Short- and Long-Term Impacts of the COVID-19 Pandemic on Suicide-Related Mental Health in Korean Adolescents
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Design
2.2. Participants
2.3. Outcomes and Covariates
2.4. Statistical Analysis
3. Results
3.1. General and Health-Related Characteristics
3.2. Suicide-Related Characteristics and Their Differences from 2019 to 2021
3.3. Differences from 2019 to 2021 in the Suicide-Related Variables and the Associated Factors
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Variables | Total | 2019 (n = 57,303) | 2020 (n = 54,948) | 2021 (n = 54,848) | |
---|---|---|---|---|---|
Age (mean ± SD) | 15.16 ± 0.01 | 15.08 ± 0.02 | 15.19 ± 0.02 | 15.23 ± 0.02 | |
School type | Middle school | 88,360 (49.5) | 29,384 (47.9) | 28,961 (49.6) | 30,015 (51.0) |
High school | 78,739 (50.5) | 27,919 (52.1) | 25,987 (50.4) | 24,833 (49.0) | |
Gender | Male | 82,679 (51.9) | 28,084 (51.8) | 27,199 (52.0) | 27,396 (51.9) |
Female | 76,510 (48.1) | 25,964 (48.2) | 25,295 (48.0) | 5251 (48.1) | |
Residence with family | Yes | 151,755 (96.1) | 51,288 (95.6) | 50,060 (96.3) | 50,407 (96.4) |
No | 7434 (3.9) | 2760 (4.4) | 23,434 (3.7) | 2240 (3.6) | |
Household SES | Low | 19,375 (11.8) | 6800 (12.3) | 3 (12.3) | 5822 (10.7) |
Middle | 77,333 (48.2) | 26,049 (48.0) | 25,243 (47.6) | 26,041 (49.1) | |
High | 62,481 (40.0) | 21,199 (39.6) | 20,498 (40.0) | 20,784 (40.3) | |
Subjective health status | Healthy | 109,574 (68.5) | 38,226 (70.4) | 36,961 (70.0) | 34,387 (65.2) |
Average | 37,305 (23.6) | 11,985 (22.4) | 11,708 (22.5) | 13,612 (25.9) | |
Unhealthy | 12,310 (7.9) | 3837 (7.2) | 3825 (7.5) | 4648 (9.0) | |
Perceived body image | Thin | 40,302 (25.5) | 13,896 (25.8) | 12,904 (24.7) | 13,502 (25.8) |
Average | 58,291 (36.6) | 19,873 (36.6) | 19,342 (36.9) | 19,076 (36.3) | |
Fat | 60,596 (37.9) | 20,279 (37.6) | 20,248 (38.4) | 20,069 (37.8) | |
Breakfast skipping | Yes | 32,963 (20.6) | 10,724 (19.8) | 10,883 (20.5) | 11,356 (21.4) |
No | 126,226 (79.4) | 43,324 (80.2) | 41,611 (79.5) | 41,291 (79.9) | |
Physical activity | Yes | 24,035 (14.4) | 8249 (14.6) | 7761 (14.0) | 8025 (14.6) |
No | 135,154 (85.6) | 45,799 (85.4) | 44,733 (86.0) | 44,622 (85.4) | |
Internet use time for study | (min) | 448.74 ± 1.51 | 468.66 ± 2.72 | 417.30 ± 2.71 | 460.11 ± 2.34 |
Internet use time for leisure | (min) | 201.53 ± 0.64 | 166.64 ± 0.83 | 229.37 ± 1.21 | 208.76 ± 1.00 |
