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This cross-sectional study analyzed data from 12,541 employees aged 19–65 across 26 companies and public institutions who underwent workplace mental health screening. Workplace bullying was self-reported and categorized into ‘Not bullied,’ ‘Occasional bullied,’ and ‘Frequently bullied.’ Depression was assessed using the Center for Epidemiological Studies Depression scale, and suicidality was measured via a self-reported questionnaire from the Korea National Health and Nutrition Examination Survey. Overall, 18.7% of women and 10.6% of men reported experiencing workplace bullying. Multivariable logistic regression revealed that both the occasionally and frequently bullied were significantly associated with increased odds of suicidal ideation (OR = 1.47, 95% CI = 1.27–1.69; OR = 1.81, 95% CI = 1.36–2.40) and suicide attempts (OR = 2.27, 95% CI = 1.34–3.85; OR = 4.43, 95% CI = 2.13–9.21). The association between bullying and suicidal ideation was significant for participants with and without depression (OR = 1.47, 95% CI = 1.28–1.69; OR = 1.86, 95% CI = 1.31–2.62). Men exhibited a stronger association (p for interaction < 0.001). Whether an individual later had depressive symptoms or not, higher exposure to workplace bullying was associated with higher suicidality risk. The study highlights the need for companies to screen for bullying and provide mental health resources to prevent workplace-related suicides.

Objective The aim of this study was to identify work stress associated with the development of suicidal ideation with a focus on gender and age differences among Korean employees. Methods The data of 95 356 healthy employees aged >18 years who had undergone at least two comprehensive health examinations at Kangbuk Samsung Hospital Health Screening Center, South Korea, were analyzed. Risk of suicidal ideation was assessed using a self-reported questionnaire examining suicidal ideation during the past year. Work stress was measured using the Korean Occupational Stress Scale-Short Form. A Cox proportional hazards model was used to examine relationship between work stress and suicidal ideation. Considering gender and age differences in the association between work stress and suicidal ideation, the data were stratified by gender and age groups. Results During 289 706 person-years of follow-up, suicide ideation was identified in 3 460 participants. For male workers, high job demands and lack of reward were associated with the risk of suicidal ideation in young adults and midlife decade group. Job insecurity was associated with the risk of suicidal ideation in midlife decade and middle-aged and older adulthood. Organizational injustice was associated with the risk of suicidal ideation in middle-aged and older adulthood. Discomfort in an organizational climate was associated with the development of suicidal ideation in all age groups. For female workers, organizational injustice and discomfort in an organizational climate were associated with the risk of suicidal ideation in early adulthood. Conclusion The results suggested that certain work stressors are risk factors of suicidal ideation. Gender and age differences in components of work stress associated with suicidal ideation were also observed.

PurposeThe aim of this study was to identify gender- and age-specific occupational stress associated with depressive symptoms among Korean employees.MethodsData of 73,014 employees aged 18 and above who had undergone comprehensive health examinations at Kangbuk Samsung Hospital Health Screening Center, South Korea, in January 2012 and who were followed up until December 2017 were collected, and 63,959 (participation rate: 87.59%, men: 50,413, women: 13,546) were finally analyzed. A Cox proportional hazards model was used to estimate the hazard ratios and 95% confidence intervals of the relationship between occupational stress and depressive symptoms. In light of gender and age differences in the association between occupational stress and depressive symptoms, interaction and stratification by gender and age groups were tested.ResultsDuring 238,630 person-years of follow-up, case-level depressive symptoms developed in 4227 participants (an incident rate of 1.8%). There were gender differences in the relationship between job stress and incident depressive symptoms. For men, high job demand, job insecurity, lack of reward, and discomfort in their organizational climate were associated with incident depressive symptoms in all age groups. Insufficient job control was associated with the development of depressive symptoms only in midlife and organizational injustice only in early adulthood. For women, the results for high job demand, organizational injustice, and discomfort in an organizational climate were associated with the onset of depressive symptoms from early adulthood to the midlife decade.ConclusionThe results suggest gender and age differences in the relationship between occupational stress and incident depressive symptoms.

