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Analysis of factors related to the use of Korean medicine treatment in adult patients with depressed mood: Based on the Korea Health Panel Annual Data 2019

Article information

J Korean Med. 2024;45(2):83-95
Publication date (electronic) : 2024 June 01
doi : https://doi.org/10.13048/jkm.24026
Tae-Hyeon Lee1orcid_icon, Il-Su Park2orcid_icon, Chan-Young Kwon3,orcid_icon
1Department of Biomedical Health Science, Dong-eui University Graduate School
2Department of Healthcare Management, Dong-eui University College of Nursing, Healthcare Sciences and Human Ecology
3Department of Oriental Neuropsychiatry, Dong-eui University College of Korean Medicine
Correspondence to: Chan-Young Kwon, Department of Oriental Neuropsychiatry, Dong-eui University College of Korean Medicine, 52-57, Yangjeong-ro, Busanjin-gu, Busan, Republic of Korea, Tel: +82-51-850-8808, Fax: +82-51-867-5162, E-mail, beanalogue@deu.ac.kr
Received 2024 April 19; Revised 2024 May 6; Accepted 2024 May 7.

Abstract

Objectives

This study analyzed the factors related to outpatient service to Western medicine (WM) and Korean medicine (KM) of Korean adults with depressed mood using data from the 2019 Korea Health Panel Study.

Methods

The general characteristics according to group of 827 individuals, and the factors influencing the use of integrative medicine (IM) medical service were identified using the Chi-square test and binary logistic regression results. The factors were classified based on the Andersen healthcare utilization model. The results of regression analysis were presented as odds ratio (OR) and 95% confidence interval (CI).

Results

Among the individuals of the study, 658 (79.6%) were in the WM group and 169 (20.4%) were in the IM group. In the WM group and the IM group, the presence of suicidal ideation was common at 37.7% and 43.2%, respectively. As a result of regression analysis, the living in Busan/Daegu/Ulsan/Gyeongsang compared to living in Seoul/Gyeonggi/Incheon [OR = 0.522 (95% CI = 0.328 to 0.830)], and presence of musculoskeletal [OR = 1.686 (95% CI = 1.071 to 2.653)] and mood disorders [OR = 1.737 (95% CI = 1.106 to 2.726)] were the most influential factors on the use of IM medical service.

Conclusions

This study is the first in Korea to analyze the patterns of medical institution use and factors used in KM treatment among adults with depressed mood. The results of this study provide preliminary evidence for the contribution of KM to national mental health in the context of depression.

Keywords: Korean medicine; Depression; Depressed mood; Pain; Korea Health Panel Annual Data

Differences in characteristics according to treatment group.

Differences in individual chronic disease according to treatment group.

감사의 말씀

This work was supported by Innovative Human Resource Development for Local Intellectualization program through the Institute of Information & Communications Technology Planning & Evaluation (IITP) grant funded by the Korea government (MSIT) (IITP-2024-2020-0-01791). This study used the Korea Health Panel Annual Data 2019 (Version 2.0.1) jointly hosted by the Korea Institute for Health and Social Affairs and the National Health Insurance Service.

