ORIGINAL RESEARCH article
Front. Psychol.
Sec. Health Psychology
Volume 16 - 2025 | doi: 10.3389/fpsyg.2025.1633445
Financial Toxicity and Psychological Distress in Cardiovascular Non-cancer Multimorbidity: A Latent Profile Analysis and Causal Weighting
Provisionally accepted
- 1Department of Nursing, Renmin Hospital of Wuhan University, Wuhan, China
- 2Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, China
- 3Department of Geriatrics, Renmin Hospital of Wuhan University, Wuhan, China
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Cardiovascular disease with multimorbidity imposes substantial long-term financial burdens. Financial toxicity, the financial burden associated with healthcare, is increasingly recognized as a psychosocial stressor affecting health outcomes among chronically ill populations. However, its psychological heterogeneity in non-cancer patients is understudied. We aimed to identify financial toxicity profiles, their determinants, and associations with anxiety/depression in cardiovascular non-cancer multimorbidity.This study used a cross-sectional design. Utilizing latent profile analysis to identify distinct financial toxicity subgroups. Univariate and multivariate logistic regression analyses were employed to explore factors associated with subgroup membership. Inverse probability of treatment weighting based on covariate balancing propensity scores was applied to assess the associations between financial toxicity profiles and psychological distress. Doubly robust regression models were utilized to validate the robustness of the observed associations.Financial toxicity was categorized into three latent profiles: mild (63.8%), moderate (11.0%), and none (25.2%). Demographic, economic, social support, and coping variables significantly differed across profiles. In weighted regression models using inverse probability of treatment weighting based on covariate balancing propensity scores, both mild and moderate toxicity were associated with elevated anxiety (β = 1.88 and 8.68, respectively) and depression scores (β = 4.21 and 11.92; all p < 0.01) compared to the no-toxicity group. These associations remained robust in doubly robust models adjusting for covariates .Financial toxicity is prevalent and heterogeneous in cardiovascular multimorbidity. Its distinct profiles predict elevated psychological distress, supporting targeted interventions to alleviate financial burden and enhance mental health resilience.
Keywords: cardiovascular, non-cancer multimorbidity, Financial toxicity, Anxiety, Depression, latent profile analysis, Inverse probability of treatment weighting, Doubly robust estimation
Received: 27 May 2025; Accepted: 04 Aug 2025.
Copyright: © 2025 Wu, Zhou, Liu, Liu, Ma, Li, Tao and Cai. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Zhongxiang Cai, Department of Nursing, Renmin Hospital of Wuhan University, Wuhan, China
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