key: cord-0961484-exow61gi authors: Kim, So Young; Kim, Hye-Rim; Park, Bumjung; Choi, Hyo Geun title: Comparison of Stress and Suicide-Related Behaviors Among Korean Youths Before and During the COVID-19 Pandemic date: 2021-12-13 journal: JAMA Netw Open DOI: 10.1001/jamanetworkopen.2021.36137 sha: f91a7f7cb6bb80e0af6232825e796b57992197fb doc_id: 961484 cord_uid: exow61gi IMPORTANCE: The COVID-19 pandemic has had a substantial psychological effect on young people. A quantitative assessment of the association between the pandemic and stress and suicidality in youths is needed. OBJECTIVE: To investigate the association of the COVID-19 pandemic with self-reported stress and suicide-related behaviors in youths. DESIGN, SETTING, AND PARTICIPANTS: This cross-sectional study used data from the the Korea Youth Risk Behavior Web-based Survey (KYRBWS) conducted in 2019 and 2020 with youths aged 12 to 18 years. Statistical analysis was performed from January to February 2021. MAIN OUTCOMES AND MEASURES: The odds ratios (ORs) with 95% CIs for subjective stress level, sadness or despair, suicidal thoughts, suicide planning, and suicide attempts among 2020 participants were compared with those of the 2019 participants using multiple logistic regression analysis with complex sampling using weighted values. RESULTS: The 48 443 youths in the 2019 KYRBWS (24 917 male youths [51.3%]; mean [SD] age, 15.0 [1.7] years) and the 44 216 youths in the 2020 KYRBWS (23 103 male youths [52.5%]; mean [SD] age, 15.1 [1.7] years) were compared. The degree of subjective stress was lower in the 2020 participants than in the 2019 participants (severe stress: adjusted OR [aOR], 0.90 [95% CI, 0.83-0.97]; very severe stress: aOR, 0.65 [95% CI, 0.60-0.72]). Sadness or despair was also lower in the 2020 participants than in the 2019 participants (aOR, 0.81 [95% CI, 0.78-0.84]). There were fewer suicide-related behaviors, including suicidal thoughts, suicide planning, and suicide attempts, among the 2020 participants than among the 2019 participants (suicidal thoughts: aOR, 0.77 [95% CI, 0.73-0.80]; suicide planning: aOR = 0.88 [95% CI, 0.81-0.96]; suicide attempts: aOR, 0.64 [95% CI, 0.58-0.70]). CONCLUSIONS AND RELEVANCE: This cross-sectional study found that severe stress, sadness or despair and suicide-related behaviors had inverse associations with the early COVID-19 pandemic in Korean youths. These findings suggest that levels of high stress decreased among Korean youths in the early period of the pandemic compared with prepandemic levels. Youth Risk Behavior Web-based Survey questionnaire. J Prev Med Public Health 43, 396-402, doi:10.3961/jpmph.2010.43.5.396 (2010 Adjusted for age, BMI, physical exercise, sedentary time for study and leisure, sleep time, sex, economic level, educational level of father and mother, scholastic performance, and subjective health status