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Unexpected effects of pandemic-related changes on mental health: Evidence from a nationwide survey in South Korea

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  • Won-Hyoung Kim
  • Jonghun Kim
  • Jiyun Oh
  • Seolim Lee
  • Jihwan Chang
  • Younhee Kim

Abstract

Background: Substantial evidence indicates that the COVID-19 pandemic has adversely affected population mental health globally. However, most studies assumed a linear relationship where only negative pandemic-induced changes led to worse mental health outcomes, overlooking the complex relationship between COVID-19-related changes and mental health. This study examined how various types and magnitudes of pandemic-related changes relate to depression and suicidal thoughts in a large, nationwide adult population sample. Methods: We analyzed data from the 2021 Korean Community Health Survey, a cross-sectional survey of 229,213 adults. The study examined the association between mental health outcomes and three types of pandemic-related changes: daily life impact (scored 0–100), economic activities (employment and income changes), and health behaviors (physical activity, instant food consumption, alcohol consumption, and smoking). Complex sample multiple logistic regression analysis was used to assess these associations, adjusting for sociodemographic factors. Results: The relationship between pandemic-related changes and mental health showed non-linear patterns. Compared to those reporting moderate changes, individuals reporting either no change (depression: aOR 1.253, 95% CI 1.135–1.384; suicidal thoughts: aOR 1.355, 95% CI 1.236–1.486) or complete disruption (depression: aOR 1.895, 95% CI 1.667–2.155; suicidal thoughts: aOR 1.788, 95% CI 1.558–2.052) in daily life showed higher risks of poor mental health. Unexpectedly, positive changes such as improved working conditions (suicidal thoughts: aOR 1.419, 95% CI 1.200–1.677) and increased income (depression: aOR 1.304, 95% CI 1.139–1.493; suicidal thoughts: aOR 1.244, 95% CI 1.079–1.435) were also associated with adverse mental health outcomes. Conclusions: This study reveals that both minimal and substantial changes in daily life, as well as both positive and negative changes in economic conditions and health behaviors, were associated with poor mental health outcomes during the pandemic. These findings suggest the need for comprehensive mental health interventions that consider various types and magnitudes of life changes during crisis situations.

Suggested Citation

  • Won-Hyoung Kim & Jonghun Kim & Jiyun Oh & Seolim Lee & Jihwan Chang & Younhee Kim, 2025. "Unexpected effects of pandemic-related changes on mental health: Evidence from a nationwide survey in South Korea," PLOS ONE, Public Library of Science, vol. 20(1), pages 1-14, January.
    • Handle: RePEc:plo:pone00:0317493
    DOI: 10.1371/journal.pone.0317493
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    References listed on IDEAS

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    1. Mihaela Elvira Vuscan & Cristina Faludi & Sergiu Ionica Rusu & Mihaela Laura Vica & Stefana Balici & Costel Vasile Siserman & Horia George Coman & Horea Vladi Matei, 2022. "Determinants of Suicide Ideation in the Romanian Population," IJERPH, MDPI, vol. 19(16), pages 1-10, August.
    2. Teresa Rubio-Tomás & Maria Skouroliakou & Dimitrios Ntountaniotis, 2022. "Lockdown Due to COVID-19 and Its Consequences on Diet, Physical Activity, Lifestyle, and Other Aspects of Daily Life Worldwide: A Narrative Review," IJERPH, MDPI, vol. 19(11), pages 1-41, June.
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