Living alone is associated with a higher prevalence of psychiatric morbidity in a population-based cross-sectional study

Abstract

BackgroundLiving alone has been linked to poor mental health, however large-scale epidemiological studies on the association between living alone and psychiatric morbidity including depression and anxiety are lacking. The aim of this study was to investigate this issue in a large Taiwanese cohort.MethodsIn this cross-sectional study, we enrolled 121,601 volunteers from 29 community recruitment stations in Taiwan and divided them into two groups based on whether or not they lived alone. Psychiatric morbidity was defined as a Generalized Anxiety Disorder 2-item score ≥ 3, Patient Health Questionnaire 2-item score ≥ 3, or self-reported depression. Logistic regression was used to explore the associations between living alone and psychiatric morbidity.ResultsThe participants who lived alone had a higher prevalence of psychiatric morbidity [odds ratio (OR) = 1.608, 95% confidence interval (CI) = 1.473 to 1.755] after adjusting for potential confounders. In a subgroup analysis, married subjects who lived alone and divorce/separation (OR = 2.013, 95% CI = 1.763 to 2.299) or widowing (OR = 1.750, 95% CI = 1.373 to 2.229) were more likely to have psychiatric morbidity than those who were married and not living alone.ConclusionsOur findings suggest that living alone is a risk factor for psychiatric morbidity, especially for married subjects who live alone in concordance with divorce, separation, or the death of a spouse.

Smaller household size and higher prevalence of serious psychological distress in younger people and never-married people: a nationwide cross-sectional survey in Japan

“…However, the association between living alone and psychiatric morbidity was significant in married subjects, but not in unmarried subjects. This study ( 9 ) evaluated only the presence or absence of living alone for household size, failed to conduct stratified analyses by gender, and did not use a randomly selected population, which may have contradicted our findings. Protective effects of living with a partner on mental health are considered to be that people living with a partner, whether married or in a common law relationship, may receive social and psychological support from their partners and that sharing financial resources reduces the stress associated with financial problems ( 38 ).…”

“…In this study, a stratified analysis by gender and marital status showed a dose–response relationship between household size and SPD in never-married persons, regardless of gender. According to a large-scale population-based study consisting of cancer-free volunteers aged 30–70 years in Taiwan ( 9 ), the prevalence of psychiatric morbidity was significantly higher among those living alone than among those living with their families. However, the association between living alone and psychiatric morbidity was significant in married subjects, but not in unmarried subjects.…”

“…Previous studies on the association of living alone and/or living arrangements with mental health have identified socio-economic status, smoking, and chronic physical conditions as important confounding factors (5)(6)(7)(8)(9)(10)(11)(12)(13). Therefore, in this study, the following variables were used as covariates: marital status, education, equivalent household expenditures (EHE), employment contract, housing tenure, smoking status, and illness under treatment.…”

“…In this association, social isolation and emotional loneliness may adversely affect mental health and increase mortality risk (7,8). Nonetheless, many of the studies on the relationship between living alone and mental health have focused on older people (9)(10)(11)(12), and there have been few studies on the general population (8,13).…”

“…These previous studies suggest that men may derive more mental health benefits from large households than women. In addition, the effects of living alone or living with others on mental health may differ depending on age and marital status as well as gender (6,9,(23)(24)(25). However, to our knowledge, no studies have examined demographic differences in an association between household size and mental health.…”