References

1. Constant A, Hesp C, Davey CG, Friston KJ, Badcock PB. 2021;Why depressed mood is adaptive: A numerical proof of principle for an evolutionary systems theory of depression. Comput Psychiatr 5(1):60–80. 10.5334/cpsy.70.
2. Association, A. P. 2013. Diagnostic and statistical manual of mental disorders (dsm-5®) American Psychiatric Publishing.
3. Sarris J, Thomson R, Hargraves F, Eaton M, de Manincor M, Veronese N, et al. 2020;Multiple lifestyle factors and depressed mood: A cross-sectional and longitudinal analysis of the uk biobank (n = 84,860). BMC Med 18(1):354. 10.1186/s12916-020-01813-5.
4. Lee SM, Song JY, Seol A, Lee S, Cho HW, Min KJ, et al. 2023;Depressed mood as a significant risk factor for gynecological cancer aggravation. Int J Environ Res Public Health 20(19):6874. 10.3390/ijerph20196874.
5. Tsai SJ, Hsiao YH, Liao MY, Lee MC. 2022;The influence of depressive mood on mortality in elderly with different health status: Evidence from the taiwan longitudinal study on aging (tlsa). Int J Environ Res Public Health 19(11):6922. 10.3390/ijerph19116922.
6. Kim KA, Kim YE, Yoon SJ. 2021;Descriptive epidemiology on the trends and sociodemographic risk factors of disease burden in years of life lost due to suicide in south korea from 2000 to 2018. BMJ Open 11(2):e043662. 10.1136/bmjopen-2020-043662.
7. OECD. 2024;suicide rates (indicator) 10.1787/a82f3459-en. accessed on 05 may 2024.
8. Favril L, Yu R, Uyar A, Sharpe M, Fazel S. 2022;Risk factors for suicide in adults: Systematic review and meta-analysis of psychological autopsy studies. Evid Based Ment Health 25(4):148–155. 10.1136/ebmental-2022-300549.
9. Schlagbaum P, Ruch DA, Tissue JL, Sheftall AH, Bridge JA. 2020;Depressed mood prior to death. Crisis 41(6):445–452. 10.1027/0227-5910/a000660.
10. Horowitz LM, Ryan PC, Wei AX, Boudreaux ED, Ackerman JP, Bridge JA. 2023;Screening and assessing suicide risk in medical settings: Feasible strategies for early detection. Focus (Am Psychiatr Publ) 21(2):145–151. 10.1176/appi.focus.20220086.
11. An JH, Jeon HJ, Cho SJ, Chang SM, Kim BS, Hahm BJ, et al. 2022;Subthreshold lifetime depression and anxiety are associated with increased lifetime suicide attempts: A korean nationwide study. J Affect Disord 302:170–176. 10.1016/j.jad.2022.01.046.
12. GH L. 2013;Interrelationship between body and mind from eastern and western medicine. The Korean Society of Body·Mind·Spirit Science Conference Proceedings 2013(10):148–155.
13. Kim D, Shih CC, Cheng HC, Kwon SH, Kim H, Lim B. 2021;A comparative study of the traditional medicine systems of south korea and taiwan: Focus on administration, education and license. Integr Med Res 10(3):100685. 10.1016/j.imr.2020.100685.
14. Lee KKC. 2023;Analysis of factors related to the use of korean medicine treatment in patients with mood disorders: Based on 2019 korea health panel annual data. J of Oriental Neuropsychiatry 34(4):349–358. 10.7231/jon.2023.34.4.349.
15. Lee B, Yang C, Yim MH. 2022;Factors affecting korean medicine health care use for functional dyspepsia: Analysis of the korea health panel survey 2017. Healthcare (Basel) 10(7):1192. 10.3390/healthcare10071192.
16. Park E, Jeong Y, Seo J, Bae J, Lee N, Kim E, et al. 2019. A study of strategies for the 2nd korea health panel project Korea Institute for Health and Social Affairs.
17. Andersen RM. 1995;Revisiting the behavioral model and access to medical care: Does it matter? J Health Soc Behav 36(1):1–10.
18. Kwon CY, Shin S, Kwon OJ, Moon W, Kim N, Park M. 2023;National health insurance data analysis for the second-wave development of korean medicine clinical practice guidelines in south korea. J Pharmacopuncture 26(2):198–209. 10.3831/kpi.2023.26.2.198.
19. You J, Li H, Xie D, Chen R, Chen M. 2021;Acupuncture for chronic pain-related depression: A systematic review and meta-analysis. Pain Res Manag 2021;:6617075. 10.1155/2021/6617075.
20. Yan B, Zhu S, Wang Y, Da G, Tian G. 2020;Effect of acupuncture on chronic pain with depression: A systematic review. Evid Based Complement Alternat Med 2020;:7479459. 10.1155/2020/7479459.
21. Yi S, Ngin C, Tuot S, Chhoun P, Fleming T, Brody C. 2017;Utilization of traditional, complementary and alternative medicine and mental health among patients with chronic diseases in primary health care settings in cambodia. Int J Ment Health Syst 11:58. 10.1186/s13033-017-0167-x.
22. Kemper KJ, Gardiner P, Birdee GS. 2013;Use of complementary and alternative medical therapies among youth with mental health concerns. Acad Pediatr 13(6):540–545. 10.1016/j.acap.2013.05.001.
23. Chen B, Wang CC, Lee KH, Xia JC, Luo Z. 2023;Efficacy and safety of acupuncture for depression: A systematic review and meta-analysis. Res Nurs Health 46(1):48–67. 10.1002/nur.22284.
24. Wang Y, Shi YH, Xu Z, Fu H, Zeng H, Zheng GQ. 2019;Efficacy and safety of chinese herbal medicine for depression: A systematic review and meta-analysis of randomized controlled trials. J Psychiatr Res 117:74–91. 10.1016/j.jpsychires.2019.07.003.
25. Cui J, Song W, Jin Y, Xu H, Fan K, Lin D, et al. 2021;Research progress on the mechanism of the acupuncture regulating neuro-endocrine-immune network system. Vet Sci 8(8):149. 10.3390/vetsci8080149.
26. Yang YH, Li CX, Zhang RB, Shen Y, Xu XJ, Yu QM. 2024;A review of the pharmacological action and mechanism of natural plant polysaccharides in depression. Front Pharmacol 15:1348019. 10.3389/fphar.2024.1348019.
27. Adams J, Sibbritt D, Broom A, Loxton D, Pirotta M, Humphreys J, et al. 2011;A comparison of complementary and alternative medicine users and use across geographical areas: A national survey of 1,427 women. BMC Complement Altern Med 11:85. 10.1186/1472-6882-11-85.
28. Adams J, Sibbritt D, Broom A, Loxton D, Wardle J, Pirotta M, et al. 2013;Complementary and alternative medicine consultations in urban and nonurban areas: A national survey of 1427 australian women. J Manipulative Physiol Ther 36(1):12–19. 10.1016/j.jmpt.2012.12.010.
29. Sheng J, Liu S, Wang Y, Cui R, Zhang X. 2017;The link between depression and chronic pain: Neural mechanisms in the brain. Neural Plast 2017;:9724371. 10.1155/2017/9724371.
30. Doan L, Manders T, Wang J. 2015;Neuroplasticity underlying the comorbidity of pain and depression. Neural Plast 2015;:504691. 10.1155/2015/504691.
31. Lee HJ, Choi EJ, Nahm FS, Yoon IY, Lee PB. 2018;Prevalence of unrecognized depression in patients with chronic pain without a history of psychiatric diseases. Korean J Pain 31(2):116–124. 10.3344/kjp.2018.31.2.116.
32. Mitchell AJ, Yadegarfar M, Gill J, Stubbs B. 2016;Case finding and screening clinical utility of the patient health questionnaire (phq-9 and phq-2) for depression in primary care: A diagnostic meta-analysis of 40 studies. BJPsych Open 2(2):127–138. 10.1192/bjpo.bp.115.001685.
33. Indu PS, Anilkumar TV, Pisharody R, Russell PSS, Raju D, Sarma PS, et al. 2017;Primary care screening questionnaire for depression: Reliability and validity of a new four-item tool. BJPsych Open 3(2):91–95. 10.1192/bjpo.bp.116.003053.

