Factors Associated with Self-Reported Depression, Diagnosis, and Treatment among Korean Adults

Haejong Lee; Kyung Sook Cho; Jangho Yoon; Hyun Suk Park

doi:10.15384/kjhp.2014.14.1.9

Korean J Health Promot > Volume 14(1); 2014 > Article

Lee, Cho, Yoon, and Park: Factors Associated with Self-Reported Depression, Diagnosis, and Treatment among Korean Adults

Original Article

Korean Journal of Health Promotion 2014;14(1):9-16.

Published online: January 20, 2014

DOI: https://doi.org/10.15384/kjhp.2014.14.1.9

Factors Associated with Self-Reported Depression, Diagnosis, and Treatment among Korean Adults

¹Department of Health Administration, Yonsei University College of Health and Science, Wonju, Korea

²Health Management and Policy Program, College of Public Health and Human Sciences, Oregon State University, Corvallis, OR, USA

³Ministry of Health and Welfare, Sejong, Korea

⁴Applied Economics Graduate Program, Oregon State University, Corvallis, OR, USA

⁵Department of Health Service Management, Daejeon University College of Business Administration, Daejeon, Korea

Haejong Lee¹, Kyung Sook Cho^2,^3,, Jangho Yoon^2,⁴, Hyun Suk Park⁵

￭ 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

Received January 11, 2014 Accepted March 17, 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.

Keywords: Depression, Diagnosis, Treatment

Table 1.

Self-reported depression, diagnosis, and treatment by socioeconomic characteristics^a

Variables	Self-reported depression (n=13,306)			Diagnosis of depression (n=1,863)			Treatment of depression (n=501)
Variables	No	Yes	P^b	No	Yes	P^b	No	Yes	P^b
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.

^aValues are presented as N (%).

^bCalculated by chi-square test.

Table 2.

Self-reported depression, diagnosis, and treatment by health behaviors and health status^a

Variables	Self-reported depression			Diagnosis of depression (n= =1,863)			Treatment of depression (n=501)
Variables	No	Yes	P^b	No	Yes	P^b	No	Yes	P^b
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)

^aValues are presented as N (%).

^bCalculated by chi-square test.

Table 3.

Factors related to self-reported depression, diagnosis, and treatment^a

Variables		OR
Variables		Self-reported depression (n=13,306)	Diagnosis of depression (n=1,863)	Treatment of depression (n=501)
Socioeconomic characteristics
Gender (ref: Male)		3.35^b	1.25	0.53^b
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	1.45^b	1.25	1.41
Residential area (ref: Rural)	Metropolitan	1.11	1.40^c	1.13
	Small & medium-sized	1.14	1.22	0.70
Economic status (ref: High)	Low	1.35^d	0.84	1.39
	Middle-low	1.29^d	0.85	1.26
	Middle-high	1.09	0.80	1.36
Occupation (ref: Employed)		1.23^d	1.08	1.24
Education (ref: College)	Elementary school	1.26^c	1.48	1.31
	Middle school	1.27^c	1.21	1.28
	High school	1.18^c	1.19	0.85
Living with others (ref: No) BMI (ref: Under weight)	Normal	1.22 1.04	1.22 0.93	1.23 2.41
	Overweight and obesity	0.93	1.14	2.09
Health behaviors
Currently smoking (ref: No)		1.19^c	NA	NA
High-risk alcohol use (ref: No)		1.18^d	NA	NA
Physical activities (ref: Yes)		0.91	NA	NA
Health status
Perceived health (ref: Excellent/Very good)	Good Poor/Fair	1.52^b 2.65^b	1.28 1.28	2.06 2.00
Chronic disease (ref: No)		1.26^b	0.98	1.73^c
Activity limitation (ref: No)		1.74^b	1.16	2.05^d
Sickbed (ref: No)		1.69^b	1.22	1.88^c

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

^aAssessed by multivariate logistic regression analysis.

^bP<0.001.

^cP<0.05.

^dP<0.01.

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