Gender Differences in Anxiety Among COVID-19 Inpatients Under Isolation: A Questionnaire Survey During the First and Second Waves of the COVID-19 Pandemic in Japan

Abstract

This study assesses the gender differences in health and anxiety, especially pertaining to mental health problems and time-course effects. We surveyed 121 patients admitted to a hospital with a COVID-19 diagnosis between March 1 and August 31, 2020. Their mental status was evaluated on admission using the Japanese General Health Questionnaire-28 (GHQ-28) and State–Trait Anxiety Inventory—Form JYZ (STAI). The patients were divided into two groups depending on the period of prevalence, that is, the first and second waves of the pandemic in Japan (from the beginning of March to the end of May 2020, Time 1 = T1; and from the beginning of June to the end of August 2020, Time 2 = T2). A multivariate analysis of covariance revealed significant differences in gender by time interactions in the GHQ-28 subscale “Insomnia and anxiety” and STAI subscale “State–Anxiety.” Post-hoc t-tests revealed that the scores of “Insomnia and Anxiety” and “State–Anxiety” were higher in women than in men at T1. However, no difference was observed at T2. Further, “Insomnia and Anxiety” and “State–Anxiety” were significantly higher at T1 than at T2 in female patients. There was no significant difference in males. Thus, female patients were more anxious and depressed in the early phase of the pandemic, whereas male patients had difficulties in coping with anxiety. We suggest more gender-specific mental care, particularly for women at the early stages of infection.

The Fear of COVID-19: Gender Differences among Italian Health Volunteers

“…In fact, the first predictor of females is Anxious arousal of the PTSD scale, which seems to play a significant role in exacerbating the Fear of COVID-19; this dimension is also found in the male group, but with a significantly lower incidence. This finding seems to be consistent with the literature on the issue, which shows that women have higher levels of anxiety regarding the COVID-19 pandemic [ 43 , 59 , 60 , 61 ]. On the other hand, for men, the factor that most explains the investigated dependant variable (i.e., fear of COVID-19) is negative effect as measured by the PTSD scale; this finding is in contrast to the previous study by Fenollar-Cortés et al [ 44 ], in which it emerges that women have significantly higher scores than men with respect to the variable negative affect.…”

“…These data are concordant with the scientific literature present for both the general population [ 13 , 76 , 77 , 78 , 79 , 80 ] and the specific volunteer population [ 75 ], in which women show higher levels of depression, anxiety, and somatisation symptoms; however, these differences are small, probably because of the period of data collection (the second pandemic wave). In fact, some studies found that gender differences in psychological well-being faded as time went by [ 43 , 44 ]; we can imagine that these differences were slowly fading, and future studies may investigate if these differences will be still present at the end of the pandemic situation.…”

“…Several studies have investigated gender differences in mental health in the general population after the spread of the COVID-19 pandemic. Specifically, the pandemic was found to have a more pronounced effect on women, who reported a higher prevalence and severity of depression, anxiety, and symptoms of posttraumatic stress disorder, such as insomnia [ 43 ] and avoidance [ 44 ], than men [ 11 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 ]. These findings are supported by a study conducted in 59 countries around the world that also find that women are more likely than men to use a variety of adaptive coping strategies, such as proactively seeking assistance or obtaining emotional support from others [ 52 ].…”

“…This might explain why females also appear to have experienced greater improvements in mental health over time. Females initially scored significantly higher than males on various measures of mental well-being but later improved, which may imply a fading of gender differences as an indicator of greater emotional distress [ 43 , 44 ]; a lack of adaptive coping strategies in men may mask the presence of greater symptoms of anxiety and difficulty coping in males [ 43 , 45 ]. Finally, women have appeared to report lower expectations of the health consequences of COVID-19 and a greater fear of personal death than men, which may be regarded as a significant predictor of anxiety symptoms [ 53 ].…”

The Impact of Gender and Age Differences and Infectious Disease Symptoms on Psychological Distress in Quarantined Asymptomatic or Mildly Ill COVID-19 Patients in Japan

“…The purpose of this study was to investigate the attributes that influenced psychological distress in COVID-19 patients (hereafter referred to as infected patients) who were isolated in residential treatment facilities and consulted at a mental health welfare center. Because previous studies have reported higher anxiety in women than in men among patients with COVID-19 who were admitted to a medical facility for treatment [ 12 , 13 , 14 , 15 , 16 ], we hypothesized that being female would have an exacerbating effect on psychological distress. Furthermore, given that younger age groups were more anxious under urban lockdowns in overseas reports [ 1 , 2 , 17 , 18 ], we postulated a second hypothesis: that being younger than 40 years old would have had an exacerbating effect on psychological distress.…”