Personal hygiene | Yes | 59,942 (37.3) | 24,599 (45.3) | 16,843 (31.9) | 18,500 (34.7) |
No | 99,247 (62.7) | 29,449 (54.7) | 35,651 (68.1) | 34,147 (65.3) | |
Current smoking | Yes | 8622 (5.5) | 3590 (6.9) | 2476 (4.7) | 2556 (5.0) |
No | 150,567 (94.5) | 50,458 (93.1) | 50,018 (95.3) | 50,091 (95.0) | |
Current drinking consumption | Yes | 18,661 (11.8) | 7694 (14.6) | 5515 (10.5) | 5452 (10.5) |
no | 140,528 (88.2) | 46,354 (85.4) | 46,979 (89.5) | 47,195 (89.5) |
Variables | Total | 2019 | 2020 | 2021 |
---|---|---|---|---|
Depression | 56,794 (26.5) | 14,949 (27.9) | 13,100 (25.0) *** | 13,933 (26.4) *** |
Suicidal ideation | 26,207 (12.2) | 6871 (12.7) | 5619 (10.7) *** | 6535 (12.4) |
Suicide planning | 8116 (3.7) | 2000 (3.6) | 1794 (3.4) | 2010 (3.8) |
Suicide attempt | 5208 (2.4) | 1474 (2.6) | 1007 (1.9) *** | 1125 (2.1) *** |
Variables | Depression | Suicidal Ideation | Suicide Planning | Suicide Attempt | |||||
---|---|---|---|---|---|---|---|---|---|
n (%) or M ± SE | χ2 or t (p) | n (%) or M ± SE | χ2 or t (p) | n (%) or M ± SE | χ2 or t (p) | n (%) or M ± SE | χ2 or t (p) | ||
Age | 15.20 ± 0.01 | 12.114 *** | 15.15± 0.02 | −1.751 | 15.09 ± 0.02 | 6.138 *** | 15.05 ± 0.02 | 6.545 *** | |
School type | Middle school | 21,112 (25.0) | 167.779 *** | 10,380 (12.3) | 22.549 *** | 3384 (4.0) | 71.180 *** | 2164 (2.5) | 66.264 *** |
High school | 20,870 (27.8) | 8645 (11.6) | 2420 (3.2) | 1442 (1.9) | |||||
Gender | Male | 17,407 (21.3) | 2321.949 *** | 7077 (8.7) | 1678.741 *** | 2267 (2.8) | 335.735 *** | 1181 (1.4) | 478.973 *** |
Female | 24,575 (31.9) | 11,948 (15.4) | 3537 (4.5) | 2425 (3.0) | |||||
Academic achievement | Low | 16,068 (31.7) | 1134.870 *** | 7518 (14.7) | 542.260 *** | 2403 (4.7) | 248.651 *** | 1638 (3.1) | 317.297 *** |
Middle | 12,038 (25.0) | 5184 (10.7) | 1535 (3.2) | 935 (1.9) | |||||
High | 13,876 (23.0) | 6323 (10.6) | 1866 (3.1) | 1033 (1.6) | |||||
Residence with family | Yes | 39,715 (26.3) | 52.684 *** | 17,915 (11.8) | 79.998 *** | 5402 (3.5) | 78.463 *** | 3341 (2.1) | 64.275 *** |
No | 2267 (30.4) | 1110 (15.6) | 402 (5.7) | 265 (3.7) | |||||
Household SES | Low | 7092 (36.5) | 1109.454 *** | 3937 (20.2) | 1378.292 *** | 1340 (6.9) | 647.865 *** | 924 (4.6) | 550.663 *** |
Middle | 19,484 (25.4) | 8577 (11.2) | 2448 (3.1) | 1483 (1.9) | |||||
High | 15,406 (24.7) | 6511 (10.5) | 2016 (3.2) | 1199 (1.9) | |||||
Subjective health status | Healthy | 23,836 (21.8) | 4630.806 *** | 9253 (8.5) | 5543.276 *** | 2636 (2.4) | 2321.515 *** | 1583 (1.4) | 1428.590 *** |
