Associations of financial strain and income with depressive and anxiety disorders
Open accessAbstract
BACKGROUND: Previous research has shown socioeconomic inequality in prevalence and onset of depressive disorders. It is not yet clear whether perceived financial strain is associated with depressive and/or anxiety disorders in addition to an objective indicator, such as income. This study examines whether financial strain is associated with the prevalence and onset/recurrence of depressive and/or anxiety disorders, above income. METHODS: Data are from the Netherlands Study of Depression and Anxiety. Associations between financial strain, income and presence of depressive and/or anxiety disorder at baseline were assessed among 2937 participants (18-65 years). Impact of financial strain and income on 4-year onset/recurrence of depressive and/or anxiety disorders were examined among 1250 participants without a depressive or anxiety disorder at baseline. Depressive and anxiety disorders were determined with the Composite-International-Diagnostic-Interview. Financial strain and income were assessed in an interview. RESULTS: Participants with mild or severe financial strain had higher odds of being depressed (OR=1.68, 95% CI 1.35 to 2.09; OR=3.88, 95% CI 2.58 to 5.81) or remitted (OR=1.56, 95% CI 1.24 to 1.96; OR=1.99, 95% CI 1.27 to 3.11) at baseline compared with healthy controls, after adjusting for income. Mild or severe financial strain was not associated with onset/recurrence of depressive and/or anxiety disorders during follow-up (OR=1.08, 95% CI 0.83 to 1.42; OR=1.05, 95% CI 0.64 to 1.73). CONCLUSIONS: Financial strain was associated with having a depressive and/or anxiety disorder, above the effect of income. Healthcare and social services should be alert to this association, even for higher income households. However, financial strain and income were not related with 4-year onset/recurrence of depressive and/or anxiety disorders.
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The findings might be explained by period factors, such as the possible higher impact on the group aged 45 to 59 of the previous economic recession, and other potential mediators in the relationship of age and depression, such as inflammation increasing with age or family and social roles.
“Moreover, these findings might be explained by a number of reasons, such as period factors (e.g. the possible higher impact on group aged 45 to 59 of the previous economic recession period, particularly in those belonging to the most disadvantaged groups) and other potential mediators in the relationship of age and depression”
From Prevalence and age patterns of depression in the United Kingdom. A population-based study (2021) · cites this paper as Dijkstra-Kersten et al., 2015
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- Authors
- Dijkstra-Kersten, S. M. A., Biesheuvel-Leliefeld, K. E. M., van der Wouden, J. C., Penninx, B. W. J. H., & van Marwijk, H. W. J.
- Affiliations
- Department of General Practice & Elderly Care Medicine and the EMGO+Institute for Health and Care Research (EMGO+), VU University Medical Center, Amsterdam, The Netherlands
- Amsterdam Public Health (NL)
- Venue
- Journal of Epidemiology and Community Health
- Publisher
- BMJ
- Published
- 2015-01-30
- Volume
- 69
- Issue
- 7
- Pages
- 660-665
- ISSN
- 0141-7681 (ISSN-L)
- 0143-005X
- 1470-2738
- OpenAlex
- W2161823627
- Cited by
- 157
- References
- 16
- Citations by year
- 2026: 7 · 2025: 17 · 2024: 16 · 2023: 14 · 2022: 25 · 2021: 21 · 2020: 23 · 2019: 13 · 2018: 8 · 2017: 8 · 2016: 4 · 2015: 1
- FWCI
- 8.73
- Type
- journal article
- Language
- en
- Open access
- green
- pure.amsterdamumc.nl
- Licence
- other-oa
- Locations
- Journal of Epidemiology & Community Health (publishedVersion)
- PubMed (publishedVersion)
- Amsterdam UMC (VU Amsterdam) - Institutional Repository (publishedVersion)
- Pure Amsterdam UMC (acceptedVersion, other-oa)
- Research Explorer (The University of Manchester) (submittedVersion)
- VU Research Portal (submittedVersion)
- Data Archiving and Networked Services (DANS) (submittedVersion)
- Funders
- Universiteit Leiden (10‐000‐1002)
- ZonMw (10‐000‐1002)
- Vrije Universiteit Amsterdam
- Leids Universitair Medisch Centrum
- Universitair Medisch Centrum Groningen
- Topics
- Social Sciences › Health › Health disparities and outcomes
- Health Sciences › Health Professions › General Health Professions › Employment and Welfare Studies
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Keywords
- financial stress, income, depressive disorders, anxiety disorders, socioeconomic disparities, mental health
- MeSH terms
- Adolescent, Adult, Aged, Anxiety Disorders, Cross-Sectional Studies, Depressive Disorder, Educational Status, Employment, Female, Humans, Income, Interviews as Topic, Longitudinal Studies, Male, Middle Aged, Netherlands, Social Class, Multicenter Studies as Topic, Logistic Models, Case-Control Studies, Young Adult
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