A Systematic Review on Sex- and Gender-Sensitive Research in Public Mental Health During the First Wave of the COVID-19 Crisis

Abstract

Background: Sex and gender are important modifiers of mental health and behavior in normal times and during crises. We investigated whether they were addressed by empirical, international research that explored the mental health and health behavior ramifications after the onset of the COVID-19 pandemic.Methods: We systematically searched the databases PsyArXiv, PubMed, PsycInfo, Psyndex, PubPsych, Cochrane Library, and Web of Science for studies assessing mental health outcomes (main outcomes) as well as potential risk and protective health behavior (additional outcomes) up to July 2, 2020.Findings: Most of the 80 publications fulfilling the selection criteria reflected the static difference perspective treating sex and gender as dichotomous variables. The focus was on internalizing disorders (especially anxiety and depression) burdening women in particular, while externalizing disorders were neglected. Sex- and gender-specific evaluation of mental healthcare use has also been lacking. With respect to unfavorable health behavior in terms of adherence to prescribed protective measures, men constitute a risk group.Interpretations: Women remain a vulnerable group burdened by multiple stresses and mental health symptoms. The neglect of sex- and gender-specific evaluation of aggression-related disorders, substance addiction, and mental healthcare use in the early stage represents a potentially dangerous oversight.Systematic Review Registration:https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020192026, PROSPERO 2020 CRD42020192026.

The impact of lockdown stress and loneliness during the COVID-19 pandemic on mental health among university students in Germany

“…On the other side, there was only one interaction effect, which was between time and gender for anxiety: while male students’ anxiety scores increased during the pandemic, female students’ scores remained at the same level (small effect). Altogether, contrary to previous studies 8 , 20 and to our hypotheses, the absence of interactions indicated that neither the mental distress of female nor non-medical students increased more than male or medical students’ distress. The interaction between anxiety and gender even indicated the opposite effect, namely that male students’ anxiety increased more than female students’ anxiety during the pandemic.…”

“…Female versus male and also non-medical versus medical students reported more mental health issues (depression, anxiety, somatic complaints), consistent with previous findings regarding gender 6 – 8 and field of study 20 . Previous findings comparing medical and non-medical students regarding depression have been inconclusive 32 , and it must be considered that medical students may become socialized to disclaim mental health problems during their training 33 .…”

“…Emerging evidence has pointed out a stress-related increase of levels of anxiety and depression, and of other symptoms of mental distress, underlining that the pandemic situation represents a stress event affecting people of all ages and different life situations 2 . In online surveys in the early phase of the pandemic, younger age 3 – 5 and student status 6 turned out as risk factors for heightened distress during the pandemic, along with female gender 6 – 8 .…”

“…We expected depression, anxiety, and somatic complaints to increase during the pandemic, particularly in female versus male students 8 and in non-medical versus medical students 20 . Pandemic-related concerns, psychosocial stress, and loneliness were expected to contribute to mental distress during the pandemic after adjustment for pre-pandemic distress.…”

Psychological Distress in Men during the COVID-19 Pandemic in Brazil: The Role of the Sociodemographic Variables, Uncertainty, and Social Support

“…In addition to that, population-based studies investigating the mental health situation in the context of the pandemic have included predominantly female samples [ 37 , 38 , 39 ], which limits a more comprehensive identification of the magnitude of the problem and, consequently, restricts the adoption of coping measures to a specific audience. In this context, this study contributes to overcoming this gap in scientific knowledge based on the research and appreciation of aspects related to the male population, which permeate the subjectivities and the social, symbolic, psychological, and psycho-emotional constructions of the population and their repercussions on health [ 40 , 41 ].…”