumption, the higher the likelihood of alcohol misuse in adulthood. While both males and females showed the same trend in response to the AUDIT-C questions, males tended to have a stronger association between early onset alcohol consumption and alcohol misuse.

Short- and Long-Term Impacts of the COVID-19 Pandemic on Suicide-Related Mental Health in Korean Adolescents

This study investigated the short-term (in 2020) and long-term (in 2021) impacts of the COVID-19 pandemic on suicide-related characteristics in Korean adolescents in comparison with the pre-pandemic period (in 2019) and examined the factors associated with those impacts. Secondary data of the cross-sectional 15th-17th (2019-2021) Korea Youth Risk Behavior Web-based Survey targeting adolescents in school were utilized. The proportions of adolescents with depression, suicidal ideation, suicide planning, and suicide attempts were 26.5%, 12.2%, 3.7%, and 2.4%, respectively. Following an adjustment, depression, suicidal ideation, and suicide attempts significantly improved in the short term and depression and suicide attempts improved significantly in the long term (i.e., 2021), albeit to a lesser degree. The associated variables in the short-term analysis (i.e., 2020) reflected the socioeconomic vulnerabilities (e.g., lower household socioeconomic status [SES], unhealthy status, and unhealthy behaviors), as well as the socioeconomically favorable indicators (e.g., high household SES and high academic achievement). In the long-term, suicidal ideation was no longer associated with a lack of engagement in hand washing, and suicide attempts were no longer associated with the amount of internet time used for studying. For a successful suicide prevention, it is necessary to develop in-school interventions that address the relevant factors identified in this study and the community-based interventions that target out-of-school adolescents.

Influence of the COVID-19 Pandemic on Quality of Life, Mental Health, and Level of Physical Activity in Colombian University Workers: A Longitudinal Study

The COVID-19 pandemic has had a strong influence on people’s quality of life, and the different restrictive measures during the phases of the pandemic have had consequences for physical and mental health. This study determined the changes in health-related quality of life (HRQoL), sleep quality, depression symptoms (DS), and physical activity (PA) level of middle-aged Colombian university personnel during the COVID-19 pandemic. The analysis was performed following a longitudinal design on a sample of 354 people at four points before and during the pandemic. The International Physical Activity Questionnaire (IPAQ), the SF-12v2, the Pittsburgh Sleep Quality Index (PSQI), and the Zung Self-Rating Depression Scale (ZSDS) were included in an online survey. The measurements showed a decrease in quality of life with respect to PCS from 91.66 ± 10.78 to 83.64 ± 17.22 (p = 0.000) and MCS from 87.57 ± 12.23 to 80.90 ± 17.31, while poor sleep quality increased from 25.99% to 47.46% (p = 0.000), with DS reaching the peak during mandatory confinement (14.69%). Regarding the level of physical activity, the period of mandatory confinement inverted the proportion, highlighting active people as a minority (32.2%). In the multivariate analysis, we adjusted for age, sex, BMI, and socioeconomic level, discarding confounding effects and their interactions with the results obtained. In conclusion, this study showed that the pandemic has had a negative impact on sleep quality, HRQoL, DS, and PA level.

Research on the Design Strategy of Healing Products for Anxious Users during COVID-19

With the spread of COVID-19 worldwide, various travel restrictions are becoming a significant trigger for anxiety. Although healing products could relieve anxiety, few scholars have proposed a practical design strategy. Therefore, we offer a design strategy for healing products that includes three phases: preparation, analysis, and verification. In Phase 1, 20 people with moderate or high anxiety are invited to rate 100 samples. Then, FCM is used to obtain representative samples. In Phase 2, a three-layer diagram (incl. the upper, middle, and lower layers) of healing products is obtained using the evaluation grid method. Subsequently, the middle layer is considered evaluation criteria. Additionally, 18 items in the lower layer are considered design guidelines. In Phase 3, we invite two teams to develop innovative designs based on design guidelines and personal experience, generating four alternatives. Finally, four alternatives and four healing commodities are evaluated using grey relation analysis and perceptual questionnaires. The consistency of both evaluations could confirm the validity of the evaluation criteria. The alternatives generated based on the design guidelines are better than other alternatives, demonstrating the effectiveness of the design guidelines. The design strategy is beneficial for developing and evaluating healing products to alleviate people’s anxiety during COVID-19.

One-Size-Fits-All Policies Are Unacceptable: A Sustainable Management and Decision-Making Model for Schools in the Post-COVID-19 Era

This paper proposes a sustainable management and decision-making model for COVID-19 control in schools, which makes improvements to current policies and strategies. It is not a case study of any specific school or country. The term one-size-fits-all has two meanings: being blind to the pandemic, and conducting inflexible and harsh policies. The former strategy leads to more casualties and does potential harm to children. Conversely, under long-lasting strict policies, people feel exhausted. Therefore, some administrators pretend that they are working hard for COVID-19 control, and people pretend to follow pandemic control rules. The proposed model helps to alleviate these problems and improve management efficiency. A customized queue model is introduced to control social gatherings. An indoor–outdoor tracking system is established. Based on tracing data, we can assess people’s infection risk, and allocate medical resources more effectively in case of emergency. We consider both social and technical feasibility. Test results demonstrate the improvements and effectiveness of the model. In conclusion, the model has patched up certain one-size-fits-all strategies to balance pandemic control and normal life.

Assessing Knowledge, Preventive Practices, and Depression Among Chinese International Students and Local Korean Students in South Korea During the COVID-19 Pandemic: An Online Cross-Sectional Study

Depression among university students and international university students is an increasing problem globally. This study aimed to clarify the differences on the conditions and determinants of the knowledge, preventive practices and depression of the Chinese international students and local Korean students in South Korea during the COVID-19 pandemic. An online cross-sectional questionnaire including general demographic characteristics, COVID-19-related knowledge, preventive practice, and the Patient Health Questionnaire (PHQ-9) was applied from March 23 to April 22, 2020. A total of 533 university students (171 Chinese international students and 362 local South Korean students) were included in the study. The majority of both Chinese international students and local South Korean students had a good comprehension of COVID-19. Chinese international students in South Korea showed better preventive practice than local Korean students, while the proportion of moderate to severe depression of Chinese international students was relatively higher (28.07%) than that of local Korean students (22.38%). Determinants of depression of Chinese international students in South Korea were information satisfaction, likelihood of survival after infection, symptoms of a cough and feelings of discrimination, while for local Korean students were gender, educational level, family, suspected symptoms, self-assessed physical health status, COVID-19 detection, population contact history and online sources of information. These results could be used as a reference for decreasing the depressive symptoms among the university students.