kjhp Korean Journal of Health Promotion Korean J Health Promot 2234-2141 2093-5676 The Korean Society of Health Promotion and Disease Prevention 10.15384/kjhp.2014.14.1.9 kjhp-14-9 Original Article Factors Associated with Self-Reported Depression, Diagnosis, and Treatment among Korean Adults LeeHaejong 1 ChoKyung Sook 2 3 YoonJangho 2 4 ParkHyun Suk 5 Department of Health Administration, Yonsei University College of Health and Science, Wonju, Korea Health Management and Policy Program, College of Public Health and Human Sciences, Oregon State University, Corvallis, OR, USA Ministry of Health and Welfare, Sejong, Korea Applied Economics Graduate Program, Oregon State University, Corvallis, OR, USA Department of Health Service Management, Daejeon University College of Business Administration, Daejeon, Korea ￭ Corresponding author：Kyung Sook Cho, PhD Health Management and Policy Program, College of Public Health and Human Sciences, Oregon State University, Waldo Hall 305, Corvallis, OR 97331, USA Tel: +1-503-851-6243, Fax: +1-541-737-4001 E-mail gabrielle@korea.kr, kyungsookcho@nate.com 01 2014 20 01 2014 14 1 9 16 11012014 17032014 Copyright © 2014 The Korean Society of Health Promotion and Disease Prevention 2014 This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. Abstract Background

We compared factors associated with self‐reported depression and, in particular, diagnosis and treatment of depressive symptoms in Korean adults.

 Methods

The sample included 13,306 adults aged 19 years or older from the 2010 and 2011 Korea National2 test and multivariate lo-Health and Nutrition Examination Survey (KNHANES Ⅴ). Data were applied to the χ gistic regression analysis.

 Results

The following characteristics of individuals are significantly associated with self-reported depression: female (vs. male, OR [odds ratio]=3.35), ages 50–59 years (vs. 60+, OR=1.45), economic status (low vs. high, OR=1.35; middle-low vs. high OR=1.29), unemployed (vs. employed, OR=1.23), education (elementary vs. college, OR=1.18; middle school vs. college, OR=1.27; vs. high school vs. college, OR=1.18), current smoking (vs. no, OR=1.19), high-risk alcohol consumption (vs. no, OR=1.18), perceived health (good vs. very good/excellent, OR=1.156; poor/fair vs. very good/excellent, OR=2.65), chronic disease (vs. no, OR=1.26), activity limitation due to health problems (vs. no, OR=1.74), and being in a sickbed during the past month (vs. not in a sickbed, OR=1.69). Living in a metropolitan area (vs. rural, OR=1.40) is significantly associated with greater odds of being diagnosed with depression. The odds of being treated for depression are lower for female (vs. male, OR=0.53). Greater odds of being treated for depression was seen for those with chronic conditions (vs. no, OR=1.73) and activity limitation due to health problems (vs. no, OR=2.05), as well as, those in a sickbed (vs. not, OR=1.88).

 Conclusions

Applying our findings, policy makers should address the lower rates of depression diagnosed in non-metropolitan areas to reduce regional variations, and also promote treatment in females.

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Self-reported depression, diagnosis, and treatment by socioeconomic characteristicsa

