Skip to main content
Top
Published in: BMC Health Services Research 1/2014

Open Access 01-12-2014 | Research article

Sociodemographic factors associated with the use of mental health services in depressed adults: results from the Korea National Health and Nutrition Examination Survey (KNHANES)

Authors: Se Jin Park, Hong Jin Jeon, Ju Young Kim, Sohye Kim, Sungwon Roh

Published in: BMC Health Services Research | Issue 1/2014

Login to get access

Abstract

Background

The aims of this study were to determine the utilization of mental health services (MHSs) by adults with a depressive mood and to identify the influencing sociodemographic factors, using a nationwide representative Korean sample.

Methods

The study included 2735 subjects, aged 19 years or older, who had experienced a depressive mood continuously for over 2 weeks within the previous year, using the data from the KNHANES IV (Fourth Korea National Health and Nutrition Examination Survey), which was performed between 2007 and 2009, and involved a nationally representative sample of the Korean community population who were visited at home. A multivariate logistic regression analysis was used to estimate the adjusted odd ratios (ORs) and 95% confidence intervals (CIs) for the use of MHSs, which was defined as using healthcare institutions, consulting services, and inpatient or outpatient treatments due to mental health problems.

Results

MHSs had been used by 9.6% of the subjects with a depressive mood. The use of the MHSs was significantly associated with age, education level, and employment status, after adjusting for sociodemographic and health-related factors. Specifically, the OR for the nonuse of MHSs by the elderly (≥65 years) relative to subjects aged 19–34 years was 2.55 (95% CI = 1.13–5.76), subjects with a lower education level were less likely to use MHSs compared to those with a higher education level (7–9 years, OR = 2.35, 95% CI = 1.19–4.64; 10–12 years, OR = 1.66, 95% CI = 1.07–2.56; ≥13 years, reference), and the OR of unemployed relative to employed was 0.47 (95% CI = 0.32–0.67).

