코로나19 발생 전후 청년층의 우울 영향요인 비교: 팬데믹 초기를 중심으로

Abstract

Objectives: This study aimed to compare the prevalence and influencing factors of depression among young adults before and during the COVID-19 pandemic, based on Pender’s Health Promotion Model as the theoretical framework. Methods: Data were drawn from the Korea National Health and Nutrition Examination Survey (KNHANES) 2018 and 2020. The sample comprised 2,147 young adults aged 19-34 years (2018: n=1,091; 2020: n=1,056). Depression was defined as a Patient Health Questionnaire-9 (PHQ-9) score of ≥10. Complex-sample analyses with stratification, clustering, and weight- ing were applied. Group differences were examined using Rao–Scott χ²-tests, and predictors of depression were identified through logistic regression. Results: Depression prevalence rose from 5.3% in 2018 to 8.1% in 2020 (p =0.022). Before the pandemic, significant factors included sex, stress, sleep duration, subjective health status, health-related quality of life (HRQOL), high-risk drinking, and economic activity. During the pandemic, significant fac- tors were low education, chronic disease, stress, short sleep, poor subjective health, low HRQOL, suicide planning, smoking, and lack of economic activ- ity. Stress, inadequate or excessive sleep, poor subjective health, low HRQOL, and unemployment were consistently related to depression across both periods. High-risk drinking was significant only before the pandemic, while low education and suicide planning emerged as new risk factors afterward. Conclusions: Depression among young adults increased significantly during the COVID-19 pandemic, with shifts in related factors. Pender’s model high- lighted the interplay of personal, cognitive–affective, and social participation factors, emphasizing the need for tailored interventions and policy support to promote mental health.