National Trends in Sadness, Suicidality, and COVID-19 Pandemic-Related Risk Factors Among South Korean Adolescents From 2005 to 2021.

Importance: Despite the COVID-19 pandemic's effect on daily life, limited research exists on the prevalence and risk factors of suicidality and sadness among South Korean adolescents. Objectives: To examine whether the observed sadness and suicidality in the early to middle periods of the COVID-19 pandemic differed from the expected level and to investigate changes in risk factors for sadness and suicidality. Design, Setting, and Participants: This nationwide serial cross-sectional survey study used data on 1 109 776 Korean adolescents aged 13 to 18 years from the Korea Youth Risk Behavior Web-based Survey from 2005 to 2021. Exposure: The COVID-19 pandemic. Main Outcomes and Measures: The pattern of changes in the percentage or proportion of sadness or suicidality, as well as the risk factors for sadness or suicidality. The transitional effect of the COVID-19 pandemic was assessed using weighted odds ratios (wORs) or weighted beta coefficients with 95% CIs. Results: Between 2005 and 2021, 1 109 776 adolescents (mean [SD] age, 15.0 [1.7] years; 51.5% male adolescents; and 51.7% in grades 7-9 and 48.3% in grades 10-12) were included in the Korea Youth Risk Behavior Web-based Survey. The slope of the long-term trends in sadness and suicidality decreased in the prepandemic period (sadness: from 37.8% [95% CI, 37.4%-38.2%] in 2005-2007 to 26.1% [95% CI, 25.9%-26.4%] in 2016-2019; suicidality: from 23.0% [95% CI, 22.7%-23.3%] in 2005-2007 to 12.3% [95% CI, 12.1%-12.5%] in 2016-2019), whereas the slope increased during the COVID-19 pandemic (sadness: from 25.0% [95% CI, 24.5%-25.6%] in 2020 to 26.6% [95% CI, 26.1%-27.1%] in 2021; trend difference in ß, 0.249 [95% CI, 0.236-0.262]; suicidality: from 10.7% [95% CI, 10.3%-11.1%] in 2020 to 12.5% [95% CI, 12.1%-12.9%] in 2021; trend difference in ß, 0.328 [95% CI, 0.312-0.344]). The trends presented a similar tendency in the subgroups according to sex, school grade, residential area, smoking status, and current alcohol use. Compared with the prepandemic period, the risk factors associated with sadness during the pandemic were younger age (wOR, 0.907; 95% CI, 0.881-0.933), female sex (wOR, 1.031; 95% CI, 1.001-1.062), urban residence (wOR, 1.120; 95% CI, 1.087-1.153), current smoking status (wOR, 1.134; 95% CI, 1.059-1.216), and current alcohol use (wOR, 1.051; 95% CI, 1.002-1.102). Female sex (wOR, 1.064; 95% CI, 1.021-1.109), urban residence (wOR, 1.117; 95% CI, 1.074-1.162), and low economic status (wOR, 1.286; 95% CI, 1.180-1.403) were the risk factors significantly associated with suicidality after the COVID-19 pandemic began. Conclusions and Relevance: In this nationwide serial cross-sectional survey study of South Korean adolescents, the slope of the prevalence of sadness and suicidality increased during the COVID-19 pandemic after a decrease prior to the pandemic. The findings suggest that public health measures are needed to recognize vulnerable groups with risk factors and to prevent an increase in sadness and suicidality among adolescents during the COVID-19 pandemic.

National Trends in Physical Activity Among Adults in South Korea Before and During the COVID-19 Pandemic, 2009-2021.