Average | 12,421 (33.1) | 6143 (16.3) | 1834 (4.8) | 1215 (3.1) | |||||
Unhealthy | 5725 (46.4) | 3629 (29.4) | 1334 (10.5) | 808 (6.3) | |||||
Perceived body image | Thin | 10,423 (25.9) | 163.435 *** | 4539 (11.4) | 383.956 *** | 1327 (3.3) | 120.453 *** | 799 (1.9) | 77.723 *** |
Average | 14,527 (24.9) | 6043 (10.3) | 1854 (3.2) | 1175 (1.9) | |||||
Fat | 17,032 (28.2) | 8443 (13.9) | 2623 (4.3) | 1632 (2.6) | |||||
Breakfast skipping | Yes | 9751 (29.6) | 211.343 *** | 4574 (13.8) | 132.457 *** | 1485 (4.5) | 94.112 *** | 977 (2.9) | 94.572 *** |
No | 32,231 (25.6) | 14,451 (11.5) | 4319 (3.4) | 2629 (2.0) | |||||
Physical activity | Yes | 6452 (26.9) | 3.357 | 2636 (11.2) | 12.595 *** | 914 (3.8) | 2.578 | 596 (2.5) | 13.104 ** |
No | 35,530 (26.3) | 16,389 (12.1) | 4890 (3.6) | 3010 (2.1) | |||||
Internet use time for study (min) | 451.65 ± 1.55 | 7.392 *** | 455.69 ± 1.71 | 8.240 *** | 451.21 ± 2.39 | 1.346 | 444.76 ± 2.69 | 1.743 | |
Internet use time for leisure (min) | 208.72 ± 0.99 | 9.452 *** | 212.01 ± 1.41 | 8.254 *** | 218.33 ± 2.49 | 6.875 *** | 219.79 ± 3.27 | 5.676 *** | |
Obesity (BMI) | Underweight | 3140 (26.0) | 23.085 *** | 1423 (11.7) | 50.173 *** | 436 (3.6) | 23.566 *** | 259 (2.1) | 2.395 |
Normal | 29,673 (26.8) | 13,005 (11.7) | 3909 (3.5) | 2489 (2.2) | |||||
Overweight | 4059 (25.4) | 1937 (12.1) | 630 (3.9) | 378 (2.3) | |||||
Obese | 5110 (25.6) | 2660 (13.5) | 829 (4.1) | 480 (2.3) | |||||
Personal hygiene | Yes | 25,596 (25.9) | 43.109 *** | 11,212 (11.3) | 109.896 *** | 3540 (3.5) | 6.482 * | 2130 (2.1) | 15.406 *** |
No | 16,386 (27.4) | 7813 (13.1) | 2264 (3.8) | 1476 (2.4) | |||||
Current smoking | Yes | 3767 (43.0) | 1311.048 *** | 1950 (22.0) | 895.837 *** | 743 (8.3) | 576.287 *** | 642 (7.0) | 1004.595 *** |
No | 38,215 (25.5) | 17,075 (11.4) | 5061 (3.3) | 2964 (1.9) | |||||
Current drinking consumption | Yes | 7541 (40.3) | 2127.632 *** | 3687 (19.7) | 1206.280 *** | 1333 (7.0) | 699.159 *** | 1023 (5.3) | 938.125 *** |
no | 34,441 (24.5) | 15,338 (10.9) | 4471 (3.2) | 2583 (1.8) |
Depression | Suicidal Ideation | Suicide Planning | Suicide Attempt | |||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|
OR | 95% CI | p | OR | 95% CI | p | OR | 95% CI | p | OR | 95% CI | p | |
Year 2020 vs. 2019 | 0.88 | 0.85~0.91 | <0.001 | 0.86 | 0.81~0.90 | <0.001 | 0.97 | 0.89~1.05 | 0.454 | 0.74 | 0.67~0.82 | <0.001 |
