Abstract
OBJECTIVE: With the rapid increase in elderly individuals living alone, concerns about their vulnerability to psychiatric disorders and suicide have grown. Jeju Island's population endures the intergenerational impact of the 4ㆍ3 Incident, a collective trauma resulting from a large-scale civilian massacre. This study aimed to classify elderly living alone in Jeju into four psychiatric groups-healthy, PTSD symptoms, depressive symptoms and comorbid PTSD and depressive symptoms-and to investigate the effect of social support on suicide risk within these groups. METHODS: A complete enumeration survey was conducted among 5,138 eligible individuals, with 4,680 completing structured, face-to-face interviews. Standardized instruments were used: PC-PTSD-5 for PTSD symptoms, SGDS-K for depression, MINI-Plus for suicide risk, and MOS-SSS for social support. Multivariate logistic regression analyzed associations between social support and suicide risk across psychiatric groups. RESULTS: Among the participants, 7.8% had PTSD symptoms, 40.4% had depressive symptoms, and 5.8% had comorbid symptoms. Overall, 10.2% reported suicide risk, with the highest rate in the comorbid group (29.5%), followed by the depressive (17.1%) and PTSD (12.8%) groups. Social support significantly decreased suicide risk in the healthy (OR = 0.976), depressive (OR = 0.980), and comorbid groups (OR = 0.979), but not in the PTSD group (OR = 0.957, p = 0.179). CONCLUSION: These findings highlight the importance of developing tailored social support interventions that consider the psychiatric profiles of elderly individuals, especially those living alone and exposed to community-wide historical trauma.