Income, depressive symptoms, and anxiety symptoms in Indonesia: a two-year cross-lagged panel analysis of socioeconomic gradients

Satrya, A, Fajri, M orcid iconORCID: 0009-0005-2072-7447, Susanti, H, Aini, K, Brooks, H, Bee, P and Maharani, A (2026) Income, depressive symptoms, and anxiety symptoms in Indonesia: a two-year cross-lagged panel analysis of socioeconomic gradients. Frontiers in Public Health, 14. pp. 1-10. ISSN 2296-2565

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Abstract

Background – Socioeconomic status influences mental health, but few long-term studies explore how household income and psychological outcomes interact in low- and middle-income countries. This study examines the 2-year bidirectional relationship between household income per capita and depressive and anxiety symptoms in Indonesia. Method – Data from the STAND survey were analyzed using a two-wave cross-lagged panel design within an SEM framework. Two models were estimated: one for depressive symptoms (CES-D 10) and one for anxiety (GAD-7). Household income per capita (IDR) was categorized into lower- and higher-income group and used as the main socioeconomic indicator. Models adjusted for comorbidities, age, sex, education, employment status, and marital status. The sample included 18, 164 respondents with complete data in 2023 and 2025. Results – At baseline, 4.4% reported depressive symptoms, and 8.5% reported anxiety. In the first model, baseline household income status predicted follow-up household income status (β = 0.361, p < 0.001) and fewer depressive symptoms (β = −0.014, p = 0.043). Those with baseline depressive symptoms were moderately likely to continue experiencing symptoms (β = 0.270, p < 0.001), which also predicted lower income later (β = −0.013, p = 0.039). In the second model, baseline household income status predicted follow-up household income status (β = 0.360, p < 0.001) and fewer anxiety symptoms (β = −0.035, p < 0.001). Baseline anxiety symptoms persisted (β = 0.257, p < 0.001), but did not significantly predict future income. Conclusions – Findings reveal a two-way link between household income status and depressive symptoms: lower household income status is associated with depressive symptoms, which then lower subsequent household income status. For anxiety, the connection is one-way: lower household income status is associated with worse symptoms, but not vice versa. These results highlight complex links between economic and mental health in Indonesia, emphasizing policies that address both poverty and mental health to break cycles.

Item Type: Article
Uncontrolled Keywords: Indonesia; anxiety symptoms; cross-lagged panel analysis; depressive symptoms; household income per capita; Indonesia; Humans; Income; Depression; Anxiety; Female; Male; Adult; Socioeconomic Disparities in Health; Middle Aged; Socioeconomic Factors; Low Socioeconomic Status; 4206 Public Health; 42 Health Sciences; Depression; Social Determinants of Health; Clinical Research; Mental Illness; Mental Health; Behavioral and Social Science; Brain Disorders; Basic Behavioral and Social Science; 2.3 Psychological, social and economic factors; Mental health; 3 Good Health and Well Being; Indonesia; Humans; Income; Depression; Anxiety; Female; Male; Adult; Socioeconomic Disparities in Health; Middle Aged; Socioeconomic Factors; Low Socioeconomic Status; 1117 Public Health and Health Services; 4203 Health services and systems; 4206 Public health
Subjects: B Philosophy. Psychology. Religion > BF Psychology
H Social Sciences > H Social Sciences (General)
R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine
Divisions: Nursing, Public and Allied Health
Publisher: Frontiers Media SA
Date of acceptance: 23 June 2026
Date of first compliant Open Access: 26 October 2026
Date Deposited: 26 Oct 2026 13:49
Last Modified: 26 Oct 2026 13:49
DOI or ID number: 10.3389/fpubh.2026.1839549
URI: https://researchonline.ljmu.ac.uk/id/eprint/29744
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