Association Between Loneliness and Suicidal Behaviors Among Korean Adolescents: A Nationwide Cross-Sectional Study

Suicide remains one of the leading causes of death among adolescents. Adolescence is a critical developmental period marked by increased vulnerability to emotional and social stressors. Loneliness has gained recognition as a factor linked to poor mental health outcomes, including suicidal behaviors. However, its relationship with suicidal behaviors has not been thoroughly examined.

A secondary analysis was conducted using data from the 19th Korea Youth Risk Behavior Survey, which included responses from 52,880 adolescents aged 12-18 years, collected from August to October 2023. Associations between loneliness and suicidal behaviors were analyzed using complex sample multiple logistic regression.

Suicidal ideation, plans, and attempts were reported by 13.5%, 5.3%, and 3.2% of adolescents, respectively, with variations by socio-demographic, mental health, and problem behavior characteristics. 81.3% of adolescents reported loneliness, with 18.2% indicating they felt 'Often' or 'Always lonely.' Loneliness was significantly associated with all forms of suicidal behavior (p < 0.001); even after controlling for 19 covariates, adolescents with moderate or high loneliness had substantially higher odds of SI, SP, and SA compared to those with no loneliness.

The significant association between loneliness and suicidal behaviors highlights the importance of incorporating loneliness assessments into adolescent suicide prevention strategies. Collaborative efforts involving schools, parents, and healthcare providers are critical to address risky behaviors and provide effective mental health support. Psychiatric mental health nurses can play a pivotal role in identifying at-risk youth, delivering therapeutic interventions, and coordinating care to reduce adolescent suicide risk.