Journal of the Korea Convergence Society (한국융합학회논문지)

Korea Convergence Society (한국융합학회)
권호 표지
DOI QR코드

DOI QR Code

Gender differences in Factors Associated with the Severity of Depression in Middle-aged Adults: An Analysis of 2014 Korean National Health and Nutrition Examination Survey

중년 성인에서 우울 중증도 관련요인의 성별 차이 : 2014년 국민건강영양조사 자료 분석

  • Lee, Young Joo (Department of Nursing, College of Nursing, Daegu Catholic University)
  • 이영주 (대구가톨릭대학교 간호대학 간호학과)
  • Received : 2018.08.09
  • Accepted : 2018.10.20
  • Published : 2018.10.28
Download PDF
⟨ Previous Next ⟩

Abstract

The purpose of this study is to examine the prevalence of depression in Korean middle-aged adults and to identify the gender difference in factors associated with the severity of depression. The data of 2,241 individuals who participated in the Sixth Korea National Health and Nutrition Examination Survey in 2014 were used. Depressive symptoms were assessed using the Patient Health Questionnaire-9 (PHQ-9), and multivariate ordinal logistic regression analysis was performed. The prevalence rate of moderate to severe depression ($PHQ-9{\geq}10$) was identified at 5.2% (men 3.3%, women 7.0%). The factors associated with the severity of depression in men were younger age, living in metropolitan, unemployed, lower body mass index, and heavily drinking. On the other hand, women were affected by having no spouse, lower income, limited physical activity, and sleeping shorter hours.

본 논문은 중년 성인의 우울 유병 현황과 성별에 따른 우울 증증도 관련요인의 차이를 분석하기 위해 시도되었다. 2014년 국민건강영양조사 원시자료를 이용하여 중년 성인(40~64세) 2,241명을 분석대상으로 하였다. 우울 증상은 Patient Health Questionnaire-9 (PHQ-9)으로 측정된 자료를 활용하였고, 우울을 3단계로 구분하여 우울 중증도의 관련요인을 다변량 순위회귀분석으로 분석하였다. 분석 결과, 중등도 이상 우울($PHQ-9{\geq}10$)은 5.2% (남성 3.3%, 여성 7.0%)로 확인되었다. 중년 남성에서 우울 중증도의 관련요인은 낮은 연령, 동 지역 거주, 무직, 저체중, 고위험 음주이었고, 중년 여성은 배우자 없음, 낮은 수입, 신체적 활동제한, 적은 수면시간이었다. 본 연구결과는 우울 위험의 성별 차이에 대한 이해를 토대로 중년 성인의 성별 특성에 기반한 정신건강 프로그램을 개발함으로써 우울증상을 조기에 발견하고 예방하는데 실질적인 도움을 줄 것으로 기대한다.