Childhood trauma is a well-established risk factor for adult psychopathology, yet the underlying neuropsychiatric mechanisms remain unclear. Therefore, this study examined whether resilience mediates the relationship between childhood trauma and depressive and anxiety symptoms, and whether this pathway is moderated by harm avoidance (HA). A total of 218 Korean adults (aged 19-50 years; 79 men and 139 women) completed validated measures of childhood trauma (Childhood Trauma Questionnaire (CTQ)-Short Form), harm avoidance (Temperament and Character Inventory-Harm Avoidance subscale), resilience (Brief Resilience Scale), depression (Patient Health Questionnaire-9), and anxiety (Generalized Anxiety Disorder-7). Mediation and moderated mediation models were tested using structural equation modeling, and indirect effects were estimated via bootstrapping with 5000 resamples. Childhood trauma was associated with lower resilience, an effect moderated by HA. Resilience was strongly inversely associated with depression and anxiety. Indirect effects of trauma through resilience were significant for both outcomes, with stronger effects at higher HA. The associations between childhood trauma and both depression and anxiety were mediated by resilience, and this indirect pathway was amplified by HA. These findings suggest a neuropsychiatric mechanism whereby early-life stress and temperament jointly shape effective neural vulnerability, leading to depression- and anxiety-associated outcomes.

AimsTo evaluate the bidirectional relationship between blood pressure (BP) and depressive symptoms using a large prospective cohort study.MethodsProspective cohort study was performed in 276 244 adults who participated in a regular health check-up and were followed annually or biennially for up to 5.9 years. BP levels were categorised according to the 2017 American College of Cardiology and American Heart Association hypertension guidelines. Depressive symptoms were assessed using Centre for Epidemiologic Studies-Depression (CESD) questionnaire and a cut-off score of ≥25 was regarded as case-level depressive symptoms.ResultsDuring 672 603.3 person-years of follow-up, 5222 participants developed case-level depressive symptoms. The multivariable-adjusted hazard ratios (HRs) [95% confidence interval (CI)] for incident case-level depressive symptoms comparing hypotension, elevated BP, hypertension stage 1 and hypertension stage 2 to normal BP were 1.07 (0.99–1.16), 0.93 (0.82–1.05), 0.89 (0.81–0.97) and 0.81 (0.62–1.06), respectively (p for trend <0.001). During 583 615.3 person-years of follow-up, 27 787 participants developed hypertension. The multivariable-adjusted HRs (95% CI) for incident hypertension comparing CESD 16–24 and ⩾25 to CESD < 16 were 1.05 (1.01–1.11) and 1.12 (1.03–1.20), respectively (p for trend <0.001) and in the time-dependent models, corresponding HRs (95% CI) were 1.12 (1.02–1.24) and 1.29 (1.10–1.50), respectively (p for trend <0.001).ConclusionsIn this large cohort study of young and middle-aged individuals, higher BP levels were independently associated with a decreased risk for developing case-level depressive symptoms and depressive symptoms were also associated with incident hypertension. Further studies are required to elucidate the mechanisms underlying the bidirectional association between BP levels and incident depression.

Background/Objectives: Anxiety disorders are highly prevalent and impairing psychiatric conditions. Conventional diagnostic approaches based on symptom checklists lack biological specificity and often fail to guide treatment decisions effectively. This study protocol outlines a multidimensional, prospective investigation designed to identify behavioral and neurobiological biomarkers predictive of treatment response in individuals with anxiety-related symptoms, grounded in the Research Domain Criteria framework. Methods: This observational, longitudinal study (NCT06773585) will include a transdiagnostic sample of clinical anxiety group alongside a healthy control group (185 participants, including 145 patients with anxiety disorders and 40 healthy controls). Participants will undergo comprehensive baseline assessments, including clinical interviews, self-report questionnaires, a virtual reality (VR)-based behavioral task, electroencephalography (EEG), electrocardiography (ECG), and structural and functional brain magnetic resonance imaging. Follow-up assessments will be conducted at 2, 6, and 12 months, with recruitment and data collection planned from 2024 to 2029. These complementary modalities are integrated to capture behavioral, physiological, and neural indicators of anxiety and its treatment response. Multimodal baseline features will be used to construct machine-learning models predicting treatment response, defined as ≥40% reduction in anxiety severity scores. Longitudinal analyses will examine symptom trajectories and neural mechanisms associated with response. Neurobiological comparisons will be made across timepoints and between responders, non-responders, and healthy controls. Conclusions: By identifying objective, biologically grounded markers of anxiety and treatment response, our findings will contribute to the development of personalized assessment tools and scalable digital interventions for psychiatric care.