Article information Continued

Table 1

Differences in characteristics according to treatment group.

Variables Category WM group (n=658) IM group (n=169) X2 or t (p-value)
Compared to WM group
Age 19–29 46 (7.0%) 7 (4.1%) 1.820 (.177)
30–49 147 (22.3%) 39 (23.1%) .042 (.838)
50–64 188 (28.6%) 40 (23.7%) 1.619 (.203)
65+ 277 (42.1%) 83 (49.1%) 2.692 (.101)
mean age (yr) 58.47±0.65 60.00±1.21 −1.08 (.280)
Sex men 217 (33.0%) 47 (27.8%) 1.653 (.120)
women 441 (67.0%) 122 (72.2%)
Education level elementary school or below 192 (29.2%) 65 (38.5%) 5.409* (.020)
middle or high school 309 (47.0%) 60 (35.5%) 7.144** (.008)
college above 157 (23.9%) 44 (26.0%) .346 (.557)
Region Seoul/Gyeonggi/Incheon 183 (27.8%) 61 (36.1%) 4.436* (.035)
Gangwon 6 (0.9%) 1 (0.6%) .164 (.685)
Daejeon/Chungcheong/Sejong 95 (14.4%) 31 (18.3%) 1.588 (.208)
Gwangju/Jeolla/Jeju 139 (21.1%) 31 (18.3%) .637 (.425)
Busan/Daegu/Ulsan/Gyeongsang 235 (35.7%) 45 (26.6%) 4.958* (.026)
Total income per year 1st percentile 271 (41.2%) 66 (39.1%) .253 (.615)
2nd percentile 162 (24.6%) 37 (21.9%) .547 (.460)
3rd percentile 124 (18.8%) 34 (20.1%) .141 (.707)
4th percentile 101 (15.4%) 32 (18.9%) 1.281 (.258)
mean income (10,000 won) 3244.33±109.63 3671.50±277.09 −1.43 (.154)
Employment status active 296 (45.0%) 84 (49.7%) 1.206 (.272)
non-active 362 (55.0%) 85 (50.3%)
Health insurance type employee or local 580 (88.1%) 154 (91.1%) 1.195 (.274)
medical aid or others 78 (11.9%) 15 (8.9%)
Disability presence 73 (11.1%) 25 (14.8%) 1.761 (.185)
Self-assessed health good 98 (14.9%) 21 (12.4%) .665 (.415)
fair 269 (40.9%) 66 (39.1%) .187 (.666)
poor 291 (44.2%) 82 (48.5%) 1.002 (.317)
Perceived stress very much 97 (14.7%) 33 (19.5%) 2.324 (.127)
much 325 (49.4%) 86 (50.9%) .120 (.729)
a little 193 (29.3%) 41 (24.3%) 1.704 (.192)
rarely 43 (6.5%) 9 (5.3%) .334 (.563)
Anxiety presence 295 (44.8%) 69 (40.8%) .875 (.350)
Suicidal ideation presence 248 (37.7%) 73 (43.2%) 1.716 (.190)
Pain/discomfort very much 38 (5.8%) 5 (3.0%) 2.164 (.141)
much 343 (52.1%) 112 (66.3%) 10.870*** (.001)
no 277 (42.1%) 52 (30.8%) 7.203** (.007)
Chronic disease N of chronic diseases 1.58±0.06 1.92±0.13 −2.48* (.013)
Cancer presence 39 (5.9%) 13 (7.7%) .711 (.399)
Cardio-cerebrovascular presence 269 (40.9%) 71 (42.0%) .071 (.790)
Endocrine presence 160 (24.3%) 39 (23.1%) .113 (.737)
Liver presence 16 (2.4%) 1 (0.6%) 2.261 (.220)
Musculoskeletal presence 224 (34.0%) 81 (47.9%) 11.139*** (.001)
Respiratory presence 24 (3.6%) 4 (2.4%) .674 (.412)
Dementia presence 9 (1.4%) 4 (2.4%) .868 (.315)
Mood disorders presence 115 (17.5%) 42 (24.9%) 4.755* (.029)
Renal presence 12 (1.8%) 1 (0.6%) 1.319 (.485)

