한국 성인의 동반 식사에 따른 우울감과 자살생각의 관련성 : 제6기(2013, 2015)와 제7기(2017) 국민건강영양조사를 활용하여

Abstract

Background: The purpose of this study was to investigate an association between commensality and mental health according to a increasing phenomenon of eating alone in a modern society. Thus, this study aim to identify more specific personal and socioeconomic factors which effect depression and suicidal ideation in korean adults. Methods: This study used a primitive data from the sixth Korean National Health and Nutrition Examination Survey in 2013-2015(excluded data in 2014) and the seventh KNHNES in 2017 by the CDCP. Totally, 14,125 adults over 19-year- olds(5,854 men and 8,271 women) were enrolled for this study population. Interest variable was commensality, eating together with family members and others, and dependent variables were the experience status of depression in two weeks and suicidal ideation in the past one year. And independent variables were used to find out which socioeconomic factors(sex, household members, generation, residential area, household income, education level, occupation) and health status and behavior factors(chronic illness, smoking, drinking) were associated with depression and suicidal ideation. The collected data was analyzed by using SAS version 9.4, frequency analysis with Rao-scott chi-square and multiple logistic regression analysis to evaluate the association using eating all 3 meals together group as a reference. Result: The results confirmed that commensality was associated with depression and suicidal ideation, and differently depending on personal or social structural characteristics(p<0.05). after adjusting for controlled variables, the result described that those who ate less meals together had greater depressive symptoms and suicidal ideation for both men and women; depression adjusted odds ratios (ORs) (95% confidence intervals [CIs]) were 1.72(1.27–2.34) in men and 1.58(1.28- 1.95) in women who ate no meals together compared to those ate all meals together. Whereas, men(OR=2.16(CI=1.41-3.30)) and women(OR=1.64(CI=1.24 -2.17)) who ate no meals together were significantly associated with suicidal ideation. In generation subgroup, those who ate no meals together of 50-64 years old male(OR=2.32(CI=1.35-3.97), 30-49 years old female(OR=1.70(CI=1.03-2.80), and over 65 years female(OR=2.04(CI=1.44-2.89) were statistically significant for depression. And in household member subgroups, both male and female who lived alone, even if there was no statistically significant results for depression and suicidal ideation, showed greater association with depression and suicidal ideation than those in living together subgroups. On the other hand, those who ate no meals together in groups of living together were significantly associated; men(OR=1.55(CI=1.08-2.24)) and women(OR=1.56(CI=1.23-1.99)) in depression and also men(OR=2.11(CI=1.29-3.46)) and women(OR=2.10(CI=1.48-2.96)) in suicidal ideation. In residential subgroup, men living in city(OR=1.92(CI=1.18-3.12)) and living in rural region(OR=3.11(CI=1.47-6.60)) were significantly associated with depression than those living in metropolis. Men living in city(OR=3.01(CI=1.53- 5.94)) only significantly associated with suicidal ideation. Whereas, women living in metropolis(OR=1.70(CI=1.23-2.34)) and living in city(OR=1.73(CI=1.22-2.46)) were significantly greater association with depression than those living in rural region. In income subgroups, men in low income group(OR=2.39(CI=1.40-4.10)) were significantly greater association with depression than men in high income group(OR=2.14(CI=1.02-4.46)). Oppositely, suicidal ideation were greater for men in high income group(OR=6.45(CI=2.15-19.33)). Whereas, both depression (OR=2.04(CI=1.24-3.35)) and suicidal ideation(OR=3.04(CI=1.34-6.91)) for women were significantly associated with medium-low income group, which statistically greater when those who ate less meals together. Conclusion: This study result found that eating alone may have an impact on depression and suicidal ideation to both men and women, which could lead to suicide attempt. Therefore, additional study and policy development on announcing an importance of commensality should be followed and promoted for a healthy mental status in korean adults. This study could be used as a basic material for future commensality research.