Systematic review of mental health symptom changes by sex or gender in early-COVID-19 compared to pre-pandemic

Santo, Tiffany Dal; Sun, Ying; Wu, Yin; He, Chen; Wang, Yutong; Jiang, Xiaowen; Li, Kexin; Bonardi, O; Krishnan, Ankur; Boruff, Jill; Rice, Danielle B; Markham, Sarah; Levis, Brooke; Azar, Marleine; Neupane, Dipika; Tasleem, Amina; Yao, Anneke; Thombs-Vite, Ian; Agic, Branka; Fahim, Christine; Martin, Michael S.; Sockalingam, Sanjeev; Turecki, Gustavo; Benedetti, Andrea; Thombs, Brett D.

doi:10.1038/s41598-022-14746-1

Cited by 32 publications

(27 citation statements)

References 63 publications

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“…On the other hand, [36] [37] find that women are more affected by COVID-19 compared with men in the United States, and [28] [29] [31] [32] [46] show that women's mental health seem more affected by the pandemic in the UK. Overall, these mixed findings related to gender are in line with [48], who in an international meta-analysis did not find clear gender differences when comparing the mental health effects of the pandemic. We find that individuals who have lower educational backgrounds and lower incomes are affected by COVID-19 more compared with individuals who have higher educational backgrounds and higher incomes 7 .…”

Section: Discussionsupporting

confidence: 50%

COVID-19 and Mental Health in China: Effects of Personality and Demographics

Zhang¹,

Battisti

Proto

2023

Preprint

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China was the first country affected by the COVID-19 virus and it reacted strongly in the first months of 2020. This paper presents new evidence on the deterioration in mental health in China between 2018 and 2020. Using two waves of the China Family Panel Studies (CFPS) we can follow the same individuals pre and during the pandemic periods. We find clear evidence of a moderate level of mental health deterioration between 2018 and 2020. The prevalence of severe cases of depression, measured using an eight-item version of the common CES-D scale, increased from 6.33% in 2018 to 7.54% in 2020; quantifiable as around a 19% increase. This deterioration is higher for individuals who are subject to strict lockdowns, about 0.3 symptoms more on average, and it is stronger among those who already reported symptoms of depression in the 2018 wave of data. The effects we find are larger for individuals with more open personalities: one standard deviation of the Openness trait corresponds to 0.08 more symptoms, while more Neurotic individuals do not seem to be more affected. Younger cohorts and individuals with lower levels of education are more affected. Males seem slightly more affected than females, although this difference is statistically non-significant.

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Section: Discussionsupporting

confidence: 50%

COVID-19 and Mental Health in China: Effects of Personality and Demographics

Zhang¹,

Battisti

Proto

2023

Preprint

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“…This finding is consistent with a previous analysis of a subset of studies from those in the present review with direct comparisons between mental health of women or females and men or males (N = 10 unique cohorts). 35 That study found significantly, albeit minimally, greater worsening of general mental health and anxiety symptoms among women (SMDchange = 0.15 for both); although, depressive symptoms were not significantly different but were worse for women (SMDchange = 0.12). 35 Significant worsening of symptoms among women or females, although by a small amount, is of concern.…”

Section: Findings In Contextmentioning

confidence: 75%

“…35 That study found significantly, albeit minimally, greater worsening of general mental health and anxiety symptoms among women (SMDchange = 0.15 for both); although, depressive symptoms were not significantly different but were worse for women (SMDchange = 0.12). 35 Significant worsening of symptoms among women or females, although by a small amount, is of concern. This is an aggregate result, and even though it is small, it suggests that the pandemic has likely impacted some women or females substantively.…”

Section: Findings In Contextmentioning

confidence: 75%

Comparison of Mental Health Symptoms Prior to and During COVID-19: Evidence from a Systematic Review and Meta-analysis of 134 Cohorts

