Relationship between unemployment, depression, and suicide during COVID-19 among males in South Korea: based on internet search trends

Background: The economic recession caused by the COVID-19 pandemic has led to significant increases in unemployment rates, which negatively affect mental health and contribute to higher rates of depression and suicide. Recent analyses of internet search trends indicate an increased public interest in these mental health issues, promoting efforts to implement web-based interventions. Methods: This study investigated the mediating effects of depression on the relationship between unemployment and suicide in South Korea during COVID-19 by analyzing internet search trends. The search volume of keywords related to unemployment, depression, and suicide during the COVID-19 period (from 21 January 2020, to 11 May 2023) was extracted from South Korea’s largest online search engine data, including searches conducted on both mobile and desktop devices. The study sample included of working-age adult males between the ages of 20 and 60. The search volume data from 1207 search volume entries were extracted and analyzed using SPSS PROCESS macro (version 4.0). Results: The analysis revealed that suicide-related searches had the highest relative frequency, followed by depression and unemployment. Unemployment was found to significantly affect depression, and depression-related keyword searches mediated the association between unemployment- and suicide-related keyword searches. Conclusions: The findings suggest that government policies should prioritize both economic recovery efforts, and mental health support, including unemployment assistance, wage support and suicide prevention services. Developing web-based mental health resources and interventions could strengthen these efforts.

COVID-19; Depression; Suicide; Unemployment; Internet search trend

[1] Bank of Korea. Three major issues related to the COVID-19 labor market and crisis. 2020. Available at: https://www.bok.or.kr/portal/bbs/P0002353/view.do?nttId=10060144&searchCnd=1&searchKwd=&depth2=201156&depth3=200433&date=&sdate=&edate=&sort=1&pageUnit=10&depth=200433&pageIndex=16&programType=newsData&menuNo=200433&oldMenuNo=200433 (Accessed: 29 April 2022).

[2] Barrero JM, Bloom N, Davis SJ. COVID-19 is also a reallocation shock. Brookings Papers on Economic Activity. 2020; 2020: 329–383.

[3] Forsythe E, Kahn LB, Lange F, Wiczer D. Labor demand in the time of COVID-19: evidence from vacancy postings and UI claims. Journal of Public Economics. 2020; 189: 104238.

[4] Organization for Economic Co-operation and Development (OECD). Tackling the mental health impact of the COVID-19 crisis: an integrated, whole-of-society response. 2021. Available at: https://www.oecd-ilibrary.org/social-issues-migration-health/tackling-the-mental-health-impact-of-the-covid-19-crisis-an-integrated-whole-of-society-response_0ccafa0b-en (Accessed: 09 July 2021).

[5] International Labour Organization. ILO Monitor: COVID-19 and the world of work, 8th edition. 2021. Available at: https://www.ilo.org/resource/brief/ilo-monitor-covid-19-and-world-work-8th-edition (Accessed: 06 September 2024).

[6] Griffiths D, Sheehan L, van Vreden C, Petrie D, Grant G, Whiteford P, et al. The impact of work loss on mental and physical health during the COVID-19 pandemic: baseline findings from a prospective cohort study. Journal of Occupational Rehabilitation. 2021; 31: 455–462.

[7] Arena AF, Mobbs S, Sanatkar S, Williams D, Collins D, Harris M, et al. Mental health and unemployment: a systematic review and meta-analysis of interventions to improve depression and anxiety outcomes. Journal of Affective Disorders. 2023; 335: 450–472.

[8] Chang SS, Gunnell D, Sterne JAC, Lu T, Cheng ATA. Was the economic crisis 1997–1998 responsible for rising suicide rates in East/Southeast Asia? A time-trend analysis for Japan, Hong Kong, South Korea, Taiwan, Singapore and Thailand. Social Science & Medicine. 2009; 68: 1322–1331.

[9] Béland LP, Fakorede O, Mikola D. Short-term effect of COVID-19 on self-employed workers in Canada. Canadian Public Policy. 2020; 46: 66–81.

[10] Zhang SX, Liu J, Afshar Jahanshahi A, Nawaser K, Yousefi A, Li J, et al. At the height of the storm: healthcare staff’s health conditions and job satisfaction and their associated predictors during the epidemic peak of COVID-19. Brain, Behavior, and Immunity. 2020; 87: 144–146.