Conclusions

Among Korean adults with a depressive mood, the elderly, those with a lower education level, and the employed are less likely to use MHSs. These findings suggest that mental health policies should be made based on the characteristics of the population in order to reduce untreated patients with depression. Greater resources and attention to identifying and treating depression in older, less educated, and employed adults are warranted.
Appendix
Available only for authorised users
Literature
1.
go back to reference World Health Organization: The global burden of disease: 2004 update. 2008, World Health Organization, Geneva World Health Organization: The global burden of disease: 2004 update. 2008, World Health Organization, Geneva
2.
go back to reference Park JH, Kim KW: A review of the epidemiology of depressive mood in Korea. JAMA. 2012, 54: 362-369. Park JH, Kim KW: A review of the epidemiology of depressive mood in Korea. JAMA. 2012, 54: 362-369.
3.
go back to reference Kessler RC, Berglund P, Demler O, Jin R, Koretz D, Merikangas KR, Rush AJ, Walters EE, Wang PS: The epidemiology of major depressive disorder: results from the National Comorbidity Survey Replication (NCS-R). JAMA. 2003, 289: 3095-3105. 10.1001/jama.289.23.3095.CrossRefPubMed Kessler RC, Berglund P, Demler O, Jin R, Koretz D, Merikangas KR, Rush AJ, Walters EE, Wang PS: The epidemiology of major depressive disorder: results from the National Comorbidity Survey Replication (NCS-R). JAMA. 2003, 289: 3095-3105. 10.1001/jama.289.23.3095.CrossRefPubMed
4.
go back to reference Kawakami N, Takeshima T, Ono Y, Uda H, Hata Y, Nakane Y, Nakane H, Iwata N, Furukawa TA, Kikkawa T: Twelve-month prevalence, severity, and treatment of common mental disorders in communities in Japan: preliminary finding from the World Mental Health Japan Survey 2002–2003. Psychiatry Clin Neurosci. 2005, 59: 441-452. 10.1111/j.1440-1819.2005.01397.x.CrossRefPubMed Kawakami N, Takeshima T, Ono Y, Uda H, Hata Y, Nakane Y, Nakane H, Iwata N, Furukawa TA, Kikkawa T: Twelve-month prevalence, severity, and treatment of common mental disorders in communities in Japan: preliminary finding from the World Mental Health Japan Survey 2002–2003. Psychiatry Clin Neurosci. 2005, 59: 441-452. 10.1111/j.1440-1819.2005.01397.x.CrossRefPubMed
5.
go back to reference Cho MJ, Park JI, Bae A, Bae JN, Son JW, Ahn JH, Lee DW, Lee YM, Lee JY, Jang SM, Jung IW, Cho SJ, Hong JP: The epidemiological survey of mental disorders in Korea. 2012, Ministry of Health & Welfare, Seoul Cho MJ, Park JI, Bae A, Bae JN, Son JW, Ahn JH, Lee DW, Lee YM, Lee JY, Jang SM, Jung IW, Cho SJ, Hong JP: The epidemiological survey of mental disorders in Korea. 2012, Ministry of Health & Welfare, Seoul
6.
go back to reference Park JH, Yoon SJ, Lee HY, Cho HS, Lee JY, Eun SJ, Park JH, Kim Y, Kim YI, Shin YS: Estimating the burden of psychiatric disorder in Korea. J Prev Med Public Health. 2006, 39: 39-45.PubMed Park JH, Yoon SJ, Lee HY, Cho HS, Lee JY, Eun SJ, Park JH, Kim Y, Kim YI, Shin YS: Estimating the burden of psychiatric disorder in Korea. J Prev Med Public Health. 2006, 39: 39-45.PubMed
7.
go back to reference Cassano P, Fava M: Depression and public health: an overview. J Psychosom Res. 2002, 53: 849-857. 10.1016/S0022-3999(02)00304-5.CrossRefPubMed Cassano P, Fava M: Depression and public health: an overview. J Psychosom Res. 2002, 53: 849-857. 10.1016/S0022-3999(02)00304-5.CrossRefPubMed
8.
go back to reference Jeon HJ, Lee JY, Lee YM, Hong JP, Won SH, Cho SJ, Kim JY, Chang SM, Lee HW, Cho MJ: Unplanned versus planned suicide attempters, precipitants, methods, and an association with mental disorders in a Korea-based community sample. J Affect Disord. 2010, 127: 274-280. 10.1016/j.jad.2010.05.027.CrossRefPubMed Jeon HJ, Lee JY, Lee YM, Hong JP, Won SH, Cho SJ, Kim JY, Chang SM, Lee HW, Cho MJ: Unplanned versus planned suicide attempters, precipitants, methods, and an association with mental disorders in a Korea-based community sample. J Affect Disord. 2010, 127: 274-280. 10.1016/j.jad.2010.05.027.CrossRefPubMed
