{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,23]],"date-time":"2026-07-23T15:59:40Z","timestamp":1784822380291,"version":"3.55.0"},"reference-count":44,"publisher":"American Medical Association (AMA)","issue":"7","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Netw Open"],"abstract":"<jats:sec id=\"ab-zoi240670-4\"><jats:title>Importance<\/jats:title><jats:p>The persistent stigma associated with mental health conditions is a major challenge worldwide. Celebrities may improve this by openly discussing their own mental health issues, potentially influencing public attitudes and encouraging individuals to seek treatment for these conditions.<\/jats:p><\/jats:sec><jats:sec id=\"ab-zoi240670-5\"><jats:title>Objective<\/jats:title><jats:p>To evaluate the impact of celebrity mental health disclosures on the incidence and prevalence of panic disorder diagnosis in South Korea.<\/jats:p><\/jats:sec><jats:sec id=\"ab-zoi240670-6\"><jats:title>Design, Setting, and Participants<\/jats:title><jats:p>This cohort study included the entire South Korean population from January 2004 to December 2021, as reflected in the National Health Insurance Service data. Analysis was conducted from May 2022 through January 2024.<\/jats:p><\/jats:sec><jats:sec id=\"ab-zoi240670-7\"><jats:title>Exposure<\/jats:title><jats:p>Time periods analyzed included the timeframe before (from January 2004 to December 2010) and after the public disclosures of panic disorder by 3 high-profile Korean celebrities between December 2010 and January 2012 (from January 2011 to December 2021).<\/jats:p><\/jats:sec><jats:sec id=\"ab-zoi240670-8\"><jats:title>Main Outcomes and Measures<\/jats:title><jats:p>Monthly incidence and prevalence of panic disorder, defined by the presence of a clinical diagnosis of the condition. Trends were assessed using interrupted time series analysis with autoregressive integrated moving average models. To assess public interest in panic disorder, trends in search data were analyzed, examining the association between the timing of increased searches and changes in the incidence and prevalence of panic disorder. Data on obsessive-compulsive disorder (OCD) were included as a control.<\/jats:p><\/jats:sec><jats:sec id=\"ab-zoi240670-9\"><jats:title>Results<\/jats:title><jats:p>The study covered the entire population of South Korea, including 48\u202f559\u202f946 individuals in January 2004 and 52\u202f593\u202f886 individuals in December 2021. Before 2011, the mean (SD) annual prevalence of panic disorder was stable at 560 (140) persons per 100\u202f000 persons per year. The celebrity disclosure in December 2010 was associated with higher monthly incidence rates of panic disorder, as measured by insurance claims data, changes that were observed in both the level (5.8 persons; 95% CI, 2.2-9.5 persons) and slope (0.78 persons per month; 95% CI, 0.19-1.40 persons per month) per 100\u202f000 persons. By 2021, the observed annual prevalence per 100\u202f000 persons reached 7530 persons, an increase of 775.6% compared with the 860 persons (95% CI, 330-1400 persons) estimated if the disclosures had not occurred. Internet searches anticipated changes in monthly prevalence with a lag of 2 or 3 months (F\u2009=\u20094.26, <jats:italic>P<\/jats:italic>\u2009=\u2009.02 and F\u2009=\u20093.11, <jats:italic>P<\/jats:italic>\u2009=\u2009.03, respectively). The celebrity disclosures had no significant association with the incidence or prevalence of OCD.<\/jats:p><\/jats:sec><jats:sec id=\"ab-zoi240670-10\"><jats:title>Conclusions and Relevance<\/jats:title><jats:p>In this observational cohort study, celebrity disclosure of mental health conditions was associated with a sustained reduction in stigma, as reflected in increased help-seeking behavior for the condition over more than a decade. This underscores the influential role celebrities can play in shaping public health perceptions and behaviors, offering valuable insights for the development of future mental health policies and public awareness campaigns.