Age | 1.04 | 1.02~1.06 | <0.001 | 0.98 | 0.95~1.00 | 0.066 | 0.95 | 0.91~0.99 | 0.007 | 0.91 | 0.86~0.95 | <0.001 |
School type High vs. middle | 0.86 | 0.81~0.92 | <0.001 | 0.74 | 0.68~0.81 | <0.001 | 0.65 | 0.56~0.75 | <0.001 | 0.61 | 0.51~0.74 | <0.001 |
Gender Female vs. male | 1.86 | 1.79~1.93 | <0.001 | 1.92 | 1.82~2.02 | <0.001 | 1.65 | 1.27~1.80 | <0.001 | 2.44 | 2.20~2.71 | <0.001 |
Academic achievement Middle vs. low | 1.07 | 1.03~1.12 | <0.001 | 0.99 | 0.94~1.05 | 0.725 | 1.03 | 0.93~1.13 | 0.621 | 1.15 | 1.02~1.29 | 0.024 |
High vs. low | 1.32 | 1.26~1.37 | <0.001 | 1.22 | 1.15~1.28 | <0.001 | 1.30 | 1.18~1.43 | <0.001 | 1.49 | 1.32~1.67 | <0.001 |
Living with family Yes vs. no | 0.87 | 0.80~0.94 | <0.001 | 0.75 | 0.68~0.83 | <0.001 | 0.60 | 0.51~0.70 | <0.001 | 0.52 | 0.48~0.70 | <0.001 |
Household SES Middle vs. low | 0.91 | 0.87~0.94 | <0.001 | 0.96 | 0.91~1.01 | 0.093 | 0.88 | 0.81~0.96 | 0.004 | 0.86 | 0.77~0.95 | 0.005 |
High vs. low | 1.34 | 1.27~1.41 | <0.001 | 1.66 | 1.56~1.77 | <0.001 | 1.61 | 1.45~1.80 | <0.001 | 1.68 | 1.47~1.91 | <0.001 |
Subjective health status Average vs. healthy | 1.66 | 1.60~1.72 | <0.001 | 1.90 | 1.81~1.99 | <0.001 | 1.87 | 1.72~2.04 | <0.001 | 1.95 | 1.75~2.17 | <0.001 |
Unhealthy vs. healthy | 2.82 | 2.67~2.98 | <0.001 | 3.93 | 3.68~4.19 | <0.001 | 4.12 | 3.73~4.54 | <0.001 | 4.13 | 3.66~4.66 | <0.001 |
Perceived body image Average vs. thin | 0.90 | 0.87~0.95 | <0.001 | 0.92 | 0.86~0.97 | 0.006 | 1.01 | 0.91~1.12 | 0.878 | 0.94 | 0.83~1.07 | 0.379 |
Fat vs. thin | 1.04 | 0.99~1.09 | 0.105 | 1.13 | 1.06~1.22 | 0.001 | 1.23 | 1.09~1.37 | 0.001 | 1.25 | 1.08~1.44 | <0.001 |
Breakfast skipping Yes vs. no | 1.12 | 1.08~1.16 | <0.001 | 1.10 | 1.05~1.16 | <0.001 | 1.16 | 1.07~1.26 | <0.001 | 1.22 | 1.10~1.34 | <0.001 |
Physical activity Yes vs. no | 1.29 | 1.24~1.35 | <0.001 | 1.19 | 1.12~1.27 | <0.001 | 1.24 | 1.11~1.38 | <0.001 | 1.49 | 1.32~1.69 | <.001 |
Internet use time for study (min) | 1.01 | 1.01~1.02 | <0.001 | 1.02 | 1.02~1.03 | <0.001 | 1.02 | 1.01~1.03 | 0.003 | 1.00 | 0.99~1.01 | 0.879 |
Internet use time for leisure (min) | 1.01 | 1.01~1.02 | <0.001 | 1.02 | 1.01~1.02 | <0.001 | 1.02 | 1.00~1.03 | 0.012 | 1.02 | 1.00~1.04 | 0.040 |
BMI Normal vs. underweight | 1.14 | 1.06~1.22 | <0.001 | 1.07 | 0.98~1.18 | 0.132 | 1.04 | 0.89~1.22 | 0.621 | 1.10 | 0.90~1.34 | 0.343 |
Overweight vs. underweight | 1.01 | 0.92~1.11 | 0.080 | 1.02 | 0.90~1.15 | 0.738 | 1.03 | 0.84~1.26 | 0.778 | 1.03 | 0.80~1.32 | 0.824 |
