OBJECTIVE: Several studies have reported controversial results regarding the association between mental health factors and the risk of herpes zoster. This study examined the effects of self-rated stress, sleep deprivation, depressive symptoms, and suicidal ideation on the risk of herpes zoster. METHODS: Data from the Korea Health Panel Survey (2008-2018) were analyzed. Associations between self-reported mental health factors and herpes zoster were determined using a generalized estimating equation model. Age, sex, socioeconomic status, health behaviors, and comorbidities were adjusted for in the model. The standardized incidence ratios (SIRs) were reported from the sensitivity analysis. RESULTS: Of the 78,896 included person-years (mean age, 51.31 ± 16.90
females, n = 43,503 [55.14 %]), 1130 (1.43 %) developed herpes zoster. The adjusted odds ratios (aORs) for the association between severe self-rated stress and herpes zoster were 1.483 (95 % confidence interval [CI]: 1.161-1.895) and for sleep deprivation, 1.194 (95 % CI: 1.038-1.374). When stratified by sex, the association remained significant in females but not in males. For depressive symptoms and suicidal ideation, the adjusted models did not reveal significant associations with herpes zoster infection. In the sensitivity analysis, the SIRs for herpes zoster were higher with severe self-rated stress (1.37, 95 % CI: 1.07-1.68) and sleep deprivation (1.21, 95 % CI: 1.07-1.36). CONCLUSIONS: Severe self-rated stress and sleep deprivation were associated with an increased risk of herpes zoster, whereas depressive symptoms and suicidal ideation were not. Further studies are required to confirm these findings and explore additional factors.