<\/jats:p><\/jats:sec>","DOI":"10.1001\/jamanetworkopen.2024.20934","type":"journal-article","created":{"date-parts":[[2024,7,10]],"date-time":"2024-07-10T15:03:57Z","timestamp":1720623837000},"page":"e2420934","source":"Crossref","is-referenced-by-count":4,"title":["Incidence of Panic Disorder Diagnoses After Celebrity Disclosures of Panic Disorder in South Korea"],"prefix":"10.1001","volume":"7","author":[{"given":"Ga Eun","family":"Kim","sequence":"first","affiliation":[{"name":"Department of Psychiatry, Ewha Womans University Mokdong Hospital, Ewha Womans University College of Medicine, Seoul, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Min-Woo","family":"Jo","sequence":"additional","affiliation":[{"name":"Department of Preventive Medicine, University of Ulsan College of Medicine, Seoul, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Young Eun","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Big Data Strategy, National Health Insurance Service, Wonju, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seok-Jun","family":"Yoon","sequence":"additional","affiliation":[{"name":"Department of Preventive Medicine, Korea University College of Medicine, Seoul, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yong-Wook","family":"Shin","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Asan Medical Centre, University of Ulsan College of Medicine, Seoul, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10","published-online":{"date-parts":[[2024,7,10]]},"reference":[{"key":"zoi240670r1","doi-asserted-by":"publisher","DOI":"10.1017\/S2045796022000488","article-title":"Impact of celebrity disclosure on mental health-related stigma.","volume":"31","author":"Gronholm","year":"2022","journal-title":"Epidemiol Psychiatr Sci"},{"issue":"1","key":"zoi240670r2","doi-asserted-by":"publisher","first-page":"11","DOI":"10.1017\/S0033291714000129","article-title":"What is the impact of mental health-related stigma on help-seeking? A systematic review of quantitative and qualitative studies.","volume":"45","author":"Clement","year":"2015","journal-title":"Psychol Med"},{"issue":"5","key":"zoi240670r3","doi-asserted-by":"publisher","first-page":"697","DOI":"10.1046\/j.1440-1614.2002.00998.x","article-title":"Depictions of mental illness in print media: a prospective national sample.","volume":"36","author":"Coverdale","year":"2002","journal-title":"Aust N Z J Psychiatry"},{"issue":"11","key":"zoi240670r4","doi-asserted-by":"publisher","first-page":"1334","DOI":"10.1080\/10410236.2015.1056329","article-title":"Young adults\u2019 information seeking following celebrity suicide: considering involvement with the celebrity and emotional distress in health communication strategies.","volume":"31","author":"Dillman Carpentier","year":"2016","journal-title":"Health Commun"},{"key":"zoi240670r5","doi-asserted-by":"publisher","DOI":"10.1016\/j.abrep.2020.100319","article-title":"A lethal imitation game? Exploring links among psychoactive substance use, self-harming behaviors and celebrity worship.","volume":"12","author":"Zsila","year":"2020","journal-title":"Addict Behav Rep"},{"issue":"8976","key":"zoi240670r6","doi-asserted-by":"publisher","first-page":"705","DOI":"10.1016\/S0140-6736(95)92315-2","article-title":"Celebrity illness.","volume":"346","author":"Cayton","year":"1995","journal-title":"Lancet"},{"key":"zoi240670r8","doi-asserted-by":"publisher","first-page":"132","DOI":"10.1192\/bjp.186.2.132","article-title":"Time trends in eating disorder incidence.","volume":"186","author":"Currin","year":"2005","journal-title":"Br J Psychiatry"},{"issue":"1","key":"zoi240670r9","doi-asserted-by":"publisher","first-page":"89","DOI":"10.1177\/1367549419861636","article-title":"The