Obese vs. underweight | 0.94 | 0.87~1.03 | 0.190 | 1.07 | 0.95~1.20 | 0.283 | 1.01 | 0.82~1.23 | 0.958 | 1.01 | 0.79~1.30 | 0.942 |
Personal hygiene Yes vs. no | 1.02 | 0.98~1.05 | 0.316 | 1.09 | 1.04~1.14 | <0.001 | 0.99 | 0.92~1.07 | 0.829 | 0.99 | 0.90~1.08 | 0.763 |
Smoking Yes vs. no | 1.66 | 1.55~1.79 | <0.001 | 1.79 | 1.64~1.96 | <0.001 | 1.99 | 1.74~2.29 | <0.001 | 2.87 | 2.46~3.36 | <0.001 |
Drinking consumption Yes vs. no | 1.78 | 1.69~1.87 | <0.001 | 1.81 | 1.69~1.93 | <0.001 | 1.89 | 1.70~2.10 | <0.001 | 2.31 | 2.04~2.63 | <0.001 |
Depression | Suicidal Ideation | Suicide Planning | Suicide Attempt | |||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|
OR | 95% CI | p | OR | 95% CI | p | OR | 95% CI | p | OR | 95% CI | p | |
Year 2021 vs. 2019 | 0.91 | 0.88~0.95 | <0.001 | 0.96 | 0.92~1.01 | 0.102 | 1.04 | 0.96~1.12 | 0.336 | 0.80 | 0.72~0.87 | <0.001 |
Age | 1.03 | 1.01~1.05 | 0.001 | 0.96 | 0.94~0.98 | <0.001 | 0.91 | 0.88~0.95 | <0.001 | 0.87 | 0.83~0.92 | <0.001 |
School type High vs. middle | 0.83 | 0.78~0.88 | <0.001 | 0.71 | 0.65~0.77 | <0.001 | 0.68 | 0.59~0.78 | <0.001 | 0.64 | 0.54~0.76 | <0.001 |
Gender Female vs. male | 1.76 | 1.70~1.82 | <0.001 | 1.94 | 1.85~2.03 | <0.001 | 1.65 | 1.52~1.79 | <0.001 | 2.30 | 2.08~2.54 | <0.001 |
Academic achievement Middle vs. low | 1.09 | 1.05~1.13 | <0.001 | 1.01 | 0.96~1.07 | 0.661 | 0.99 | 0.90~1.09 | 0.870 | 1.14 | 1.02~1.28 | 0.024 |
High vs. low | 1.34 | 1.29~1.40 | <0.001 | 1.18 | 1.12~1.25 | <0.001 | 1.15 | 1.05~1.26 | 0.003 | 1.40 | 1.22~1.58 | <0.001 |
Living with family Yes vs. no | 0.83 | 0.77~0.89 | <0.001 | 0.68 | 0.62~0.76 | <0.001 | 0.54 | 0.47~0.64 | <0.001 | 0.52 | 0.44~0.63 | <0.001 |
Household SES Middle vs. low | 0.88 | 0.85~0.92 | <0.001 | 0.96 | 0.91~1.01 | 0.097 | 0.89 | 0.81~0.96 | 0.004 | 0.86 | 0.78~0.96 | 0.006 |
High vs. low | 1.31 | 1.24~1.38 | <0.001 | 1.68 | 1.57~1.79 | <0.001 | 1.72 | 1.55~1.91 | <0.001 | 1.79 | 1.58~2.02 | <0.001 |
Subjective health status Average vs. unhealthy | 1.70 | 1.64~1.76 | <0.001 | 1.94 | 1.86~2.03 | <0.001 | 1.94 | 1.78~2.10 | <0.001 | 1.96 | 1.77~2.17 | <0.001 |
Unhealthy vs. healthy | 2.83 | 2.69~2.98 | <0.001 | 4.07 | 3.82~4.33 | <0.001 | 4.35 | 3.96~4.79 | <0.001 | 3.94 | 3.50~4.44 | <0.001 |
Perceived body image Average vs. thin | 0.91 | 0.87~0.95 | <0.001 | 0.89 | 0.84~0.95 | <0.001 | 1.04 | 0.93~1.16 | 0.514 | 1.06 | 0.92~1.21 | 0.435 |