9.
go back to reference Alonso J, Angermeyer MC, Bernert S, Bruffaerts R, Brugha TS, Bryson H, de Girolamo G, Graaf R, Demyttenaere K, Gasquet I, Haro JM, Katz SJ, Kessler RC, Kovess V, Lépine JP, Ormel J, Polidori G, Russo LJ, Vilagut G, Almansa J, Arbabzadeh-Bouchez S, Autonell J, Bernal M, Buist-Bouwman MA, Codony M, Domingo-Salvany A, Ferrer M, Joo SS, Martínez-Alonso M, Matschinger H, Mazzi F, Morgan Z, Morosini P, Palacín C, Romera B, Taub N, Vollebergh WA: Use of mental health services in Europe: results from the European Study of the Epidemiology of Mental Disorders (ESEMeD) project. Acta Psychiatr Scand. 2004, 420: 47-54. Alonso J, Angermeyer MC, Bernert S, Bruffaerts R, Brugha TS, Bryson H, de Girolamo G, Graaf R, Demyttenaere K, Gasquet I, Haro JM, Katz SJ, Kessler RC, Kovess V, Lépine JP, Ormel J, Polidori G, Russo LJ, Vilagut G, Almansa J, Arbabzadeh-Bouchez S, Autonell J, Bernal M, Buist-Bouwman MA, Codony M, Domingo-Salvany A, Ferrer M, Joo SS, Martínez-Alonso M, Matschinger H, Mazzi F, Morgan Z, Morosini P, Palacín C, Romera B, Taub N, Vollebergh WA: Use of mental health services in Europe: results from the European Study of the Epidemiology of Mental Disorders (ESEMeD) project. Acta Psychiatr Scand. 2004, 420: 47-54.
10.
go back to reference Mojtabai R, Olfson M, Mechanic D: Perceived need and help-seeking in adults with mood, anxiety, or substance use disorders. Arch Gen Psychiatry. 2002, 59: 77-84. 10.1001/archpsyc.59.1.77.CrossRefPubMed Mojtabai R, Olfson M, Mechanic D: Perceived need and help-seeking in adults with mood, anxiety, or substance use disorders. Arch Gen Psychiatry. 2002, 59: 77-84. 10.1001/archpsyc.59.1.77.CrossRefPubMed
11.
go back to reference Cho SJ, Lee JY, Hong JP, Lee HB, Cho MJ, Hahm BJ: Mental health service use in a nationwide sample of Korean adults. Soc Psychiatry Psychiatr Epidemiol. 2009, 44: 943-951. 10.1007/s00127-009-0015-7.CrossRefPubMed Cho SJ, Lee JY, Hong JP, Lee HB, Cho MJ, Hahm BJ: Mental health service use in a nationwide sample of Korean adults. Soc Psychiatry Psychiatr Epidemiol. 2009, 44: 943-951. 10.1007/s00127-009-0015-7.CrossRefPubMed
12.
go back to reference Amone-P'Olak K, Ormel J, Oldehinkel AJ, Reijneveld SA, Verhulst FC, Burger H: Socioeconomic position predicts specialty mental health service use independent of clinical severity: the TRAILS study. J Am Acad Child Adolesc Psychiatry. 2010, 49: 647-655. 10.1016/j.jaac.2010.03.007.CrossRefPubMed Amone-P'Olak K, Ormel J, Oldehinkel AJ, Reijneveld SA, Verhulst FC, Burger H: Socioeconomic position predicts specialty mental health service use independent of clinical severity: the TRAILS study. J Am Acad Child Adolesc Psychiatry. 2010, 49: 647-655. 10.1016/j.jaac.2010.03.007.CrossRefPubMed
13.
go back to reference Sareen J, Jagdeo A, Cox BJ, Clara I, ten Have M, Belik SL, de Graaf R, Stein MB: Perceived barriers to mental health service utilization in the United States, Ontario, and the Netherlands. Psychiatr Serv. 2007, 58: 357-364. 10.1176/ps.2007.58.3.357.CrossRefPubMed Sareen J, Jagdeo A, Cox BJ, Clara I, ten Have M, Belik SL, de Graaf R, Stein MB: Perceived barriers to mental health service utilization in the United States, Ontario, and the Netherlands. Psychiatr Serv. 2007, 58: 357-364. 10.1176/ps.2007.58.3.357.CrossRefPubMed
14.