celebritization of self-care: The celebrity health narrative of Demi Lovato and the sickscape of mental illness.","volume":"23","author":"Franssen","year":"2020","journal-title":"Eur J Cult Stud"},{"issue":"2","key":"zoi240670r10","doi-asserted-by":"publisher","first-page":"237","DOI":"10.1007\/s40596-020-01200-5","article-title":"\u201cI feel like I know them\u201d: the positive effect of celebrity self-disclosure of mental illness.","volume":"44","author":"Calhoun","year":"2020","journal-title":"Acad Psychiatry"},{"key":"zoi240670r11","doi-asserted-by":"publisher","first-page":"24","DOI":"10.3389\/fcomm.2019.00024","article-title":"Ups and downs: social media advocacy of bipolar disorder on World Mental Health Day.","volume":"4","author":"Nelson","year":"2019","journal-title":"Front Commun (Lausanne)"},{"key":"zoi240670r13","doi-asserted-by":"publisher","DOI":"10.12811\/kshsm.","article-title":"Research trend analysis of health and mental health literacy in Korea: 2007-2017.","author":"Baik","year":"2018","journal-title":"Korean J Health Service Manage"},{"issue":"2","key":"zoi240670r15","doi-asserted-by":"publisher","first-page":"103","DOI":"10.12997\/jla.2022.11.2.103","article-title":"Understanding and utilizing claim data from the Korean National Health Insurance Service (NHIS) and Health Insurance Review & Assessment (HIRA) database for research.","volume":"11","author":"Kyoung","year":"2022","journal-title":"J Lipid Atheroscler"},{"issue":"7","key":"zoi240670r16","doi-asserted-by":"publisher","first-page":"711","DOI":"10.1001\/jamadermatol.2023.1261","article-title":"Autoimmune, inflammatory, atopic, thyroid, and psychiatric outcomes of offspring born to mothers with alopecia areata.","volume":"159","author":"Lee","year":"2023","journal-title":"JAMA Dermatol"},{"issue":"6","key":"zoi240670r17","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2023.16696","article-title":"Evaluation of assisted reproductive technology health insurance coverage for multiple pregnancies and births in Korea.","volume":"6","author":"Cha","year":"2023","journal-title":"JAMA Netw Open"},{"key":"zoi240670r18","doi-asserted-by":"publisher","first-page":"381","DOI":"10.1016\/j.jpsychires.2020.07.047","article-title":"Illuminating the treatment gap of mental disorders: a comparison of community survey-based and national registry-based prevalence rates in Korea.","volume":"130","author":"Jo","year":"2020","journal-title":"J Psychiatr Res"},{"issue":"3","key":"zoi240670r19","doi-asserted-by":"publisher","first-page":"281","DOI":"10.31887\/DCNS.2003.5.3\/pmartin","article-title":"The epidemiology of anxiety disorders: a review.","volume":"5","author":"Martin","year":"2003","journal-title":"Dialogues Clin Neurosci"},{"issue":"4","key":"zoi240670r20","doi-asserted-by":"publisher","first-page":"237","DOI":"10.1177\/0706743716640757","article-title":"The age of onset of anxiety disorders.","volume":"62","author":"Lijster","year":"2017","journal-title":"Can J Psychiatry"},{"issue":"3","key":"zoi240670r21","doi-asserted-by":"publisher","first-page":"277","DOI":"10.1023\/A:1010357216925","article-title":"The ability of the Symptom Checklist SCL-90 to differentiate various anxiety and depressive disorders.","volume":"72","author":"Kennedy","year":"2001","journal-title":"Psychiatr Q"},{"issue":"2","key":"zoi240670r23","doi-asserted-by":"publisher","first-page":"164","DOI":"10.4306\/pi.2015.12.2.164","article-title":"Prevalence and correlates of DSM-IV Mental Disorders in South Korean adults: the Korean Epidemiologic Catchment Area Study 2011.","volume":"12","author":"Cho","year":"2015","journal-title":"Psychiatry Investig"},{"issue":"2","key":"zoi240670r24","doi-asserted-by":"publisher","first-page":"257","DOI":"10.1017\/S0033291705006367","article-title":"Twelve-month