JMIR Publications

ABSTRACT

Background:

As of January 2022, the number of people infected with coronavirus disease (COVID-19) worldwide has exceeded 350 million. As the COVID-19 pandemic continues, people are affected in a wide range of areas of life, which, in turn, causes numerous psychological problems. Depression is a serious problem for people who have suffered from COVID-19. It can worsen COVID-19 precautionary behavior compliance or the health behavior itself. In addition, these depressive symptoms may have different characteristics depending on the gender of the victim.

Objective:

This study aimed to determine whether depression is a factor that may affect COVID-19 fear, precautionary behavior compliance, and health behavior, and to determine how these characteristic trends differ by gender.

Methods:

This was a secondary analysis of a national cross-sectional study that used data from the 2020 Korea Community Health Survey (KCHS). The data used complex sampling analysis, and the distribution of males and females according to the depression level was calculated after weighting based on the KCHS guidelines. The data were collected using standardized scales of the Patient Health Questionnaire-9, multiple-choice questions related to precautionary behavior compliance, COVID-19-related fears, and health behavior changes.

Results:

Of the 204,787 participants, those who were clinically depressed tended to not comply with precautionary behaviors. Also, in the case of COVID-19, fear showed decreasing trends in both men (OR=0.72, 95% CI:0.61 – 0.83) and women (0.74, 0.63 – 0.86) with clinically relevant depression. Moreover, health behaviors likewise deteriorated as depression intensified, in both men and women: the OR for changes in sleep duration was 2.28 (2.00 – 2.59) in men and 2.15 (1.96 – 2.36) in women. In particular, clinically depressed women showed a doubled increase in both drinking (2.25, 1.88 – 2.70) and smoking (2.71, 1.95 – 3.77) compared to non-depressed women.

Conclusions:

Both men and women with more severe depression were likelier to violate precautionary behaviors and depression worsened. Health behaviors also deteriorated for both men and women: women tended to change more. Therefore, additional studies and interventions in vulnerable groups, such as severely depressed people, are needed, and studies comparing men and women statistically and developing interventions for them are needed.