Perceived financial decline and depressive symptoms among undergraduate students in Japan in 2022 during the COVID-19 pandemic: a cross-sectional study of potential indirect associations

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BACKGROUND: While the short-term impact of financial difficulties due to the COVID-19 pandemic among undergraduate students has been studied, the prolonged impact remains largely unknown. This study aims to investigate the association between perceived financial decline due to the COVID-19 pandemic and depressive symptoms among undergraduate students in Japan in 2022. The study also explores the cross-sectional roles of financial anxiety, the imbalance between part-time job and academic study (work-study imbalance), and worry about degree attainment in accounting for the association. METHODS: A cross-sectional study was conducted via an online survey of undergraduate students (n = 2,120) recruited through a Japanese internet research service company between 9 and 14 February 2022. Depressive symptoms were assessed using the 9-item Patient Health Questionnaire (PHQ-9), with a cut-off score of 10. Perceived financial change compared to the pre-pandemic level was categorised as 'Better,' 'Same,' or 'Worse.' Poisson regression analysis with robust error variance was used to estimate prevalence ratios (PRs) and 95% confidence intervals (CIs). Using the difference method, we calculated the percentage change in the PR accounted for by the three variables. RESULTS: The prevalence of depressive symptoms among the participants was 27.2%, and 31.2% reported financial decline. The adjusted PR for depressive symptoms among those reporting financial decline was 1.52 (95% CI: 1.31-1.76) compared to those reporting no change. The proportion of the association accounted for by financial anxiety, work-study imbalance, and worry about degree attainment was 64.0%, 42.4%, and 12.7%, respectively. When adjusted for simultaneously, these three variables accounted for 81.9% of the association. CONCLUSIONS: Perceived financial decline was associated with depressive symptoms among undergraduate students even in 2022. These findings highlight the need for continued financial and mental health support for vulnerable students.

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