Variables Self-reported depression (n=13,306) Diagnosis of depression (n=1,863) Treatment of depression (n=501)
No Yes Pb No Yes Pb No Yes Pb
Gender                  
 Male 4,876 (92.8) 378 (7.2) <0.001 289 (76.5) 89 (23.5) 0.056 56 (62.9) 33 (37.1) 0.069
 Female 5,538 (78.8) 1,485 (21.2)   1,073 (72.3) 412 (27.7)   295 (71.6) 117 (28.4)  
Age, y
 19–29 1,290 (89.4) 153 (10.6) <0.001 108 (70.6) 45 (29.4) 0.034 38 (84.4) 7 (15.6) 0.150
 30–39 2,044 (87.1) 303 (12.9)   237 (78.2) 66 (21.8)   50 (75.8) 16 (24.2)  
 40–49 1,947 (88.0) 266 (12.0)   205 (77.1) 61 (22.9)   41 (67.2) 20 (32.8)  
 50–59 1,922 (81.6) 433 (18.4)   299 (69.1) 134 (30.9)   90 (67.2) 44 (32.8)  
 60+ 3,211 (81.9) 708 (18.1)   513 (72.5) 195 (27.5)   132 (67.7) 63 (32.3)  
Residential area                  
 Metropolitan Small & medium-sized 4,795 (85.3)3,657 (84.8) 824 (14.7)657 (15.2) 0.179 585 (71.0)487 (74.1) 239 (29.0)170 (25.9) 0.153 162 (67.8)129 (75.9) 77 (32.2)41 (24.1) 0.111
 Rural 1,962 (83.7) 382 (16.3)   290 (75.9) 92 (24.1)   60 (65.2) 32 (34.8)  
Economic status                  
 Low 1,922 (78.8) 518 (21.2) <0.001 376 (72.6) 142 (27.4) 0.600 89 (62.7) 53 (37.3) 0.057
 Middle-low 2,607 (83.5) 514 (16.5)   378 (73.5) 136 (26.5)   95 (69.9) 41 (30.1)  
 Middle-high High 2,908 (87.0)2,862 (88.1) 432 (12.9)385 (11.9)   326 (75.5)275 (71.4) 106 (24.5)110 (28.6)   77 (72.6)86 (78.2) 29 (27.4)24 (21.8)  
Education                  
 Elementary school and under 2,862 (88.1) 385 (11.9) <0.001 489 (70.0) 210 (30.0) 0.065 137 (65.2) 73 (34.8) 0.046
 Middle school 1,111 (82.5) 236 (17.5)   173 (73.0) 63 (27.0)   40 (63.5) 23 (36.5)  
 High school 3,519 (86.5) 549 (13.5)   406 (74.0) 143 (26.0)   108 (75.5) 35 (24.5)  
 College and over 3,313 (89.8) 376 (10.2)   291 (77.4) 85 (22.6)   66 (77.6) 19 (22.4)  
Occupation                  
 Unemployed 3,996 (80.0) 1,007 (20.0) <0.001 721 (71.6) 286 (28.4) 0.067 191 (66.8) 95 (33.2) 0.040
 Employed 6,412 (88.3) 853 (11.7)   638 (74.8) 215 (25.2)   160 (74.4) 55 (25.6)  
Living with others                  
 Living alone 670 (80.0) 168 (20.0) <0.001 127 (75.6) 41 (24.4) 0.253 26 (63.4) 15 (36.6) 0.212
 Not alone 9,740 (85.2) 1,695 (14.8)   1,235 (72.9) 460 (27.1)   325 (70.7) 135 (29.3)  
BMI, kg/m2                  
 <18.5 477 (84.6) 87 (15.4) 0.970 64 (73.6) 23 (26.4) 0.140 20 (87.0) 3 (13.0) 0.175
 18.5–25 6,582 (84.7) 1,187 (15.3)   884 (74.5) 303 (25.5)   212 (70.0) 91 (30.0)  
 >25 3,276 (84.9) 584 (15.1)   409 (70.0) 175 (30.0)   119 (68.0) 56 (32.0)  

Abbreviation: BMI, body mass index.

Values are presented as N (%).

Calculated by chi-square test.

Self-reported depression, diagnosis, and treatment by health behaviors and health statusa

