Abstract
BACKGROUND: Rising digitalization and individualism in the workplace after the COVID-19 pandemic have increased loneliness and related problems in the working-age population. The potential effects of various forms of loneliness on suicidal ideation may differ depending on employment status. METHOD: This is a cross-sectional study based on a national survey of mental health in the general Korean population. We classified occupations as "employed," "self-employed," or "unemployed." Loneliness was assessed using the UCLA Loneliness Scale, which measures both qualitative and quantitative aspects of loneliness. Suicidal ideation was evaluated using the Patient Health Questionnaire-9. RESULTS: A total of 1770 participants aged 30-65 years (mean age: 47.7 years) were included. The mean loneliness score was 43.9 (SD = 10.4), and 28% of the participants experienced a high level of loneliness. The prevalence ratio for suicidal ideation in the group with high levels of loneliness was 3.06 (95% CI 2.57, 3.63) compared to the group with low levels of loneliness. In our subgroup analysis, we consistently observed an association between loneliness and suicidal ideation across the employed group; however, the employed was more related with qualitative loneliness, the self-employed and the unemployed were more related with quantitative loneliness. CONCLUSIONS: Loneliness was associated with suicidal ideation. According to employment status, the associations were consistent, but there were interactions between type of loneliness and employment status. These findings suggest that interventions to reduce loneliness and prevent suicidal ideation should be tailored to specific employment groups, focusing on qualitative aspects for employed individuals and quantitative aspects for self-employed and unemployed individuals.