go back to reference Cook TM, Wang J: Descriptive epidemiology of stigma against depressive mood in a general population sample in Alberta. BMC Psychiatry. 2010, 10: 29-10.1186/1471-244X-10-29.CrossRefPubMedPubMedCentral Cook TM, Wang J: Descriptive epidemiology of stigma against depressive mood in a general population sample in Alberta. BMC Psychiatry. 2010, 10: 29-10.1186/1471-244X-10-29.CrossRefPubMedPubMedCentral
15.
go back to reference Gonzalez JM, Alegría M, Prihoda TJ, Copeland LA, Zeber JE: How the relationship of attitudes toward mental health treatment and service use differs by age, gender, ethnicity/race and education. Soc Psychiatry Psychiatr Epidemiol. 2011, 46: 45-57. 10.1007/s00127-009-0168-4.CrossRefPubMed Gonzalez JM, Alegría M, Prihoda TJ, Copeland LA, Zeber JE: How the relationship of attitudes toward mental health treatment and service use differs by age, gender, ethnicity/race and education. Soc Psychiatry Psychiatr Epidemiol. 2011, 46: 45-57. 10.1007/s00127-009-0168-4.CrossRefPubMed
16.
go back to reference Gudmundsdottir G, Vilhjalmsson R: Group differences in outpatient help-seeking for psychological distress: results from a national prospective study of Icelanders. Scand J Public Health. 2010, 38: 160-167. 10.1177/1403494809357357.CrossRefPubMed Gudmundsdottir G, Vilhjalmsson R: Group differences in outpatient help-seeking for psychological distress: results from a national prospective study of Icelanders. Scand J Public Health. 2010, 38: 160-167. 10.1177/1403494809357357.CrossRefPubMed
17.
go back to reference Rhodes AE, Goering PN, To T, Williams JI: Gender and outpatient mental health service use. Soc Sci Med. 2002, 4: 1-10. 10.1016/S0277-9536(01)00002-8.CrossRef Rhodes AE, Goering PN, To T, Williams JI: Gender and outpatient mental health service use. Soc Sci Med. 2002, 4: 1-10. 10.1016/S0277-9536(01)00002-8.CrossRef
18.
go back to reference Greenley JR, Mechanic D, Cleary PD: Seeking help for psychologic problems: a replication and extension. Med Care. 1987, 25: 1113-1128. 10.1097/00005650-198712000-00001.CrossRefPubMed Greenley JR, Mechanic D, Cleary PD: Seeking help for psychologic problems: a replication and extension. Med Care. 1987, 25: 1113-1128. 10.1097/00005650-198712000-00001.CrossRefPubMed
19.
go back to reference Have M, Oldehinkel A, Vollebergh W, Ormel J: Does educational background explain inequalities in care service use for mental health problems in the Dutch general population?. Acta Psychiatr Scand. 2003, 107: 178-187. 10.1034/j.1600-0447.2003.00074.x.CrossRefPubMed Have M, Oldehinkel A, Vollebergh W, Ormel J: Does educational background explain inequalities in care service use for mental health problems in the Dutch general population?. Acta Psychiatr Scand. 2003, 107: 178-187. 10.1034/j.1600-0447.2003.00074.x.CrossRefPubMed
20.
go back to reference Wang PS, Lane M, Olfson M, Pincus HA, Wells KB, Kessler RC: Twelve-month use of mental health services in the United States: results from the National Comorbidity Survey Replication. Arch Gen Psychiatry. 2005, 62: 629-640. 10.1001/archpsyc.62.6.629.CrossRefPubMed Wang PS, Lane M, Olfson M, Pincus HA, Wells KB, Kessler RC: Twelve-month use of mental health services in the United States: results from the National Comorbidity Survey Replication. Arch Gen Psychiatry. 2005, 62: 629-640. 10.1001/archpsyc.62.6.629.CrossRefPubMed
21.
go back to reference Kwon S: Thirty years of national health insurance in South Korea: lessons for achieving universal health care coverage. Health Policy Plan. 2009, 24 (1): 63-71. 10.1093/heapol/czn037.CrossRefPubMed Kwon S: Thirty years of national health insurance in South Korea: lessons for achieving universal health care coverage. Health Policy Plan. 2009, 24 (1): 63-71. 10.1093/heapol/czn037.CrossRefPubMed
22.
