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. 2022 Jul 6;12(1):11417.
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

Tiffany Dal Santo  1 , Ying Sun  1 , Yin Wu  1   2 , Chen He  1 , Yutong Wang  1 , Xiaowen Jiang  1 , Kexin Li  1 , Olivia Bonardi  1 , Ankur Krishnan  1 , Jill T Boruff  3 , Danielle B Rice  1   4 , Sarah Markham  5 , Brooke Levis  1   6 , Marleine Azar  1 , Dipika Neupane  1 , Amina Tasleem  1 , Anneke Yao  1 , Ian Thombs-Vite  1 , Branka Agic  7   8 , Christine Fahim  9 , 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

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

Tiffany Dal Santo et al. Sci Rep. .

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.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Figure 1
Figure 1
Forest plots of standardized mean difference of the difference in change in continuous anxiety symptom scores (a), depression symptom scores (b), general mental health scores (c), and stress scores (d) between females or women and males or men. Positive numbers indicate greater negative change in mental health in females or women compared to males or men.
Figure 2
Figure 2
Forest plots of standardized mean difference of the difference in change in proportion above a cut-off for anxiety (a), depression (b), general mental health (c), and stress (d) between females or women and males or men. Positive numbers indicate greater negative change in mental health in females or women compared to males or men. (c) reflects dichotomous COVID-19 mental health measured in early 2020, whereas (e) reflects measurements from late 2020 for Daly and van der Velden.
Figure 3
Figure 3
Illustration of the magnitude of change for SMD = 0.15 assuming a normal distribution. The hypothetical blue distribution represents pre-COVID-19 scores, and the grey distribution represents post-COVID-19 scores with a mean symptom increase of SMD = 0.15.
See this image and copyright information in PMC

References

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