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Associations of financial strain and income with depressive and anxiety disorders
  1. Sandra M A Dijkstra-Kersten1,
  2. Karolien E M Biesheuvel-Leliefeld1,
  3. Johannes C van der Wouden1,
  4. Brenda W J H Penninx2,
  5. Harm W J van Marwijk1
  1. 1Department of General Practice & Elderly Care Medicine and the EMGO+Institute for Health and Care Research (EMGO+), VU University Medical Center, Amsterdam, The Netherlands
  2. 2Department of Psychiatry and the EMGO+Institute for Health and Care Research (EMGO+), VU University Medical Center, Amsterdam, The Netherlands
  1. Correspondence to Sandra M A Dijkstra-Kersten, Department of General Practice & Elderly Care Medicine, Medicine and the EMGO+Institute for Health and Care Research (EMGO+), VU University Medical Center, Van der Boechorststraat 7, 1007 MB, Amsterdam, The Netherlands; s.kersten{at}vumc.nl

Abstract

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.

  • DEPRESSION
  • SOCIAL INEQUALITIES
  • MENTAL HEALTH

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