Sun

Fan

et al. 2021

Preprint

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Objectives: The rapid pace, high volume, and limited quality of mental health evidence being generated during COVID-19 poses a barrier to effective decision-making. The objective of the present report is to compare mental health outcomes assessed during COVID-19 to outcomes prior to COVID-19 in the general population and other population groups. Design: Living systematic review. Data Sources: MEDLINE (Ovid), PsycINFO (Ovid), CINAHL (EBSCO), EMBASE (Ovid), Web of Science Core Collection: Citation Indexes, China National Knowledge Infrastructure, Wanfang, medRxiv (preprints), and Open Science Framework Preprints (preprint server aggregator). The initial search was conducted on April 13, 2020 with ongoing weekly updates. Eligibility criteria for selecting studies: For this report, we included studies that compared general mental health, anxiety symptoms, or depression symptoms, assessed January 1, 2020 or later, to the same outcomes collected between January 1, 2018 and December 31, 2019. We required ≥ 90% of participants pre-COVID-19 and during COVID-19 to be the same or the use of statistical methods to address missing data. For population groups with continuous outcomes for at least three studies in an outcome domain, we conducted restricted maximum-likelihood random-effects meta-analyses. Results: As of March 22, 2021, we had identified 36 unique eligible studies with data from 33 cohorts. All reported COVID-19 outcomes between March and June 2020, and 3 studies also reported outcomes between September and November 2020. Estimates of changes in general mental health were close to zero in the general population (standardized mean difference [SMD] = 0.02, 95% CI -0.11 to 0.16, I2 = 94.6%; 4 studies, N = 19,707) and among older adults (SMD = 0.02, 95% CI -0.11 to 0.16, I2 = 90.4%; 4 studies, N = 5,520) and university students (SMD = -0.01, 95% CI -0.33 to 0.30, I2 = 92.0%; 3 studies, N = 3,372). Changes in anxiety symptoms were close to zero and not statistically significant in university students (SMD = 0.00, 95% CI -0.35 to 0.36, I2 = 95.4%; 5 studies, N = 1,537); women or females (SMD = 0.02, 95% CI -0.35 to 0.39, I2 = 92.3%; 3 studies, N = 2,778); and men or males (SMD = 0.07, 95% CI -0.01 to 0.15; I2 = 0.01%; 3 studies, N = 1,250); anxiety symptoms increased, however, among people with pre-existing medical conditions (SMD = 0.27, 95% CI 0.01 to 0.54, I2 = 91.0%; 3 studies, N = 2,053). Changes in depression symptoms were close to zero or small and not statistically significant among university students (SMD = 0.19, 95% CI -0.08 to 0.45, I2 = 91.8%; 5 studies, N = 1,537); people with pre-existing medical conditions (SMD = 0.01, 95% CI -0.15 to 0.17, I2 = 14.9%; 3 studies, N = 2,006); women or females (SMD = 0.21, 95% CI -0.14 to 0.55, I2 = 91.2%; 3 studies, N = 2,843); and men or males (SMD = 0.00, 95% CI -0.21 to 0.22; I2 = 92.3%; 4 studies, N = 3,661). In 3 studies with data from both March to June 2020 and September to November 2020, symptoms were unchanged from pre-COVID-19 at both time points or there were increases at the first assessment that had largely dissipated by the second assessment. Conclusions: Evidence does not suggest a widespread negative effect on mental health symptoms in COVID-19, although it is possible that gaps in data have not allowed identification of changes in some vulnerable groups. Continued updating is needed as evidence accrues.

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“…The pandemic’s burden on mental health is associated with multiple intersecting factors, including economic decline resulting in increased job insecurity [ 3 , 4 ]; housing precarity [ 5 , 6 ]; childcare disruptions and school closures [ 7 , 8 , 9 ]; increased risk of interpersonal violence [ 10 , 11 ]; and general disruption to daily routines [ 12 ]. Furthermore, the burden of COVID-19 disease, and its psychosocial sequelae, has disproportionately impacted certain populations, such as children and youth [ 12 , 13 ], cisgender women [ 14 , 15 , 16 ], minoritized communities [ 17 , 18 ], people who use drugs [ 19 ], older adults [ 20 , 21 ], people with disabilities [ 22 , 23 ], and LGBTQIA+ individuals [ 24 , 25 , 26 , 27 ].…”

Section: Introductionmentioning

confidence: 99%

COVID-19 Related Shifts in Social Interaction, Connection, and Cohesion Impact Psychosocial Health: Longitudinal Qualitative Findings from COVID-19 Treatment Trial Engaged Participants

Perez-Brumer

Balasa

Doshi

et al. 2022

IJERPH

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While effective for slowing the transmission of SARS-CoV-2, public health measures, such as physical distancing and stay-at-home orders, have significantly shifted the way people interact and maintain social connections. To better understand how people sought social and psychological support amid the pandemic, we conducted a longitudinal qualitative evaluation of participants enrolled in a COVID-19 treatment trial (N = 30). All participants from the parent trial who consented to being contacted for future research studies were recruited electronically via email, and first-round virtual interviews were conducted between December 2020 and March 2021. Participants who participated in first-round interviews were contacted again, and follow-up interviews were conducted in January–February 2022. The results reported significant shifts in how participants connected to social support, including changes from physical to virtual modalities, and using different social networks for distinct purposes (i.e., Reddit/Facebook for information, WhatsApp for community connection). While having COVID-19, profound loneliness during isolation was described; yet, to mitigate effects, virtual support (i.e., emotional, knowledge-seeking) as well as in-person material support (e.g., groceries, snow-shoveling), were key. Public health efforts are needed to develop interventions that will improve the narratives about mental health challenges related to COVID-19 isolation, and to provide opportunities to share challenges in a supportive manner among social networks. Supporting social cohesion, despite the everchanging nature of COVID-19, will necessitate innovative multimodal strategies that learn from lived experiences across various stages of the pandemic.

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Systematic review of mental health symptom changes by sex or gender in early-COVID-19 compared to pre-pandemic

Cited by 32 publications

References 63 publications

COVID-19 and Mental Health in China: Effects of Personality and Demographics

COVID-19 and Mental Health in China: Effects of Personality and Demographics

Comparison of Mental Health Symptoms Prior to and During COVID-19: Evidence from a Systematic Review and Meta-analysis of 134 Cohorts

COVID-19 Related Shifts in Social Interaction, Connection, and Cohesion Impact Psychosocial Health: Longitudinal Qualitative Findings from COVID-19 Treatment Trial Engaged Participants

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