Experience of financial hardship and depression: a longitudinal population-based multi-state analysis.

Abstract

Aims: Little is known about the effects of both financial hardship and people's perception of it on mental health. This study aimed to evaluate the effect of perceived financial hardship on individuals' depressive symptoms across several strata of objective financial situations.

Methods: We used data from a four-wave French national population-based cohort (N = 14,236, 2020-2022) to assess the relationship between depressive symptoms and perceived financial hardship. Multi-state models (MSM) were used on a three-level scale for depressive symptom severity based on the Patient Health Questionnaire (PHQ-9). Analyses were stratified by household income to study the interaction with the objective financial situation.

Results: We showed a link between perceived financial hardship and the onset and deterioration of depressive symptoms in subsequent waves, with effect sizes ranging from HR = 1.29 (0.87-1.90) to 2.23 (1.66-2.98). This association was stronger in the high-income population. There was no significant link between perceived financial hardship and the improvement of depressive symptomatology.

Conclusions: This study confirms that perceived financial hardship is linked to the onset and deterioration of depressive symptoms. Furthermore, it suggests a stronger effect in high-income households, which could mean that the experience of financial hardship and the objective financial situation interact in their effect on mental health.