prevalence, severity, and unmet need for treatment of mental disorders in metropolitan China.","volume":"36","author":"Shen","year":"2006","journal-title":"Psychol Med"},{"key":"zoi240670r25","doi-asserted-by":"publisher","first-page":"554","DOI":"10.1016\/j.jad.2018.08.050","article-title":"Prevalence, treatment, and the correlates of common mental disorders in the mid 2010's in Japan: the results of the world mental health Japan 2nd survey.","volume":"241","author":"Ishikawa","year":"2018","journal-title":"J Affect Disord"},{"issue":"2","key":"zoi240670r27","doi-asserted-by":"publisher","first-page":"149","DOI":"10.1177\/0022022119901297","article-title":"Countries and cultural differences in the stigma of mental illness: the East\u2013West Divide.","volume":"51","author":"Krendl","year":"2020","journal-title":"J Cross Cult Psychol"},{"issue":"1","key":"zoi240670r28","doi-asserted-by":"publisher","first-page":"8","DOI":"10.1186\/s12888-020-02991-5","article-title":"Stigma of mental illness and cultural factors in Pacific Rim region: a systematic review.","volume":"21","author":"Ran","year":"2021","journal-title":"BMC Psychiatry"},{"issue":"5","key":"zoi240670r29","doi-asserted-by":"publisher","first-page":"1261","DOI":"10.1093\/schbul\/sbaa181","article-title":"Self-stigma in serious mental illness: a systematic review of frequency, correlates, and consequences.","volume":"47","author":"Dubreucq","year":"2021","journal-title":"Schizophr Bull"},{"issue":"6","key":"zoi240670r30","doi-asserted-by":"publisher","first-page":"593","DOI":"10.1001\/archpsyc.62.6.593","article-title":"Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication.","volume":"62","author":"Kessler","year":"2005","journal-title":"Arch Gen Psychiatry"},{"issue":"6","key":"zoi240670r31","doi-asserted-by":"publisher","first-page":"354","DOI":"10.1016\/j.eurpsy.2010.06.004","article-title":"Panic disorder and subthreshold panic in the UK general population: epidemiology, comorbidity and functional limitation.","volume":"26","author":"Skapinakis","year":"2011","journal-title":"Eur Psychiatry"},{"issue":"3","key":"zoi240670r32","doi-asserted-by":"publisher","first-page":"262","DOI":"10.30773\/pi.2022.0307","article-title":"Prevalence of mental disorders and associated factors in Korean adults: National Mental Health Survey of Korea 2021.","volume":"20","author":"Rim","year":"2023","journal-title":"Psychiatry Investig"},{"issue":"3","key":"zoi240670r33","doi-asserted-by":"publisher","first-page":"760","DOI":"10.1016\/j.jad.2013.02.035","article-title":"Measuring depression in South Korea: validity and reliability of a brief questionnaire in the Korean Cancer Prevention Study.","volume":"150","author":"Chang","year":"2013","journal-title":"J Affect Disord"},{"issue":"29","key":"zoi240670r34","doi-asserted-by":"publisher","DOI":"10.3346\/jkms.2021.36.e214","article-title":"The prevalence of depression, anxiety and associated factors among the general public during COVID-19 pandemic: a cross-sectional study in Korea.","volume":"36","author":"Kim","year":"2021","journal-title":"J Korean Med Sci"},{"key":"zoi240670r36","doi-asserted-by":"publisher","DOI":"10.4178\/epih.e2022018","article-title":"Depression, anxiety, and stress in Korean general population during the COVID-19 pandemic.","volume":"44","author":"Lee","year":"2022","journal-title":"Epidemiol Health"},{"key":"zoi240670r37","doi-asserted-by":"publisher","DOI":"10.4178\/epih.e2023022","article-title":"Changes in mental health service utilization before and during the COVID-19 pandemic: a nationwide database analysis in Korea.","volume":"45","author":"Kim","year":"2023","journal-title":"Epidemiol Health"},{"key":"zoi240670r38","doi-asserted-by":"publisher","DOI":"10.1017\/S2045796024000088","article-title":"Incidence of mental health diagnoses during the