Keywords

References

  1. World Health Organization. (2015). Depression: let's talk 2015. World Health Organization [Online]. www.who.int/mental_health/management/depression/en/
  2. World Health Organization. (2015). Male : female ratio of age-standardized suicide rates 2015. World Health Organization [Online]. www.who.int/gho/mental_health/ suicide_rates_male_female/en/
  3. S. Yang, K. S. Lee, J. S Lee, H. J. Kwan, M.H. Lee, K.O. Oh, et al. (2016) Psychiatric Mental Health Nursing. 5th ed. Seoul ; Hyunmoonsa.
  4. M. Azizi, E. Fooladi, M. Masoumi, T.G. Orimi, F. Elyasi, S.R. Davis. (2018). Depressive symptoms and their risk factors in midlife women in the Middle East: a systematic review. Climacteric : the journal of the International Menopause Society, 21(1), 13-21. DOI : 10.1080/13697137.2017.1406908.
  5. Y. R. Chin, H. Y. Lee, E. S. So. (2011). Suicidal ideation and associated factors by sex in Korean adults: a population-based cross-sectional survey. International journal of public health, 56(4), 429-39. DOI : 10.1007/s00038-011-0245-9.
  6. C. Park & J. Lee. (2011). Analysis of Factors Affecting the Change of Depression of Korean Adult Male and Female. Health and Social Science, 29, 99-128.
  7. M. J. Han & J. H. Lee. (2013). Factors Influencing Self-Identity and Menopausal Symptoms on Level of Depression in Middle Aged Women. Korean Journal of Women Health Nursing, 19(4), 275-84. https://doi.org/10.4069/kjwhn.2013.19.4.275
  8. J. Kim & T. J. Lee. (2018). Economic Insecurity and Mental Health in the Middle-aged Men. The Korean Journal of Health Economics and Policy, 24(1), 142-66.
  9. A. Pan, O.H. Franco, Y.F. Wang, Z.J. Yu, X.W. Ye & X. Lin. (2008). Prevalence and geographic disparity of depressive symptoms among middle-aged and elderly in China. Journal of affective disorders, 105(1-3), 167-75. DOI : 10.1016/j.jad.2007.05.003.
  10. Z. Li, Y. Li, L. Chen, P. Chen & Y. Hu. (2015). Prevalence of Depression in Patients With Hypertension: A Systematic Review and Meta-Analysis. Medicine, 94(31), e1317. DOI : 10.1097/md.0000000000001317.
  11. Y. Wang, J.M. Lopez, S.C. Bolge, V.J. Zhu & P.E. Stang. (2016). Depression among people with type 2 diabetes mellitus, US National Health and Nutrition Examination Survey (NHANES), 2005-2012. BMC psychiatry, 16:88. DOI : 10.1186/s12888-016-0800-2.
  12. W. K. Kim, D. Shin & W. O. Song. (2015). Depression and Its Comorbid Conditions More Serious in Women than in Men in the United States. Journal of Women's Health (Larchmt), 24(12), 978-85. DOI : 10.1089/jwh.2014.4919.
  13. R. T. Demmer, S. Gelb, S. F. Suglia, K.M. Keyes, A.E. Aiello & P.C. Colombo, et al. (2015). Sex differences in the association between depression, anxiety, and type 2 diabetes mellitus. Psychosomatic medicine, 77(4), 467-77. DOI : 10.1097/psy.0000000000000169.
  14. A.M. Krebber, L.M. Buffart, G. Kleijn, I.C. Riepma, R. de Bree & C.R. Leemans, et al. (2014). Prevalence of depression in cancer patients: a meta-analysis of diagnostic interviews and self-report instruments. Psycho-oncology, 23(2), 121-30. DOI : 10.1002/pon.3409.
  15. J. E. Chu, H. Lee, C.H. Yoon, H. I. Cho, J.Y. Hwang & Y.J. Park. (2014). Relationships between Depressed Mood and Life Style Patterns in Koreans Aged 40 Years. Journal of the Korean Society of Food Science and Nutrition, 43(5), 772-83. https://doi.org/10.3746/JKFN.2014.43.5.772
  16. K. A. Kong, H.Y. Choi & S.I. Kim. (2017). Mental health among single and partnered parents in South Korea. PloS one, 12(8), e0182943. DOI : 10.1371/journal.pone.0182943.
  17. K. Kroenke, R.L. Spitzer & J .B. Williams. (2001). The PHQ-9: validity of a brief depression severity measure. Journal of general internal medicine, 16(9), 606-13. https://doi.org/10.1046/j.1525-1497.2001.016009606.x
  18. C. Han, S.A. Jo, J.H. Kwak, C.U. Pae, Steffens D & Jo I, et al. (2008). Validation of the Patient Health Questionnaire-9 Korean version in the elderly population: the Ansan Geriatric study. Comprehensive psychiatry, 49(2), 218-23. DOI : 10.1016/j.comppsych.2007.08.006.
  19. Korea Centers for Disease Control and Prevention. (2014). Guide to the utilization of the data from the sixth Korea National Health and Nutrition Examination Survey. Korea Centers for Disease Control and Prevention [Online]. https://knhanes.cdc.go.kr/knhanes/sub03/sub03_06_02.do
  20. A.S. Fullerton. (2009). A Conceptual Framework for Ordered Logistic Regression Models. Sociological Methods and Research, 38(2), 307
  21. C.S. Lopes, N. Hellwig, G.A.E. Silva, P.R. Menezes. (2016). Inequities in access to depression treatment: results of the Brazilian National Health Survey - PNS. International journal for equity in health, 15(1), 154. DOI : 10.1186/s12939-016-0446-1.
  22. J. Hoebel, U.E. Maske, H. Zeeb, T. Lampert. (2017). Social Inequalities and Depressive Symptoms in Adults: The Role of Objective and Subjective Socioeconomic Status. PloS one, 12(1), e0169764. DOI : 10.1371/journal.pone.0169764.
  23. Y. Liu, I.D. Ozodiegwu, Y. Yu, R. Hess, R. Bie. (2017). An association of health behaviors with depression and metabolic risks: Data from 2007 to 2014 U.S. National Health and Nutrition Examination Survey. Journal of affective disorders, 217, 190-6. DOI : 10.1016/j.jad.2017.04.009.
  24. L.E. McKenzie, R.N. Polur, C. Wesley, J.D. Allen, R.E. McKeown, J. Zhang. (2013). Social contacts and depression in middle and advanced adulthood: findings from a US national survey, 2005-2008. International Journal of Social Psychiatry, 59(7), 627-35. DOI : 10.1177/0020764012463302.
  25. L.M. de Wit, A. van Straten, M. van Herten, B.W. Penninx, P. Cuijpers. (2009). Depression and body mass index, a u-shaped association. BMC public health, 9:14. DOI : 10.1186/1471-2458-9-14.
  26. S.J. Danke, J.P. Loenneke, P.D. Loprinzi. (2016). Mild Depressive Symptoms Among Americans in Relation to Physical Activity, Current Overweight/Obesity, and Self-Reported History of Overweight/Obesity. International journal of behavioral medicine, 23(5), 553-60. DOI : 10.1007/s12529-016-9541-3.
  27. J.H. Kim, W.ML Kang & S.Y. Mun. (2013). The Effects of Problem Drinking on Life Satisfaction Mediated by Depression among the Middle-Aged: Focusing on Gender. Korean Journal of Family Welfare, 18(3), 185-203. https://doi.org/10.13049/jofw.2013.18.3.185
  28. A.C. Hayley, L.J. Williams, K. Venugopal, G.A. Kennedy, M. Berk, J.A. Pasco. (2015). The relationships between insomnia, sleep apnoea and depression: findings from the American National Health and Nutrition Examination Survey, 2005-2008. Australian & New Zealand Journal of Psychiatry, 49(2), 156-70. DOI : 10.1177/0004867414546700.
  29. M. R. Song, Y.S. Lee, J. D. Baek & M. Miller. (2012). Physical activity status in adults with depression in the National Health and Nutrition Examination Survey, 2005-2006. Public health nursing (Boston, Mass), 29(3), 208-17. DOI : 10.1111/j.1525-1446.2011.00986.x.
  30. J.T. Bromberger, L. Schott, H.M. Kravitz & H. Joffe. (2015). Risk factors for major depression during midlife among a community sample of women with and without prior major depression: are they the same or different? Psychological medicine, 45(8), 1653-64. DOI : 10.1017/s0033291714002773.