[11] Wilson JM, Lee J, Fitzgerald HN, Oosterhoff B, Sevi B, Shook NJ. Job insecurity and financial concern during the COVID-19 pandemic are associated with worse mental health. Journal of Occupational and Environmental Medicine. 2020; 62: 686–691.

[12] Nemteanu MS, Dinu V, Davija DC. Job insecurity, job instability, and job satisfaction in the context of the COVID-19 pandemic. Journal of Competitiveness. 2021; 13: 65–82.

[13] Stevenson C, Wakefield JRH. Financial distress and suicidal behavior during COVID-19: family identification attenuates the negative relationship between COVID-19-related financial distress and mental ill-health. Journal of Health Psychology. 2021; 26: 2665–2675.

[14] Chang SS, Stuckler D, Yip P, Gunnell D. Impact of 2008 global economic crisis on suicide: time trend study in 54 countries. The BMJ. 2013; 347: f5239.

[15] Breuer C. Unemployment and suicide mortality: evidence from regional panel data in Europe. Health Economics. 2015; 24: 936–950.

[16] Nordt C, Warnke I, Seifritz E, Kawohl W. Modelling suicide and unemployment: a longitudinal analysis covering 63 countries, 2000–11. The Lancet Psychiatry. 2015; 2: 239–245.

[17] Laanani M, Ghosn W, Jougla E, Rey G. Impact of unemployment variations on suicide mortality in Western European countries (2000–2010). Journal of Epidemiology and Community Health. 2015; 69: 103–109.

[18] Demirci Ş, Konca M, Yetim B, İlgün G. Effect of economic crisis on suicide cases: an ARDL bounds testing approach. The International Journal of Social Psychiatry. 2020; 66: 34–40.

[19] Brenner MH, Bhugra D. Acceleration of anxiety, depression, and suicide: secondary effects of economic disruption related to COVID-19. Frontiers in Psychiatry. 2020; 11: 592467.

[20] Elbogen EB, Lanier M, Blakey SM, Wagner HR, Tsai J. Suicidal Ideation and Thoughts of Self-Harm during the COVID-19 pandemic: the role of COVID-19-related stress, social isolation, and financial strain. Depression and Anxiety. 2021; 38: 739–748.

[21] Kawohl W, Nordt C. COVID-19, unemployment, and Suicide. The Lancet Psychiatry. 2020; 7: 389–390.

[22] Statistics Korea. Causes of death statistics 2020. 2021. Available at: https://kostat.go.kr/board.es?mid=a20108100000&bid=11773&act=view&list_no=414516 (Accessed: 20 August 2023).

[23] Korean Society for Traumatic Stress Studies. 2021 COVID-19 National mental health survey. 2021. Available at: http://kstss.kr/?p=2463 (Accessed: 23 May 2024).

[24] Knipe D, Gunnell D, Evans H, John A, Fancourt D. Is Google trends a useful tool for tracking mental and social distress during a public health emergency? A time-series analysis. Journal of Affective Disorders. 2021; 294: 737–744.

[25] Wang A, McCarron R, Azzam D, Stehli A, Xiong G, DeMartini J. Utilizing big data from Google trends to map population depression in the United States: exploratory infidemiology study. JMIR Mental Health. 2022; 9: e35253.

[26] Lopez-Agudo LA. The association between internet searches and suicide in Spain. Psychiatry Research. 2020; 291: 13215.

[27] Roza TH, Souza Seibel G, Recamonde-Mendoza M, Lotufo PA, Bensenor IM, Passos IC, et al. Suicide risk classification with machine learning techniques in a large Brazilian community sample. Psychiatry Research. 2023; 325: 115258.

[28] National Information Society Agency. Internet usage survey 2021. 2021. Available at: https://www.nia.or.kr/site/nia_kor/ex/bbs/View.do?cbIdx=99870&bcIdx=24456&parentSeq=24456 (Accessed: 06 June 2023).

[29] Sueki H, Ito J. Suicide prevention through online gatekeeping using search advertising techniques: a feasibility study. Crisis. 2015; 36: 267–273.

[30] Arendt F. Suicide rates and information seeking via search engines: a cross-national correlational approach. Death Studies. 2018; 42: 508–512.

[31] Fond G, Gaman A, Brunel L, Haffen E, Llorca PM. Google trends: ready for real-time suicide prevention or just a zeta-jones effect? An exploratory study. Psychiatry Research. 2015; 228: 913–917.