Importance: There is a lack of comprehensive data on the association of the COVID-19 pandemic with the prevalence of physical activity in large-scale data sets. Objective: To investigate long-term trends in physical activity using information from a nationally representative survey covering 2009 to 2021. Design, Setting, and Participants: This general population-based and repeated cross-sectional study was conducted from 2009 to 2021 using the Korea Community Health Survey, a nationally representative survey in South Korea. Data from 2009 to 2021 for 2 748 585 Korean adults were obtained through a nationwide, large-scale, serial study. Data were analyzed from December 2022 through January 2023. Exposure: COVID-19 pandemic onset. Main Outcomes and Measures: The trend of sufficient aerobic physical activity was measured by prevalence and mean metabolic equivalent of task (MET) score based on World Health Organization physical activity guidelines and defined as 600 MET-min/wk or greater. The cross-sectional survey included age, sex, body mass index (BMI), region of residence, education level, income level, smoking status, alcohol consumption level, stress status, physical activity level, and history of diabetes, hypertension, and depression. Results: Among 2 748 585 Korean adults (738 934 aged 50-64 years [29.1%] and 657 560 aged ≥65 years [25.9%]; 1 178 869 males [46.4%]), the prevalence of sufficient physical activity did not change significantly during the prepandemic period (ß difference, 1.0; 95% CI, 0.6 to 1.4). During the pandemic, the prevalence of sufficient physical activity decreased significantly, from 36.0% (95% CI, 35.9% to 36.1%) in 2017 to 2019 to 30.0% (95% CI, 29.8% to 30.2%) in 2020 and 29.7% (95% CI, 29.5% to 29.9%) in 2021. Trends showed decreases in the prevalence of sufficient physical activity among older adults (ages ≥65 years; ß difference, -16.4; 95% CI, -17.5 to -15.3) and younger adults (ages 19 to 29 years; ß difference, -16.6; 95% CI, -18.1 to -15.0) during the pandemic. In particular, the trend of sufficient physical activity declined during the pandemic in females (ß difference, -16.8; 95% CI, -17.6 to -16.0), individuals in urban residences (ß difference, -21.2; 95% CI, -22.2 to -20.2), healthy participants (eg, those with normal BMI, 18.5 to 22.9: ß difference,-12.5; 95% CI, -13.4 to -11.7), and individuals at increased risk of stress (eg, history of a depressive episode; ß difference, -13.7; 95% CI, -19.1 to -8.4). Prevalence trends in mean MET score were similar to those in the main results; total mean MET score decreased from the 2017 to 2019 period (1579.1 MET-min/wk; 95% CI, 1567.5 to 1590.7 MET-min/wk) to the 2020 to 2021 period (1191.9 MET-min/wk; 95% CI, 1182.4 to 1201.4 MET-min/wk. Conclusions and Relevance: This cross-sectional study found that the national prevalence of physical activity was stable or consistent before the pandemic period, with a marked decrease during the pandemic, particularly among healthy individuals and subgroups at increased risk of negative outcomes, including older adults, females, urban residents, and those with depressive episodes. Future studies may be needed to evaluate the association between the COVID-19 pandemic and changes in physical activity.

Reaching Up, Down, In, and Around: Couple and Family Coping During the Coronavirus Pandemic.

The worldwide coronavirus (COVID-19) has had profound effects on all aspects of life: physical health, the ability to travel locally or to more distant destinations, material and financial resources, and psychosocial wellbeing. Couples, families, and communities and individual persons in those relationships have struggled to cope with emerging depression, anxiety, and trauma, and the rise of relational conflict. In this article, we suggest that the existential nature of the pandemic's challenges requires more than just the usual psychosocial interventions. We propose a taxonomy of responses to foster coping and resilience-"Reaching Up, Down, In, and Around." "Reaching Up" includes accessing spiritual, religious, and ethical values. "Reaching Down" includes ideas and practices that foster a revised relationship with the Earth and its resources, and that engage families to participate in activities that aid the Earth's recovery from decades of human-caused damage. "Reaching In" represents a turn towards experiences available in the mind and in shared minds in relationships that provide pleasure, excitement, joy, and peace, given that external sources of these emotions are of limited availability due to quarantine. "Reaching Around" involves reframing the mandate for "social distancing" as fostering social connection and support while maintaining physical distancing. The challenges for family therapists, whose practices are confined largely to online therapy, and who are struggling with the same fears and constraints as those persons they are attempting to help, are also discussed.

El coronavirus (la COVID-19) mundial ha tenido efectos profundos en todos los aspectos de la vida: en la salud física, en la posibilidad de viajar a nivel local o a destinos más distantes, en los recursos materiales y económicos y en el bienestar psicosocial. Las parejas, las familias, las comunidades y las personas individuales de esas relaciones se han esforzado para hacer frente a la depresión, la ansiedad y el trauma emergentes, y al aumento del conflicto relacional. En este artículo, sugerimos que la índole existencial de las dificultades de la pandemia necesita más que solo las intervenciones psicosociales habituales. Proponemos una taxonomía de respuestas para fomentar el afrontamiento y la resiliencia: "Llegar arriba, abajo, adentro y alrededor". "Llegar arriba" implica acceder a valores espirituales, religiosos y éticos. "Llegar abajo" implica ideas y prácticas que fomenten una relación revisada con la Tierra y sus recursos, y que capten la atención de las familias para participar en actividades que ayuden a la recuperación de la Tierra de décadas de daño causado por los humanos. "Llegar adentro" representa un giro hacia experiencias que hay en la mente y entre mentes por relaciones que brindan placer, entusiasmo, alegría y paz, dado que la disponibilidad de las fuentes externas de estas emociones es limitada debido a la cuarentena. "Llegar alrededor" implica replantear la orden de "distanciamiento social" como fomento de la conexión social y el apoyo mientras se mantiene la distancia física. También se explican las dificultades para los terapeutas familiares, cuyas prácticas están limitadas en gran medida a la terapia en línea, y quienes están luchando contra los mismos miedos y limitaciones que esas personas a quienes intentan ayudar.