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

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

doi:10.1038/s41598-022-14746-1

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

Sci Rep. 2022 Jul 6;12(1):11417. doi: 10.1038/s41598-022-14746-1.

Authors

Tiffany Dal Santo¹, Ying Sun¹, Yin Wu^{1

2}, Chen He¹, Yutong Wang¹, Xiaowen Jiang¹, Kexin Li¹, Olivia Bonardi¹, Ankur Krishnan¹, Jill T Boruff³, Danielle B Rice^{1

4}, Sarah Markham⁵, Brooke Levis^{1

6}, Marleine Azar¹, Dipika Neupane¹, Amina Tasleem¹, Anneke Yao¹, Ian Thombs-Vite¹, Branka Agic^{7

8}, Christine Fahim⁹, Michael S Martin^{10

11}, Sanjeev Sockalingam^{7

12}, Gustavo Turecki^{2

13}, Andrea Benedetti^{14

15

16}, Brett D Thombs^{17

18

19

20

21

22

23}

Affiliations

¹ Lady Davis Institute for Medical Research, Jewish General Hospital, 3755 Cote Ste-Catherine, Pavilion H4.83, Montréal, QC, H3T 1E2, Canada.
² Department of Psychiatry, McGill University, Montréal, QC, Canada.
³ Schulich Library of Physical Sciences, Life Sciences, and Engineering, McGill University, Montréal, QC, Canada.
⁴ Department of Psychology, McGill University, Montréal, QC, Canada.
⁵ Department of Biostatistics and Health Informatics, King's College London, London, UK.
⁶ Centre for Prognosis Research, School of Medicine, Keele University, Staffordshire, UK.
⁷ Centre for Addiction and Mental Health, Toronto, ON, Canada.
⁸ Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.
⁹ Li Ka Shing Knowledge Institute, Unity Health Toronto, Toronto, ON, Canada.
¹⁰ School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada.
¹¹ Correctional Service of Canada, Ottawa, ON, Canada.
¹² Department of Psychiatry, University of Toronto, Toronto, ON, Canada.
¹³ McGill Group for Suicide Studies, Douglas Mental Health University Institute, McGill University, Montréal, QC, Canada.
¹⁴ Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montréal, QC, Canada.
¹⁵ Department of Medicine, McGill University, Montréal, QC, Canada.
¹⁶ Respiratory Epidemiology and Clinical Research Unit, McGill University Health Centre, Montréal, QC, Canada.
¹⁷ Lady Davis Institute for Medical Research, Jewish General Hospital, 3755 Cote Ste-Catherine, Pavilion H4.83, Montréal, QC, H3T 1E2, Canada. brett.thombs@mcgill.ca.
¹⁸ Department of Psychiatry, McGill University, Montréal, QC, Canada. brett.thombs@mcgill.ca.
¹⁹ Department of Psychology, McGill University, Montréal, QC, Canada. brett.thombs@mcgill.ca.
²⁰ Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montréal, QC, Canada. brett.thombs@mcgill.ca.
²¹ Department of Medicine, McGill University, Montréal, QC, Canada. brett.thombs@mcgill.ca.
²² Department of Educational and Counselling Psychology, McGill University, Montréal, QC, Canada. brett.thombs@mcgill.ca.
²³ Biomedical Ethics Unit, McGill University, Montréal, QC, Canada. brett.thombs@mcgill.ca.

Abstract

Women and gender-diverse individuals have faced disproportionate socioeconomic burden during COVID-19. There have been reports of greater negative mental health changes compared to men based on cross-sectional research that has not accounted for pre-COVID-19 differences. We compared mental health changes from pre-COVID-19 to during COVID-19 by sex or gender. 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) were searched to August 30, 2021. Eligible studies included mental health symptom change data by sex or gender. 12 studies (10 unique cohorts) were included, all of which reported dichotomized sex or gender data. 9 cohorts reported results from March to June 2020, and 2 of these also reported on September or November to December 2020. One cohort included data pre-November 2020 data but did not provide dates. Continuous symptom change differences were not statistically significant for depression (standardized mean difference [SMD] = 0.12, 95% CI -0.09-0.33; 4 studies, 4,475 participants; I² = 69.0%) and stress (SMD = - 0.10, 95% CI -0.21-0.01; 4 studies, 1,533 participants; I² = 0.0%), but anxiety (SMD = 0.15, 95% CI 0.07-0.22; 4 studies, 4,344 participants; I² = 3.0%) and general mental health (SMD = 0.15, 95% CI 0.12-0.18; 3 studies, 15,692 participants; I² = 0.0%) worsened more among females/women than males/men. There were no significant differences in changes in proportions above cut-offs: anxiety (difference = - 0.05, 95% CI - 0.20-0.11; 1 study, 217 participants), depression (difference = 0.12, 95% CI -0.03-0.28; 1 study, 217 participants), general mental health (difference = - 0.03, 95% CI - 0.09-0.04; 3 studies, 18,985 participants; I² = 94.0%), stress (difference = 0.04, 95% CI - 0.10-0.17; 1 study, 217 participants). Mental health outcomes did not differ or were worse by small amounts among women than men during early COVID-19.

Publication types

Systematic Review
Research Support, Non-U.S. Gov't

MeSH terms

Anxiety / epidemiology
Anxiety / psychology
COVID-19* / epidemiology
Cross-Sectional Studies
Female
Humans
Male
Mental Health*
Pandemics

Abstract

Publication types

MeSH terms

Grants and funding