go back to reference Kim J, Jo I: Age-dependent association between sleep duration and hypertension in the adult Korean population. Am J Hypertens. 2010, 23: 1286-1291. 10.1038/ajh.2010.166.CrossRefPubMed Kim J, Jo I: Age-dependent association between sleep duration and hypertension in the adult Korean population. Am J Hypertens. 2010, 23: 1286-1291. 10.1038/ajh.2010.166.CrossRefPubMed
23.
go back to reference Herrman H, Patrick DL, Diehr P, Martin ML, Fleck M, Simon GE, Buesching DP: Longitudinal investigation of depression outcomes in primary care in six countries: the LIDO study. Functional status, health service use and treatment of people with depressive symptoms. Psychol Med. 2002, 32: 889-902.CrossRefPubMed Herrman H, Patrick DL, Diehr P, Martin ML, Fleck M, Simon GE, Buesching DP: Longitudinal investigation of depression outcomes in primary care in six countries: the LIDO study. Functional status, health service use and treatment of people with depressive symptoms. Psychol Med. 2002, 32: 889-902.CrossRefPubMed
24.
go back to reference Andersen RM: Revisiting the behavioral model and access to medical care: does it matter?. J Health Soc Behav. 1995, 36: 1-10. 10.2307/2137284.CrossRefPubMed Andersen RM: Revisiting the behavioral model and access to medical care: does it matter?. J Health Soc Behav. 1995, 36: 1-10. 10.2307/2137284.CrossRefPubMed
25.
go back to reference Aromaa E, Tolvanen A, Tuulari J, Wahlbeck K: Personal stigma and use of mental health services among people with depressive mood in a general population in Finland. BMC Psychiatry. 2011, 11: 52-10.1186/1471-244X-11-52.CrossRefPubMedPubMedCentral Aromaa E, Tolvanen A, Tuulari J, Wahlbeck K: Personal stigma and use of mental health services among people with depressive mood in a general population in Finland. BMC Psychiatry. 2011, 11: 52-10.1186/1471-244X-11-52.CrossRefPubMedPubMedCentral
26.
go back to reference Bakish D: The patient with comorbid depressive mood and anxiety: the unmet need. J Clin Psychiatry. 1999, 60: 20-24.PubMed Bakish D: The patient with comorbid depressive mood and anxiety: the unmet need. J Clin Psychiatry. 1999, 60: 20-24.PubMed
27.
go back to reference Hämäläinen J, Isometsä E, Laukkala T, Kaprio J, Poikolainen K, Heikkinen M, Lindeman S, Aro H: Use of health services for major depressive episode in Finland. J Affect Disord. 2004, 79: 105-112. 10.1016/S0165-0327(02)00342-7.CrossRefPubMed Hämäläinen J, Isometsä E, Laukkala T, Kaprio J, Poikolainen K, Heikkinen M, Lindeman S, Aro H: Use of health services for major depressive episode in Finland. J Affect Disord. 2004, 79: 105-112. 10.1016/S0165-0327(02)00342-7.CrossRefPubMed
28.
go back to reference Verhulst FC, van der Ende J: Factors associated with child mental health service use in the community. J Am Acad Child Adolesc Psychiatry. 1997, 36: 901-909. 10.1097/00004583-199707000-00011.CrossRefPubMed Verhulst FC, van der Ende J: Factors associated with child mental health service use in the community. J Am Acad Child Adolesc Psychiatry. 1997, 36: 901-909. 10.1097/00004583-199707000-00011.CrossRefPubMed
29.
go back to reference Leaf PJ, Bruce ML: Gender differences in the use of mental health-related services: a re-examination. J Health Soc Behav. 1987, 28: 171-183. 10.2307/2137130.CrossRefPubMed Leaf PJ, Bruce ML: Gender differences in the use of mental health-related services: a re-examination. J Health Soc Behav. 1987, 28: 171-183. 10.2307/2137130.CrossRefPubMed
30.
go back to reference Wang J, Fick G, Adair C, Lai D: Gender specific correlates of stigma toward depressive mood in a Canadian general population sample. J Affect Disord. 2007, 103: 91-97. 10.1016/j.jad.2007.01.010.CrossRefPubMed Wang J, Fick G, Adair C, Lai D: Gender specific correlates of stigma toward depressive mood in a Canadian general population sample. J Affect Disord. 2007, 103: 91-97. 10.1016/j.jad.2007.01.010.CrossRefPubMed
31.
