Socio-economic factors associated with mental health outcomes during the COVID-19 pandemic in South Korea

Abstract

BackgroundIndividuals are at an increased risk of adverse mental health outcomes during the COVID-19 pandemic. To reduce the impact on mental health outcomes that were induced by national-level policies, which may influence an individual at the community level, exploring the comprehensive relations between individual and environmental factors are needed. The aim is to examine socio-ecological factors associated with mental health outcomes, including depressive and anxiety symptoms, with the perspective of support to provide interventions that help the community during future disease outbreaks.MethodFrom 5 November to 20 November 2020, a cross-sectional and population-based study was conducted to assess the socio-ecological factors of mental health outcomes during the COVID-19 pandemic. A total of 1,000 participants, aged 20–69 years, in Chungnam Region, South Korea, were included in this study. Multiple linear regression models were used to examine the association between socio-ecological factors and mental health outcomes. The primary outcomes were individuals' mental health outcomes which are measured by PHQ-9 and GAD-7 scores.ResultsOf the 1,000 participants, the average PHQ-9 was 4.39, and GAD-7 was 3.21 during the COVID-19 pandemic. Specifically, the participants with moderate or severe levels of PHQ-9 and GAD-7 were 12.6 and 6.8%, respectively. Higher levels of depressive and anxiety symptoms were associated with participants who were single, reported a lower household income, had decreased support from friends or family, and increased stress from the workplace or home. In subgroup analyses by age, gender, and household income, a similar trend was reported in individual and interpersonal-level factors. There were significant associations between regional-level factors, including gross regional domestic product (GRDP), mental health institutions, psychiatrists, nurse-to-population ratios, and individuals' mental health outcomes.ConclusionThe management of depressive and anxiety symptoms of individuals during the pandemic was better explained by individual and interpersonal characteristics rather than regional-level factors, highlighting the need for more policies aimed at these lower levels.

Changes of Walking Activity During the First Cycle Phases of COVID-19 Pandemic: A Case Study of Seoul, Korea

“…Korea has not implemented any compulsory travel restriction, such as lockdown or curfew, but voluntary strategies, like social distancing and wearing mask campaigns, are widely promoted. Citizens have been encouraged not to go to mass gatherings but never been banned from walking around unless he or she was confirmed as COVID-19 positive (Lee et al, 2020a;Lee et al, 2020b). It is encouraged to stay home safely, though, yet it is free to go to parks and natural amenities.…”

“…A radical increase of newly confirmed cases was an unambiguous pandemic situation. After 2 months of struggles, in the mid of April, the South Korean government was succeeding in reducing the daily number of confirmed cases to less than 50 and continued to try to prevent the secondary pandemic from occurring, according to the Korea Centers for Disease Control and Prevention (Lee et al, 2020b). The example of Korea showed a case of apparent changes in pandemic phases over about 15 weeks.…”

Susceptibility and severity of COVID-19 and risk of psychiatric disorders in European populations: a Mendelian randomization study

“…A cohort study conducted in the United States comprising 153,848 people showed that the risk of psychiatric disorders in patients with COVID-19 was 1.46 (95% CI: 1.40–1.52), including 1.41 (95% CI: 1.40–1.52) for sleep disorders, 1.38 (95% CI: 1.34–1.43) for stress disorders, and 1.35 (95% CI: 1.30–1.39) for anxiety disorders ( 11 ). A cross-sectional population study in South Korea showed that participants with moderate or severe depressive symptoms and anxiety symptoms accounted for 12.6 and 6.8%, respectively ( 12 ). In addition, during the COVID-19 pandemic, the disruption of the daily lives, physical activities, social life and educational progress of children and adolescents also had an impact on their physical and mental health, with symptoms such as anxiety, depression, post-traumatic stress disorder (PTSD), sleep problems and non-suicidal self-injury ( 13 ).…”

A Comparison of Changes in Health Behavior, Obesity, and Mental Health of Korean Adolescents Before and During the COVID-19 Pandemic: Online Cross-Sectional Study

“…1,2 Although adolescents are generally not at risk of developing severe COVID-19, 3 the effects of a lockdown may still severely affect adolescents due to the changes imposed on their normal daily routine. 4 Recently, the prevalence of cigarette smoking and alcohol consumption among Korean adolescents showed a decreasing trend, while the prevalence of obesity among adolescents showed an increasing trend before the 2020 COVID-19 pandemic. 5 However, the COVID-19 pandemic has had a substantial effect on the lifestyle behaviors across the world.…”

“…Korean government implemented infection control policies such as social distancing, travel restrictions, and quarantine to respond to the pandemic. 4 This included restrictions on school attendance and conducting online classes over a long period of time which have significantly changed adolescents' daily lives. 14 Pandemic-associated negative impacts on adolescents' mental health and health behaviors need to be monitored and addressed to mitigate short-and long-term impacts.…”