Factors associated with depressive symptoms among Republic of Korea commissioned and non-commissioned officers: a secondary analysis of the 2024 Military Health Survey

Objectives This study aimed to estimate the proportion screening positive for depressive symptoms and identify factors associated with depressive symptoms among Republic of Korea (ROK) commissioned and non-commissioned officers. Methods A secondary analysis was conducted using data from 1815 commissioned and non-commissioned officers who participated in the 2024 Military Health Survey. Depressive symptoms were assessed using the Korean version of the Center for Epidemiologic Studies Depression Scale, with a cut-off score of 16. Multivariable logistic regression was used to identify factors associated with depressive symptoms. Results The proportion screening positive for depressive symptoms was 7.1%. In the multivariable analysis, female sex (OR=2.08, 95% CI 1.17 to 3.67), single marital status (OR=2.22, 95% CI 1.09 to 4.53), former smoking (OR=2.74, 95% CI 1.54 to 4.90), lack of vigorous physical activity (OR=2.03, 95% CI 1.24 to 3.32), poor subjective sleep satisfaction (OR=3.03, 95% CI 1.82 to 5.05), high work-related stress (OR=11.76, 95% CI 4.77 to 29.01), high personal life-related stress (OR=6.52, 95% CI 2.08 to 20.42) and officer rank (OR=1.95, 95% CI 1.22 to 3.13) were associated with higher odds of depressive symptoms, whereas higher family support was associated with lower odds (OR=0.90, 95% CI 0.83 to 0.99). Conclusions Depressive symptoms among ROK commissioned and non-commissioned officers are multifactorial and associated with personal and work-related stress, lifestyle and military-related factors and protective social relationships. These findings suggest that stress management, sleep quality improvement and strengthening family support may be important targets for further intervention development and evaluation.