Panic disorder (PD) is a disabling anxiety condition in which early improvement during treatment can predict better long-term outcomes. This study investigated whether a newly developed virtual reality-based assessment tool, the Virtual Reality Assessment of Panic Disorder (VRA-PD), can help predict early treatment response in individuals with PD. In total, 52 participants, including 25 patients diagnosed with PD and 27 healthy individuals, were evaluated every 2 months over a 6-month period. Assessments included self-reported anxiety levels and heart rate variability measured during virtual reality scenarios, as well as standard clinical questionnaires. Patients with PD were further categorized based on their treatment progress into early responders (  = 7) and delayed responders (  = 18). A machine-learning model (CatBoost) was used to classify participants into early responder, delayed responder, and healthy control groups. The model that combined virtual reality-based and conventional clinical data achieved higher accuracy (85%) and F1-score (0.71) than models using only clinical (accuracy: 77%, F1-score: 0.56) or only virtual reality data (accuracy: 75%, F1-score: 0.64). The most important predictors included anxiety levels during virtual scenarios, heart rate variability metrics, and scores from clinical scales such as the Panic Disorder Severity Scale and Anxiety Sensitivity Index. This study highlights the value of virtual reality-based assessments for predicting early treatment outcomes in PD. By providing ecologically valid and individualized measures, virtual reality may enhance clinical decision-making and support personalized mental healthcare.

Background/Objectives: Stressors occurring across the life course are considered to have a cumulative impact on health, but there is no instrument for assessing lifetime stressor exposure in Korea. Therefore, we validated the Stress and Adversity Inventory (Adult STRAIN) in Korean. Methods: We translated the Adult STRAIN into Korean and examined its concurrent, predictive, and comparative predictive validity in 218 Korean adults (79 men, 139 women; Mage = 29.5; 19–50 years old) recruited from a psychiatric setting. We assessed concurrent validity using Pearson’s correlations, predictive validity using multiple regression models, and comparative predictive validity using multivariate logistic regression to identify participants with lifetime psychiatric diagnoses. Results: The Korean STRAIN exhibited sufficient usability and acceptability; good concurrent validity with other measures of early adversity, life events, and perceived stress (rs = 0.48–0.61); and strong predictive validity in relation to anxiety and depressive symptoms (β = 0.08–0.47; ΔR2 = 0.11–0.21). Each domain of Korean-style stress, based on the timing, type, life domain, and sociopsychological characteristics of stress exposure, showed a different distribution of lifetime psychiatric diagnosis probabilities (odds ratios = 1.20–4.85). Finally, the test–retest reliability for total lifetime stressor count and severity over four weeks was high. Conclusions: The Korean STRAIN is a practical, valid, and reliable instrument for researchers and clinicians to efficiently assess lifetime stressor exposure.

We developed and evaluated an interpersonal model of depression in employees, where passion and perseverance affect occupational stress and perceived control, which in turn affect risk of depression. The participants were employees of 18 private companies and local government organizations in Korea aged 19 to 65 years. A total of 11,422 participants completed questionnaires including the Korean version of the Grit scale, the occupational stress scale, the perceived control subscale in the perceived stress scale, and the Center for Epidemiologic Studies Depression Scale. Mediation analysis was performed to determine relationships among trait-level passion and perseverance, work-related stress, perceived control, and depression. Passion and perseverance preceded depression in employees. Higher occupational stress and lower perceived control mediated the association between passion and depression, and between perseverance and depression. Passion and perseverance exert preventive effects on depression by decreasing workplace stress and elevating perceived control. Future studies should investigate the effects of psychological characteristics on the development of depression in employees.

Workplace bullying is a prevalent issue with a significant impact on employees’ mental health. This study aimed to explore the relationship between workplace bullying and the prevalence of depression, with a particular focus on the role of gender. A total of 12,344 Korean employees aged 19–65 years were included in the study. They completed the Center for Epidemiologic Studies Depression Scale (CES-D) and a score of 16 or higher in CES-D indicated depression. The association between workplace bullying and depression was analyzed using logistic regression analyses. The average CES-D scores were higher for both male and female employees who experienced bullying than for those who did not (p < 0.001). The association between the experience of workplace bullying and the prevalence of depression was statistically significant for both genders, with a stronger correlation observed among male employees (p for interaction < 0.001). Organizations are urged to address workplace bullying, particularly for male employees, through the implementation of anti-bullying strategies and policies, as well as the provision of mental health resources and support.