Kim Won-Hyoung, Kim Jonghun, Oh Jiyun, Lee Seolim, Chang Jihwan, Kim Younhee
Department of Psychiatry and Mental Health, College of Medicine, Inha University, Incheon, South Korea.
College of Medicine, Inha University, Incheon, South Korea.
PLoS One. 2025 Jan 13;20(1):e0317493. doi: 10.1371/journal.pone.0317493. eCollection 2025.
Substantial evidence indicates that the COVID-19 pandemic has adversely affected population mental health globally. However, most studies assumed a linear relationship where only negative pandemic-induced changes led to worse mental health outcomes, overlooking the complex relationship between COVID-19-related changes and mental health. This study examined how various types and magnitudes of pandemic-related changes relate to depression and suicidal thoughts in a large, nationwide adult population sample.
We analyzed data from the 2021 Korean Community Health Survey, a cross-sectional survey of 229,213 adults. The study examined the association between mental health outcomes and three types of pandemic-related changes: daily life impact (scored 0-100), economic activities (employment and income changes), and health behaviors (physical activity, instant food consumption, alcohol consumption, and smoking). Complex sample multiple logistic regression analysis was used to assess these associations, adjusting for sociodemographic factors.
The relationship between pandemic-related changes and mental health showed non-linear patterns. Compared to those reporting moderate changes, individuals reporting either no change (depression: aOR 1.253, 95% CI 1.135-1.384; suicidal thoughts: aOR 1.355, 95% CI 1.236-1.486) or complete disruption (depression: aOR 1.895, 95% CI 1.667-2.155; suicidal thoughts: aOR 1.788, 95% CI 1.558-2.052) in daily life showed higher risks of poor mental health. Unexpectedly, positive changes such as improved working conditions (suicidal thoughts: aOR 1.419, 95% CI 1.200-1.677) and increased income (depression: aOR 1.304, 95% CI 1.139-1.493; suicidal thoughts: aOR 1.244, 95% CI 1.079-1.435) were also associated with adverse mental health outcomes.
This study reveals that both minimal and substantial changes in daily life, as well as both positive and negative changes in economic conditions and health behaviors, were associated with poor mental health outcomes during the pandemic. These findings suggest the need for comprehensive mental health interventions that consider various types and magnitudes of life changes during crisis situations.
大量证据表明，新冠疫情对全球人口心理健康产生了不利影响。然而，大多数研究假定存在线性关系，即只有疫情引发的负面变化才会导致更差的心理健康结果，而忽视了新冠疫情相关变化与心理健康之间的复杂关系。本研究调查了在一个全国性的大型成年人口样本中，各种类型和程度的疫情相关变化与抑郁及自杀念头之间的关系。
我们分析了2021年韩国社区健康调查的数据，这是一项对229,213名成年人进行的横断面调查。该研究考察了心理健康结果与三种疫情相关变化之间的关联：日常生活影响（得分0 - 100）、经济活动（就业和收入变化）以及健康行为（体育活动、即食食品消费、饮酒和吸烟）。采用复杂样本多元逻辑回归分析来评估这些关联，并对社会人口学因素进行了调整。
疫情相关变化与心理健康之间呈现出非线性模式。与报告有中度变化的人相比，报告日常生活没有变化（抑郁：调整后比值比[aOR] 1.253，95%置信区间[CI] 1.135 - 1.384；自杀念头：aOR 1.355，95% CI 1.236 - 1.486）或完全中断（抑郁：aOR 1.895，95% CI 1.667 - 2.155；自杀念头：aOR 1.788，95% CI 1.558 - 2.052）的人心理健康状况不佳的风险更高。出乎意料的是，诸如工作条件改善（自杀念头：aOR 1.419，95% CI 1.200 - 1.677）和收入增加（抑郁：aOR 1.304，95% CI 1.139 - 1.493；自杀念头：aOR 1.244，95% CI 1.079 - 1.435）等积极变化也与不良心理健康结果相关。
本研究表明，疫情期间日常生活中最小和最大程度的变化，以及经济状况和健康行为中的积极和消极变化，均与不良心理健康结果相关。这些发现表明，需要采取全面的心理健康干预措施，以考虑危机情况下生活变化的各种类型和程度。
