Living Alone with Depression and Anxiety Dramatically Increases Suicide Risk in Korean Adults, New Study Finds

A comprehensive international research team, including experts from Charité Universitätsmedizin Berlin, Soongsil University, and Sungkyunkwan University, has discovered that Korean adults living alone while suffering from both depression and anxiety face a staggering 558% higher risk of suicide. The study, published in
JAMA Network Open, highlights that individuals aged 40 to 64 and men are particularly vulnerable.

Suicide remains a significant global health challenge, claiming over 700,000 lives annually. South Korea, among OECD nations, reports the highest suicide rate, with 24.1 deaths per 100,000 people between 2003 and 2023. Living alone has become increasingly common, now making up more than one-third of Korean households, reflecting changing family structures, fewer multigenerational households, and rising divorce rates. While living alone does not necessarily equate to social isolation, population studies often use it as a proxy for social disconnection, which is linked with adverse health outcomes.

Social isolation has previously been associated with various health issues, including mental health deterioration, dementia, poor nutrition, diabetes, and cardiovascular disease. It may also heighten feelings of loneliness and hopelessness, leading to suicidal thoughts and behaviors.

The study analyzed data from over 3.76 million Korean adults aged 20 or older enrolled in the Korean National Health Insurance Service's General Health Screening Program in 2009. Researchers excluded incomplete data and individuals who died by suicide within the first year. The follow-up period spanned from 2009 to 2021. Living arrangements were verified through national registration records; individuals classified as living alone had resided in one-person households for at least five years at baseline. Depression and anxiety were identified via health insurance claims from the year prior, and suicide deaths were confirmed through national mortality records.

Findings revealed that 3% had depression, 6.2% had anxiety, and 8.5% lived alone. During the study, 11,648 individuals died by suicide. The risk was markedly elevated among those living alone with both depression and anxiety, with a 558% increase (adjusted hazard ratio [AHR], 6.58). Specifically, individuals living alone with depression faced a 290% higher risk, those with anxiety had a 90% increased risk, and even living alone without psychiatric conditions increased risk by 44%.

The highest risks were observed in men and adults aged 40 to 64. Men living alone with depression had a 332% higher risk, and adults in this age bracket faced a 502% increased risk. These findings suggest that living alone, coupled with mental health conditions, significantly amplifies the likelihood of suicide, even after accounting for other lifestyle, clinical, and psychiatric factors.

Researchers believe that infection of hopelessness and social isolation may intensify suicidal tendencies. The societal stigma associated with mental illness and traditional gender roles might also hinder help-seeking, especially among men. Further studies are recommended to explore whether these patterns are common across different cultures and societies.