COVID-19 pandemic: a multinational network study.","volume":"33","author":"Chai","year":"2024","journal-title":"Epidemiol Psychiatr Sci"},{"issue":"3","key":"zoi240670r39","doi-asserted-by":"publisher","first-page":"259","DOI":"10.1111\/comt.2015.25.issue-3","article-title":"Examining four processes of audience involvement with media personae: transportation, parasocial interaction, identification, and worship.","volume":"25","author":"Brown","year":"2015","journal-title":"Commun Theory"},{"key":"zoi240670r40","doi-asserted-by":"publisher","first-page":"b309","DOI":"10.1136\/bmj.b309","article-title":"Celebrities help promote campaign to destigmatise mental illness.","volume":"338","author":"Eaton","year":"2009","journal-title":"BMJ"},{"issue":"10023","key":"zoi240670r41","doi-asserted-by":"publisher","first-page":"1123","DOI":"10.1016\/S0140-6736(15)00298-6","article-title":"Evidence for effective interventions to reduce mental-health-related stigma and discrimination.","volume":"387","author":"Thornicroft","year":"2016","journal-title":"Lancet"},{"key":"zoi240670r42","doi-asserted-by":"publisher","DOI":"10.3389\/fpubh.2020.569539","article-title":"A call to action: a critical review of mental health related anti-stigma campaigns.","volume":"8","author":"Walsh","year":"2021","journal-title":"Front Public Health"},{"issue":"3","key":"zoi240670r43","doi-asserted-by":"publisher","first-page":"379","DOI":"10.1007\/s10940-010-9127-1","article-title":"The series hazard model: an alternative to time series for event data.","volume":"27","author":"Dugan","year":"2011","journal-title":"J Quant Criminol"},{"key":"zoi240670r7","first-page":"103","volume-title":"21st Century Media and Female Mental Health: Profitable Vulnerability and Sad Girl Culture","author":"Thelandersson","year":"2022"},{"key":"zoi240670r22","doi-asserted-by":"crossref","first-page":"205","DOI":"10.1017\/CBO9780511984679.011","volume-title":"Bayesian time series models","author":"Eckley","year":"2011"},{"key":"zoi240670r26","first-page":"389","volume-title":"Epidemiology of Depressive and Anxiety Disorders. Textbook in Psychiatric Epidemiology","author":"Horwath","year":"2002"},{"key":"zoi240670r44","doi-asserted-by":"crossref","DOI":"10.1093\/0198288107.001.0001","volume-title":"Cointegration, Error Correction, and the Econometric Analysis of Non-Stationary Data","author":"Banerjee","year":"1993"},{"key":"zoi240670r12","unstructured":"Han? HJ. What was the \u2018panic disorder\u2019 that plagued Cha? Healthchosun. December 3, 2010. Accessed May 26, 2023. https:\/\/m.health.chosun.com\/svc\/news_view.html?contid=2010120300347&"},{"key":"zoi240670r14","unstructured":"Shin? Hi. Shadow behind the light: celebrities fighting panic disorder. The Korea Herald. January 9, 2012. Accessed May 13, 2023. https:\/\/www.koreaherald.com\/view.php?ud=20120109000872"},{"key":"zoi240670r35","unstructured":"Korean Society for Traumatic Stress Studies. The Fourth National Mental Health Survey: Korean Society for Traumatic Stress Studies. 2021. Accessed May 1, 2024. http:\/\/kstss.kr\/?p=2065"}],"container-title":["JAMA Network Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/jamanetwork.com\/journals\/jamanetworkopen\/articlepdf\/2820967\/kim_2024_oi_240670_1719929578.21505.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,7,10]],"date-time":"2024-07-10T15:04:03Z","timestamp":1720623843000},"score":1,"resource":{"primary":{"URL":"https:\/\/jamanetwork.com\/journals\/jamanetworkopen\/fullarticle\/2820967"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,7,10]]},"references-count":44,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2024,7,1]]}},"URL":"https:\/\/doi.org\/10.1001\/jamanetworkopen.2024.20934","relation":{},"ISSN":["2574-3805"],"issn-type":[{"value":"2574-3805","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,7,10]]}}}