Financial insecurity and depression appear to be connected in both directions over time. New research using data from the Netherlands Study of Depression and Anxiety (NESDA), one of the cohorts within Amsterdam Cohort Hub, shows that food insecurity and financial strain predict later depression, while depression in turn predicts subsequent financial insecurity. The evidence for a bidirectional relationship with anxiety was weaker.

Following the relationship over 13 years

The researchers examined the longitudinal relationship between financial insecurity and depression and anxiety using NESDA data collected at four time points over a period of 13 years. Financial insecurity was assessed through two indicators: food insecurity, not having enough money to buy the food needed, and financial strain at the end of the month. Depression and anxiety were assessed using both clinical diagnoses and symptom severity.
The analyses examined whether food insecurity and financial strain at one assessment predicted changes in depression or anxiety at the next assessment, and whether depression and anxiety in turn predicted later changes in financial insecurity.

Financial insecurity predicts later depression

Participants who reported food insecurity or financial strain had higher odds of developing a depressive disorder at the next assessment. Higher levels of food insecurity and financial strain were also associated with greater depressive symptom severity at the following assessment.
Associations with anxiety were also found, but were generally weaker. For food insecurity, only the highest category was significantly associated with an increased risk of a subsequent anxiety disorder. For financial strain, increased odds of anxiety disorder were found among participants who reported not having enough money at the end of the month.

Depression also predicts later financial insecurity

The relationship also worked in the opposite direction. Both depressive disorders and higher levels of depressive symptoms were associated with increased food insecurity and financial strain at the next assessment. Anxiety disorders also predicted subsequent food insecurity and financial strain, whereas anxiety symptom severity did not.

Overall, the researchers conclude that the findings support a bidirectional temporal association between food insecurity, financial strain and depression across 13 years, with weaker evidence for anxiety. The authors state that integrating attention to financial difficulties within mental health services may help address the interrelated challenges of financial insecurity and mental health.

Read the full paper: Caught in a downward spiral? The bidirectional relationship between food insecurity, financial strain, and depression and anxiety: a NESDA study.

About the study
The study Caught in a downward spiral? The bidirectional relationship between food insecurity, financial strain, and depression and anxiety: a NESDA study was conducted by researchers from Leiden University Medical Center, University Medical Center Groningen and Amsterdam UMC.