농촌의학ㆍ지역보건 (Journal of agricultural medicine and community health)

한국농촌의학지역보건학회 (Korean Society for Rural Medicine and Community Health)
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우울증 위험요인에 관한 다수준 분석: 전라북도 주민을 대상으로

Multilevel Analysis on the Risk Factors for Depression in Jeollabuk-do

  • 손정우 (전북대학교 의과대학 예방의학교실)
  • Jungwoo, Sohn (Department of Preventive Medicine, Jeonbuk National University Medical School)
  • 투고 : 2022.11.16
  • 심사 : 2022.12.14
  • 발행 : 2022.12.30
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초록

우울증은 정신과적 질환 중 가장 흔한 질환이자 삶의 질과 직접적으로 연결되어 있으며 신체적 질환과도 연관되어 있는 등 많은 사회적 비용을 초래할 수 있는 중요한 질환이다. 이 연구는 우울증 유무와 연관성이 있는 개인수준과 집단수준의 요인들을 포괄적으로 파악하기 위해 다수준 분석을 시행하였으며, 연구 결과 여러 개인수준의 변수들과 집단수준의 변수에서 우울증과 연관성이 있는 요인들에 대해 파악할 수 있었다. 이러한 연구 결과를 통해 우울증 발생에 있어 전통적인 개인수준의 위험 요인 외에도 지역사회 네트워크를 비롯한 여러 요인들이 함께 영향을 미칠 수 있음을 확인할 수 있었으며, 따라서 우울증을 비롯한 정신건강 관리에 있어 다양한 위험요인들을 종합적으로 관리하는 보건사업이 요구된다 할 수 있다.

Objectives: The purpose of this study was to identify the individual and regional risk factors on depression using community-based data in Jeollabuk-do. Methods: This cross-sectional study obtained data from the Community Health Survey 2018 in Jeollabuk-do. The dependent variable was depression measured by Patient Health Questionnaire-9 (PHQ-9). The prevalence of depression was defined if total score of PHQ-9 was 10 or higher. A multilevel analysis was conducted to consider individual and regional level independent variables that could be risk factors for depression. Results: In the individual level, female gender and smokers had significantly higher odds ratios (ORs) for depression of 1.58 and 1.72, respectively. Subjects with economic activity, higher income and higher education had significantly lower ORs of 0.53, 0.41 and 0.66. In the regional level, higher greening rates and lower levels of PM2.5 had statistically lower ORs at the significance level of 10%. Conclusion: By conducting this study, risk factors associated with depression were identified in individual- and regional-level. This study suggests that health projects are needed to control regional level risk factors including community networks for mental health management in addition to the traditional individual level risk factors.

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참고문헌

  1. World Health Organization, Depression and other common mental disorders: global health estimates. 2017, World Health Organization.
  2. Cavanagh JT, Carson AJ, Sharpe M, Lawrie SM. Psychological autopsy studies of suicide: a systematic review. Psychol Med 2003;33(3):395-405
  3. Katon W, Ciechanowski P. Impact of major depression on chronic medical illness. J Psychosom Res 2002;53(4):859-63 https://doi.org/10.1016/S0022-3999(02)00313-6
  4. Lee H-K, Sohn M-S, Choi M. Factors affecting the mental health of the aged in Korea. The Journal of the Korea Contents Association 2012;12(12):672-682
  5. Lee YH, Shin MH, Kweon SS, Choi SW, Ryu SY, Rhee JA, Choi JS. Prevalence and correlates of depression among the elderly in an urban community. Journal of Agricultural Medicine and Community Health 2008;33(3):303-315 https://doi.org/10.5393/JAMCH.2008.33.3.303
  6. Fan Y, Das KV, Chen Q. Neighborhood green, social support, physical activity, and stress: assessing the cumulative impact. Health Place 2011;17(6):1202-11 https://doi.org/10.1016/j.healthplace.2011.08.008
  7. Kim KN, Lim YH, Bae HJ, Kim M, Jung K, Hong YC. Long-Term Fine Particulate Matter Exposure and Major Depressive Disorder in a Community-Based Urban Cohort. Environ Health Perspect 2016;124(10):1547-1553 https://doi.org/10.1289/ehp192
  8. Korea Centers for Disease Control and Prevention, Community health survey 2018. 2018. p. 4-7
  9. Kroenke K, Spitzer RL, Williams JB. The PHQ-9: validity of a brief depression severity measure. J Gen Intern Med 2001;16(9):606-13 https://doi.org/10.1046/j.1525-1497.2001.016009606.x
  10. Wakefield J. Multi-level modelling, the ecologic fallacy, and hybrid study designs. Int J Epidemiol 2009;38(2):330-6 https://doi.org/10.1093/ije/dyp179
  11. Glaser D, Hastings RH. An introduction to multilevel modeling for anesthesiologists. Anesth Analg 2011;113(4):877-87 https://doi.org/10.1213/ANE.0b013e3182198a01
  12. Stawski RS, Multilevel analysis: an introduction to basic and advanced multilevel modeling. 2013, Taylor & Francis.
  13. Hankin BL, Abramson LY. Development of gender differences in depression: an elaborated cognitive vulnerability-transactional stress theory. Psychol Bull 2001;127(6):773-96 https://doi.org/10.1037/0033-2909.127.6.773
  14. Leventhal AM, Zvolensky MJ. Anxiety, depression, and cigarette smoking: a transdiagnostic vulnerability framework to understanding emotion-smoking comorbidity. Psychol Bull 2015;141(1):176-212 https://doi.org/10.1037/bul0000003
  15. Braithwaite I, Zhang S, Kirkbride JB, Osborn DPJ, Hayes JF. Air Pollution (Particulate Matter) Exposure and Associations with Depression, Anxiety, Bipolar, Psychosis and Suicide Risk: A Systematic Review and Meta-Analysis. Environ Health Perspect 2019;127(12):126002