go back to reference Conner KO, Copeland VC, Grote NK, Koeske G, Rosen D, Reynolds CF, Brown C: Mental health treatment seeking among older adults with depressive mood: the impact of stigma and race. Am J Geriatr Psychiatry. 2010, 18: 531-543. 10.1097/JGP.0b013e3181cc0366.CrossRefPubMedPubMedCentral Conner KO, Copeland VC, Grote NK, Koeske G, Rosen D, Reynolds CF, Brown C: Mental health treatment seeking among older adults with depressive mood: the impact of stigma and race. Am J Geriatr Psychiatry. 2010, 18: 531-543. 10.1097/JGP.0b013e3181cc0366.CrossRefPubMedPubMedCentral
32.
go back to reference Young AS, Klap R, Sherbourne CD, Wells KB: The quality of care for depressive and anxiety disorders in the United States. Arch Gen Psychiatry. 2001, 58: 55-61. 10.1001/archpsyc.58.1.55.CrossRefPubMed Young AS, Klap R, Sherbourne CD, Wells KB: The quality of care for depressive and anxiety disorders in the United States. Arch Gen Psychiatry. 2001, 58: 55-61. 10.1001/archpsyc.58.1.55.CrossRefPubMed
33.
go back to reference Lee HY, Hahm MI, Park EC: Differential association of socio-economic status with gender- and age-defined suicidal ideation among adult and elderly individuals in South Korea. Psychiatry Res. 2013, 210 (1): 323-328. 10.1016/j.psychres.2013.05.012. [Epub 2013 Jun 14]CrossRefPubMed Lee HY, Hahm MI, Park EC: Differential association of socio-economic status with gender- and age-defined suicidal ideation among adult and elderly individuals in South Korea. Psychiatry Res. 2013, 210 (1): 323-328. 10.1016/j.psychres.2013.05.012. [Epub 2013 Jun 14]CrossRefPubMed
34.
go back to reference Tijhuis MA, Peters L, Foets M: An orientation toward help-seeking for emotional problems. Soc Sci Med. 1990, 31: 989-995. 10.1016/0277-9536(90)90108-5.CrossRefPubMed Tijhuis MA, Peters L, Foets M: An orientation toward help-seeking for emotional problems. Soc Sci Med. 1990, 31: 989-995. 10.1016/0277-9536(90)90108-5.CrossRefPubMed
35.
go back to reference Taube CA, Kessler LG, Burns BJ: Estimating the probability and level of ambulatory mental health services use. Health Serv Res. 1986, 21: 321-340.PubMedPubMedCentral Taube CA, Kessler LG, Burns BJ: Estimating the probability and level of ambulatory mental health services use. Health Serv Res. 1986, 21: 321-340.PubMedPubMedCentral
36.
go back to reference Watkins C, Daniels L, Jack C, Dickinson H, van Den Broek M: Accuracy of a single question in screening for depression in a cohort of patients after stroke: comparative study. BMJ. 2001, 323: 1159-10.1136/bmj.323.7322.1159.CrossRefPubMedPubMedCentral Watkins C, Daniels L, Jack C, Dickinson H, van Den Broek M: Accuracy of a single question in screening for depression in a cohort of patients after stroke: comparative study. BMJ. 2001, 323: 1159-10.1136/bmj.323.7322.1159.CrossRefPubMedPubMedCentral
37.
go back to reference Mahoney J, Drinka TJ, Abler R, Gunter-Hunt G, Matthews C, Gravenstein S, Carnes M: Screening for depression: single question versus GDS. J Am Geriatr Soc. 1994, 42: 1006-1008.CrossRefPubMed Mahoney J, Drinka TJ, Abler R, Gunter-Hunt G, Matthews C, Gravenstein S, Carnes M: Screening for depression: single question versus GDS. J Am Geriatr Soc. 1994, 42: 1006-1008.CrossRefPubMed
Metadata
Title
Sociodemographic factors associated with the use of mental health services in depressed adults: results from the Korea National Health and Nutrition Examination Survey (KNHANES)
Authors
Se Jin Park
Hong Jin Jeon
Ju Young Kim
Sohye Kim
Sungwon Roh
Publication date
01-12-2014
Publisher
BioMed Central
Published in
BMC Health Services Research / Issue 1/2014
Electronic ISSN: 1472-6963
DOI
https://doi.org/10.1186/s12913-014-0645-7

Other articles of this Issue 1/2014

BMC Health Services Research 1/2014 Go to the issue

Reviewer acknowledgement

Reviewer acknowledgement 2013