Variables Self-reported depression Diagnosis of depression (n= =1,863) Treatment of depression (n=501)
No Yes Pb No Yes Pb No Yes Pb
Health behaviors                  
 Currently smoking                  
  No 8,106 (83.6) 1,587 (16.4) <0.001 1,151 (72.5) 436 (27.5) 0.088 313 (71.8) 123 (28.2) 0.045
  Yes 2,284 (89.4) 270 (10.6)   207 (76.7) 63 (23.3)   38 (60.3) 25 (39.7)  
 High-risk alcohol use                  
  No 5,274 (82.0) 1,156 (18.0) <0.001 835 (72.2) 321 (27.8) 0.154 220 (68.5) 101 (31.5) 0.186
  Yes 5,128 (87.9) 706 (12.1)   526 (74.5) 180 (25.5)   131 (72.8) 49 (27.2)  
 Physical activities                  
  No 5,459 (84.5) 1,005 (15.5) 0.103 731 (72.7) 274 (27.3) 0.376 191 (69.7) 83 (30.3) 0.405
  Yes 4,922 (85.3) 849 (14.7)   624 (73.5) 225 (26.5)   160 (71.1) 65 (28.9)  
Health status                  
 Perceived health                  
  Excellent/Very good 3,868 (91.4) 364 (8.6) <0.001 284 (78.0) 80 (22.0) 0.034 68 (85.0) 12 (15.0) <0.001
  Good 4,823 (86.0) 788 (14.0)   576 (73.1) 212 (26.9)   155 (73.1) 57 (26.9)  
  Poor/Fair 1,723 (70.8) 711 (29.2)   502 (70.6) 209 (29.4)   128 (61.2) 81 (38.8)  
 Chronic disease                  
  No 6,863 (87.9) 943 (12.1) <0.001 705 (74.8) 238 (25.2) 0.057 186 (78.2) 52 (21.8) <0.001
  Yes 3,550 (79.4) 920 (20.6)   657 (71.4) 263 (28.6)   165 (62.7) 98 (37.3)  
 Activity limitation                  
  No 9,428 (87.0) 1,411 (13.0) <0.001 1,049 (74.3) 362 (26.7) 0.019 278 (76.8) 84 (23.2) <0.001
  Yes 984 (68.6) 451 (31.4)   312 (69.2) 139 (30.8)   73 (52.5) 66 (47.5)  
 Sickbed                  
  No 9,692 (86.4) 1,525 (13.6) <0.001 1,130 (74.1) 395 (25.9) 0.028 292 (73.9) 103 (26.1) <0.001
  Yes 720 (68.2) 336 (31.8)   231 (68.8) 105 (31.2)   59 (56.2) 46 (43.8)  

Values are presented as N (%).

Calculated by chi-square test.

Factors related to self-reported depression, diagnosis, and treatmenta

Variables   OR
Self-reported depression (n=13,306) Diagnosis of depression (n=1,863) Treatment of depression (n=501)
Socioeconomic characteristics        
 Gender (ref: Male)   3.35b 1.25 0.53b
 Age (ref: 60+) 19–29 0.92 1.36 0.96
  30–39 40–49 1.23 1.11 0.88 0.92 1.40 1.87
  50–59 1.45b 1.25 1.41
 Residential area (ref: Rural) Metropolitan 1.11 1.40c 1.13
  Small & medium-sized 1.14 1.22 0.70
 Economic status (ref: High) Low 1.35d 0.84 1.39
  Middle-low 1.29d 0.85 1.26
  Middle-high 1.09 0.80 1.36
 Occupation (ref: Employed)   1.23d 1.08 1.24
 Education (ref: College) Elementary school 1.26c 1.48 1.31
  Middle school 1.27c 1.21 1.28
  High school 1.18c 1.19 0.85
 Living with others (ref: No)BMI (ref: Under weight) Normal 1.221.04 1.220.93 1.232.41
  Overweight and obesity 0.93 1.14 2.09
Health behaviors        
 Currently smoking (ref: No)   1.19c NA NA
 High-risk alcohol use (ref: No)   1.18d NA NA
 Physical activities (ref: Yes)   0.91 NA NA
Health status
 Perceived health (ref: Excellent/Very good) GoodPoor/Fair 1.52b2.65b 1.281.28 2.062.00
 Chronic disease (ref: No)   1.26b 0.98 1.73c
Activity limitation (ref: No)   1.74b 1.16 2.05d
Sickbed (ref: No)   1.69b 1.22 1.88c

Abbreviations: OR, odds ratio; ref, reference; BMI, body mass index; NA, not available.

Assessed by multivariate logistic regression analysis.

P<0.001.

P<0.05.

P<0.01.