James Donaldson on Mental Health – Living Alone and Depressed Increases Suicide Risk

Ron Goldberg 

Men living alone aged 40 to 64 with depression or anxiety faced the highest risk for suicide in a South Korean population study.

Significantly increased risk for suicide is associated with adults, particularly men and middle-aged individuals living alone with depression or anxiety, according to study findings published in JAMA Network Open.

Researchers in South Korea explored the association between living arrangements and depression or anxiety with suicide risk. Death by suicide was the primary outcome.

The researchers conducted a population-based observational cohort study from January 2009 through December 2021 using ICD-10 codes and data from the Korean National Health Insurance Service (NHIS) database that included adults at least 20 years of age who participated in the 2009 General Health Screening Program in Korea. Exposures included living alone or living with others for at least 5 years, and depression and anxiety. The Korean NHIS covers 97% of the Korean population through mandatory health insurance, and conducts biennial health screenings for the insured. Death records obtained from Statistics Korea, the National Statistical Office, were used to identify death by suicide.

The current study included more than three-and-a-half million adults (N=3,764,279; mean [SD] age, 47.2 [14.0] years; 44.2% women) among whom 8.5% (n=319,993 individuals) lived alone, 91.5% lived together (n=3,444,286), 3.0% (n=112,460) had depression, and 6.2% (n=232,305 individuals) had anxiety.

#James Donaldson notes:
Welcome to the “next chapter” of my life… being a voice and an advocate for #mentalhealthawarenessandsuicideprevention, especially pertaining to our younger generation of students and student-athletes.
Getting men to speak up and reach out for help and assistance is one of my passions. Us men need to not suffer in silence or drown our sorrows in alcohol, hang out at bars and strip joints, or get involved with drug use.
Having gone through a recent bout of #depression and #suicidalthoughts myself, I realize now, that I can make a huge difference in the lives of so many by sharing my story, and by sharing various resources I come across as I work in this space.  #http://bit.ly/JamesMentalHealthArticle
Find out more about the work I do on my 501c3 non-profit foundation
website www.yourgiftoflife.org Order your copy of James Donaldson’s latest book,
#CelebratingYourGiftofLife: From The Verge of Suicide to a Life of Purpose and Joy

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[L]iving alone, when combined with depression or anxiety, was associated with an increased risk of suicide, highlighting the importance of targeted mental health interventions and suicide-prevention strategies.

Among those living alone, 2.4% had depression vs 3.0% living together with depression. Among those living alone, 5.0% were diagnosed with anxiety vs 6.3% living together with anxiety. Regardless of living arrangements, individuals living alone with depression or anxiety tended to be older women with lower incomes and greater prevalence of comorbid conditions including hypertension, cardiovascular disease, dyslipidemia, and diabetes, compared with individuals without depression or anxiety.

Individuals living alone with depression and anxiety compared with individuals with neither depression nor anxiety not living alone, had a 558% increased risk for suicide (adjusted hazard ratio [aHR], 6.58; 95% CI, 4.86-8.92). Living alone with depression associated with a 290% increased suicide risk (aHR, 3.91; 95% CI, 2.96-5.16). Living alone with anxiety associated with a 90% increased risk for suicide (aHR, 1.90; 95% CI, 1.48-2.43). Compared with other demographics, aHRs were higher for the association between living alone and suicide among men and individuals aged 40 to 64 years.

“… [L]iving alone, when combined with depression or anxiety, was associated with an increased risk of suicide, highlighting the importance of targeted mental health interventions and suicide-prevention strategies,” the study authors concluded.

Study limitations include the observational design precluding the establishment of causality, so while this study suggests that living arrangements and mental health are associated with suicide risk, the causal direction remains unclear. Additionally, living arrangements were only classified at baseline, possibly leading to misclassification during follow-up.