Note.

*

p<.05;

**

p<.01;

***

p<.001.

Abbreviations. IM, integrative medicine; WM, Western medicine.

Appendix 1

Differences in individual chronic disease according to treatment group.

Variables Category WM group (n=658) IM group (n=169) X2(p-value)
Compared to WM group
Cancer Gastric cancer presence 2 (0.3%) 2 (1.2%) 2.161 (.187)
Colon cancer presence 3 (0.5%) 1 (0.6%) 0.052 (1.000)
Lung cancer presence 8 (1.2%) 1 (0.6%) 0.487 (.695)
Breast cancer presence 8 (1.2%) 2 (1.2%) 0.001 (1.000)
Cervical cancer presence 2 (0.3%) 0 (0%) 0.515 (1.000)
Thyroid cancer presence 8 (1.2%) 4 (2.4%) 1.246 (.279)
Other cancer presence 14 (2.1%) 4 (2.4%) 0.036 (.772)
Cardio-cerebrovascular Hypertension presence 244 (37.1%) 63 (37.3%) 0.002 (1.000)
Angina pectoris presence 28 (4.3%) 6 (3.6%) 0.170 (.829)
Myocardial infarction presence 27 (4.1%) 11 (6.5%) 1.775 (.214)
Cerebral hemorrhage presence 8 (1.2%) 1 (0.6%) 0.487 (.695)
Cerebral infarction presence 20 (3.0%) 13 (7.7%) 7.598* (.013)
Endocrine Diabetes mellitus presence 134 (20.4%) 36 (21.3%) 0.072 (.831)
Hypothyroidism presence 24 (3.6%) 5 (3.0%) 0.189 (.817)
Hyperthyroidism presence 10 (1.5%) 1 (0.6%) 0.882 (.705)
Liver Hepatitis B&C presence 8 (1.2%) 1 (0.6%) 0.487 (.695)
Alcoholic hepatitis presence 0 (0%) 0 (0%) NA
Liver cirrhosis presence 8 (1.2%) 0 (0%) 2.075 (.371)
Musculoskeletal Knee arthrosis presence 121 (18.4%) 43 (25.4%) 4.209 (.051)
Degenerative arthritis of joints other than the knee presence 48 (7.3%) 19 (11.2%) 2.815 (.113)
Rheumatoid arthritis presence 14 (2.1%) 5 (3.0%) 0.414 (.564)
Intervertebral disc disorder presence 108 (16.4%) 52 (30.8%) 17.759*** (.000)
Other spinal disorders presence 25 (3.8%) 4 (2.4%) 0.815 (.485)
Respiratory Asthma presence 19 (2.9%) 2 (1.2%) 1.578 (.279)
Emphysema presence 0 (0%) 0 (0%) NA
COPD presence 7 (1.1%) 2 (1.2%) 0.018 (1.000)
Bronchiectasis presence 3 (0.5%) 0 (0%) 0.773 (1.000)
Dementia Dementia presence 9 (1.4%) 4 (2.4%) 0.868 (.315)
Mood disorders Depressive or bipolar disorder presence 115 (17.5%) 42 (24.9%) 4.755* (.029)
Renal Chronic renal failure presence 12 (1.8%) 1 (0.6%) 1.319 (.485)

Note.

*

p<.05;

***

p<.001.

Abbreviations. COPD, chronic obstructive pulmonary disease; IM, integrative medicine; NA, not applicable; WM, Western medicine.