Fat vs. thin | 1.05 | 1.00~1.11 | 0.056 | 1.11 | 1.03~1.19 | 0.004 | 1.15 | 1.03~1.29 | 0.018 | 1.21 | 1.04~1.41 | 0.012 |
Breakfast skipping Yes vs. no | 1.11 | 1.07~1.16 | <0.001 | 1.12 | 1.07~1.18 | <0.001 | 1.20 | 1.11~1.30 | <0.001 | 1.28 | 1.16~1.40 | <0.001 |
Physical activity Yes vs. no | 1.31 | 1.25~1.37 | <0.001 | 1.24 | 1.17~1.32 | <0.001 | 1.36 | 1.23~1.50 | <0.001 | 1.48 | 1.31~1.68 | <0.001 |
Internet use time for study (min) | 1.01 | 1.00~1.01 | <0.001 | 1.02 | 1.01~1.02 | <0.001 | 1.01 | 1.00~1.02 | <0.001 | 1.00 | 0.99~1.02 | 0.621 |
Internet use time for leisure (min) | 1.02 | 1.01~1.02 | <0.001 | 1.02 | 1.01~1.03 | <0.001 | 1.03 | 1.01~1.04 | <0.001 | 1.01 | 0.99~1.03 | 0.237 |
BMI Normal vs. underweight | 1.12 | 1.05~1.20 | 0.001 | 1.08 | 0.98~1.18 | 0.105 | 0.91 | 0.78~1.06 | 0.204 | 0.98 | 0.80~1.19 | 0.821 |
Overweight vs. underweight | 0.97 | 0.89~1.06 | 0.530 | 1.06 | 0.94~1.20 | 0.333 | 0.96 | 0.78~1.17 | 0.651 | 0.97 | 0.75~1.25 | 0.893 |
Obese vs. underweight | 0.91 | 0.84~0.99 | 0.027 | 1.06 | 0.94~1.19 | 0.329 | 0.92 | 0.75~1.12 | 0.393 | 0.92 | 0.71~1.19 | 0.533 |
Personal hygiene Yes vs. no | 0.96 | 0.93~0.99 | 0.020 | 1.04 | 0.99~1.08 | 0.114 | 0.94 | 0.87~1.02 | 0.143 | 0.97 | 0.89~1.06 | 0.483 |
Smoking Yes vs. no | 1.63 | 1.52~1.75 | <0.001 | 1.91 | 1.75~2.09 | <0.001 | 1.94 | 1.70~2.22 | <0.001 | 2.65 | 2.26~3.10 | <0.001 |
Drinking consumption Yes vs. no | 1.80 | 1.72~1.89 | <0.001 | 1.74 | 1.64~1.86 | <0.001 | 2.11 | 1.90~2.34 | <0.001 | 2.47 | 2.18~2.81 | <0.001 |
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Lee, B.; Hong, J.S. Short- and Long-Term Impacts of the COVID-19 Pandemic on Suicide-Related Mental Health in Korean Adolescents. Int. J. Environ. Res. Public Health 2022, 19, 11491. https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph191811491
Lee B, Hong JS. Short- and Long-Term Impacts of the COVID-19 Pandemic on Suicide-Related Mental Health in Korean Adolescents. International Journal of Environmental Research and Public Health. 2022; 19(18):11491. https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph191811491
Chicago/Turabian StyleLee, Byungha, and Jung Su Hong. 2022. "Short- and Long-Term Impacts of the COVID-19 Pandemic on Suicide-Related Mental Health in Korean Adolescents" International Journal of Environmental Research and Public Health 19, no. 18: 11491. https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph191811491