[32] Ma-Kellams C, Or F, Baek J, Kawachi I. Rethinking suicide surveillance: Google search data and self-reported suicidality differentially estimate completed suicide risk. Clinical Psychological Science. 2016; 4: 480–484.

[33] Yang AC, Tsai SJ, Huang NE, Peng CK. Association of internet search trends with suicide death in Taipei City, Taiwan, 2004–2009. Journal of Affective Disorders. 2011; 132: 179–184.

[34] Vaidyanathan U, Sun Y, Shekel T, Chou K, Galea S, Gabrilovich E, et al. An evaluation of internet searches as a marker of trends in population mental health in the US. Scientific Reports. 2022; 12: 8946.

[35] Raffagnato A, Iannattone S, Fasolato R, Parolin E, Ravaglia B, Biscalchin G, et al. A pre-adolescent and adolescent clinical sample study about suicidal ideation, suicide attempt, and self-harming. European Journal of Investigation in Health, Psychology and Education. 2022; 12: 1441–1462.

[36] Silva C, McGovern C, Gomez S, Beale E, Overholser J, Ridley J. Can I count on you? Social support, depression and suicide risk. Clinical Psychology & Psychotherapy. 2023; 30: 1191–1533.

[37] Rangaswamy A, Giles CL, Seres S. A strategic perspective on search engines: thought candies for practitioners and researchers. Journal of Interactive Marketing. 2009; 23: 49–60.

[38] Harris KM, McLean JP, Sheffield J. Examining suicide-risk individuals who go online for suicide-related purposes. Archives of Suicide Research. 2009; 13: 264–276.

[39] Song TM. Development of suicide online prediction model through analysis of social big data. Health and Welfare Policy Forum. 2013; 8: 74–86.

[40] Gunn III JF, Lester D. Using Google searches on the internet to monitor suicidal behavior. Journal of Affective Disorders. 2013; 148: 411–412.

[41] Lee YS, Cha KC, Kim SH. Internet search behavior and box office performance. Korean Management Review. 2016; 45: 1501–1526.

[42] Mavragani A, Gkillas K. COVID-19 predictability in the United States using Google Trends time series. Scientific Reports. 2020; 10: 20693.

[43] Ahn JY, Keum GJ, Jang AR, Song JC. An analysis of key words related to traditional Korean medicine using big data of two search engines. The Journal of Korean Medical History. 2017; 30: 45–61.

[44] Nuti SV, Wayda B, Ranasinghe I, Wang SS, Dreyer RP, Chen SI, et al. The use of Google Trends in health care research: a systematic review. PLOS ONE. 2014; 9: e109583.

[45] Nielsen Media Korea. Korean click. 2021. Available at: http://www.koreanclick.com (Accessed: 05 December 2021).

[46] Chandler V. Google and suicide: what can we learn about the use of internet to prevent suicides? Public Health. 2018; 154: 144–150.

[47] Sedgwick R, Epstein S, Dutta R, Ougrin D. Social media, internet use and suicide attempts in adolescents. Current Opinion in Psychiatry. 2019; 32: 534–541.

[48] Hayes AF. Introduction to mediation, moderation, and conditional process analysis: a regression-based approach. 2nd edn. Guilford Press: New York. 2018.

[49] Toyama H, Mauno S. Associations of trait emotional intelligence with social support, work engagement, and creativity in Japanese eldercare nurses. Japanese Psychological Research. 2017; 59: 14–25.

[50] Kline TJ. Psychological testing: a practical approach to design and evaluation. 1st edn. Sage Publications: Thousand Oaks, CA. 2005.

[51] Hagihara A, Miyazaki S, Abe T. Internet suicide searches and the incidence of suicide in young people in Japan. European Archives of Psychiatry and Clinical Neuroscience. 2012; 262: 39–46.

[52] Page A, Chang SS, Gunnell D. Surveillance of Australian suicidal behaviour using the internet? The Australian and New Zealand Journal of Psychiatry. 2011; 45: 1020–1022.

[53] Barros JM, Melia R, Francis K, Bogue J, O’Sullivan M, Young K, et al. The validity of Google trends search volumes for behavioral forecasting of national suicide rates in Ireland. International Journal of Environmental Research and Public Health. 2019; 16: 3201.