Living alone with depression and anxiety increases the risk of suicide by more than 500%, the study of Korean adults suggests

An international team including Charité Universitätsmedizin Berlin, Soongsil University and Sungkyunkwan University have found that Korean adults living alone with depression and anxiety are faced with an increased risk of suicide. People aged 40 to 64 and men had the highest risk.

Suicide is a global health problem responsible for more than 700,000 deaths each year. South Korea has reported the highest suicide rate among the countries of Economic Cooperation and Development (OECD) from 2003 to 2023, with 24.1 suicides per 100,000 people. Living alone has become a social determinant of health, often linked to social isolation and psychiatric conditions.

Social isolation has already been associated with undesirable results, including psychiatric, dementia, bad nutrition, diabetes and cardiovascular disease. It can also intensify loneliness and despair, which are psychological precursors of suicidal behavior.

Households of a person now represent more than a third of all households in Korea, reflecting changing family structures, down multigenerational households and increasing divorce rates. Although living alone is not intrinsically equal to the experience of social isolation, it is often used as a obtaining social isolation in population studies because it can increase the probability of experimenting.

In the study, “Suicide Risk and Living Alone with depression and anxiety”, published in Jama Network OpenThe researchers conducted a cohort study based on the population to examine the association of living arrangements and depression or anxiety with the risk of suicide.

The data included 3,764,279 Korean adults aged 20 or over who participated in the General Coorean Health Insurance Score Detection Program in 2009. People with incomplete data and those who died by suicide during the first year were excluded. The follow -up extended from 2009 to 2021.

Life agreements were classified using national registration files. Individuals were classified as alive alone if they were registered as a person’s household for five years or more at the start. Depression and anxiety have been identified using health insurance complaints in the year preceding the health examination. Suicide deaths were determined in the files of national death.

Among 3,764,279 participants, 112,460 people (3.0%) had depression, 232,305 (6.2%) had anxiety and 319,993 (8.5%) lived alone. Suicide occurred in 11,648 individuals during the study period. Living alone with depression and anxiety was associated with an increased risk of 558% suicide (adjusted risk ratio (AHR), 6.58; 95% CI, 4.86–8.92).

Living alone with depression was associated with an increased risk of 290% (AHR, 3.91; 95% CI, 2.96–5.16). Living alone with anxiety was associated with an increased risk of 90% (AHR, 1.90; 95% CI, 1.48–2.43). Even those who live alone without depression or anxiety had an increased risk of 44% compared to people living with others and without psychiatric conditions (AHR, 1.44; 95% CI, 1.35–1.54).

People living with others but diagnosed with depression had an increased risk of 198% (AHR, 2.98; 95% CI, 2.74–3.25). Those who suffer from anxiety but not from depression, living with others, had an increased risk of 64% (AHR, 1.64; 95% CI, 1.52–1.76).

Men and adults aged 40 to 64 have experienced the highest risk of suicide in all groups. Among people with alive depression alone, men had an increased risk of suicide (AHR, 4.32; 95%CI, 3.30–5.67) and adults aged 40 to 64 years had an increased risk of 502%(AHR, 6.02; 95%CI, 4.70–7.71).

Living alone with depression or anxiety was associated with a significantly increased risk of suicide, those presenting the two conditions facing the highest risk. These associations remained after adjustment for lifestyle, clinical and psychiatric factors. Adults and middle ages have experienced the highest risk, in accordance with the previous results on suicide and mortality of all causes of causes in these groups.

Researchers speculate that living alone can intensify feelings of despair and isolation, which are psychological precursors established in suicidal behavior.

Cultural stigmatization surrounding mental illness and traditional gender expectations can contribute to a search for reduced help, especially in men. The authors recommend additional research to determine if similar models are observed in other social and cultural contexts.

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