Lifestyle health behaviors and experience of depression among middle and high school students in South Korea: A comparison between 2010-2013 and 2020-2023.

Objectives: A rapidly changing sociocultural environment has led to shifts in the lifestyles of adolescents, which have affected their mental health. This study investigated the relationship between adolescent health behaviors and experience of depression. Methods: We analyzed data from the Korea Youth Risk Behavior Survey, conducted nationwide in South Korea during 2010-2013 and 2020-2023. The sample included 536,450 middle and high school students aged 13-18 years. Complex samples multiple logistic regression was conducted to examine the association between health behaviors and experience of depression. Results: Compared to data from 10 years earlier, among middle school students, the odds ratio (OR) for experiencing depression associated with smoking increased from the past (OR = 1.68, 95 % confidence interval [CI] = 1.59-1.78) to more recent years (OR = 1.95, 95 % CI = 1.75-2.17), and for drinking, it increased from the past (OR = 1.75, 95 % CI = 1.68-1.84) to more recent years (OR = 1.90, 95 % CI = 1.79-2.02). Similarly, among high school students, the OR for experiencing depression associated with smoking increased from the past (OR = 1.46, 95 % CI = 1.40-1.51) to more recent years (OR = 1.70, 95 % CI = 1.60-1.81), and for drinking, it increased from the past (OR = 1.48, 95 % CI = 1.43-1.52) to more recent years (OR = 1.52, 95 % CI = 1.46-1.59). Conclusions: The associations between smoking and drinking and experience of depression appear to have strengthened recently. These findings suggest that continued attention to these health behaviors may be important for adolescent mental health.