Do depressive and anxiety symptoms vary across the adult life course and between genders? A cross-sectional cultural comparison between Indonesia and the UK

BACKGROUND: Depressive and anxiety symptoms are associated with adverse physical health outcomes, and a high global prevalence is burdening healthcare systems. Understanding mental health differences across age groups, genders and cultures can help in designing effective targeted interventions. This study examined (1) if depressive and anxiety symptom levels are similar in the United Kingdom (UK) and Indonesia, (2) the age-related patterns of depressive and anxiety symptoms and whether this differs between countries, and (3) if age-related patterns of depressive and anxiety symptoms differ by gender within countries. METHODS: Convenience and purposeful sampling (to reduce potential age bias and enhance diversity) were used to recruit 1355 participants aged 18 to 91 from Indonesia (n = 706) and the UK (n = 649). Patient Health Questionnaire-9 and Generalized Anxiety Disorder Questionnaire-7 were used to measure depressive and anxiety symptoms, respectively. RESULTS: Depressive and anxiety symptoms were higher in the UK. The association between age and mental health symptoms showed variations in non-linear patterns between countries. In the UK, both symptoms generally declined initially, with a slight upturn in middle age before continued decline. In Indonesia, symptoms declined in middle age followed by a subsequent increase for depression, whilst anxiety remained stable in later life. Country interaction increased model fit for depressive and anxiety symptoms while gender interaction increased model fit only for anxiety symptoms in the UK. CONCLUSION: Mental health symptoms vary across age groups, genders and cultures. Understanding these variations can provide insights to inform tailored mental health interventions for vulnerable groups.