title: Associations of financial strain and income with depressive and anxiety disorders.
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.
authors: Department of General Practice & Elderly Care Medicine and the EMGO+Institute for Health and Care Research (EMGO+), VU University Medical Center, Amsterdam, The Netherlands.
authors: Sandra M A
authors: SM
authors: Dijkstra-Kersten
authors: Department of General Practice & Elderly Care Medicine and the EMGO+Institute for Health and Care Research (EMGO+), VU University Medical Center, Amsterdam, The Netherlands.
authors: Karolien E M
authors: KE
authors: Biesheuvel-Leliefeld
authors: Department of General Practice & Elderly Care Medicine and the EMGO+Institute for Health and Care Research (EMGO+), VU University Medical Center, Amsterdam, The Netherlands.
authors: Johannes C
authors: JC
authors: van der Wouden
authors: Department of Psychiatry and the EMGO+Institute for Health and Care Research (EMGO+), VU University Medical Center, Amsterdam, The Netherlands.
authors: Brenda W J H
authors: BW
authors: Penninx
authors: Department of General Practice & Elderly Care Medicine and the EMGO+Institute for Health and Care Research (EMGO+), VU University Medical Center, Amsterdam, The Netherlands.
authors: Harm W J
authors: HW
authors: van Marwijk
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001008:Anxiety Disorders / Q000191:economics* / Q000453:epidemiology; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D003866:Depressive Disorder / Q000191:economics* / Q000453:epidemiology; D004522:Educational Status; D004651:Employment; D005260:Female; D006801:Humans; D007182:Income / Q000145:classification / Q000706:statistics & numerical data*; D007407:Interviews as Topic; D016015:Logistic Models; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D015337:Multicenter Studies as Topic; D009426:Netherlands / Q000453:epidemiology; D012923:Social Class; D055815:Young Adult
keywords: DEPRESSION; MENTAL HEALTH; SOCIAL INEQUALITIES