Abstract
We examined depression and anxiety prior to and during COVID-19 restrictions in Australian gay and bisexual men (GBM). In an online cohort, a COVID-19-focused survey was conducted in April 2020. During 2019 and in April 2020, 664 GBM completed the Patient Health Questionnaire (PHQ-9, measuring depression) and Generalized Anxiety Disorder Assessment (GAD-7, measuring anxiety). Increased depression and anxiety were defined as a ≥ 5 point increase on the respective scales. Mean PHQ-9 and GAD-7 scores increased between 2019 and 2020 (PHQ-9: from 5.11 in 2019 to 6.55 in 2020; GAD-7: from 3.80 in 2019 to 4.95 in 2020). The proportion of participants with moderate-severe depression (PHQ-9 ≥ 10) increased from 18.8% (n = 125) to 25.5% (n = 169), while the proportion of participants with moderate-severe anxiety (GAD-7 ≥ 10) increased from 12.7% (n = 84) to 17.3% (n = 115). Almost one-quarter of participants (n = 158, 23.8%) had increased depression; in these men, mean PHQ-9 increased from 2.49 in 2019 to 11.65 in 2020 (p < 0.001). One-in-five (20.6%) participants (n = 137) had increased anxiety; among these men, mean GAD-7 increased from 2.05 in 2019 to 10.22 in 2020 (p < 0.001). Increases were associated with concerns about job security, reduction in social and sexual connections and opportunities, and being personally concerned about COVID-19 itself. COVID-19 appeared to have a sudden and pronounced impact on depression and anxiety in Australian GBM, with a significant minority showing sharp increases. Ongoing monitoring is required to determine longer-term impacts and GBM need access to appropriate and sensitive supports both during and after the COVID-19 pandemic.
Highlights
Severe Acute Respiratory Syndrome coronavirus-2 (SARSCoV-2), the cause of COVID-19, is highly transmissible through close proximity with an infected person (Guan et al, 2020; Guo et al, 2020)
Factors independently associated with increased symptoms were identified using logistic regression; we present adjusted odds ratios, 95% confidence intervals and p-values
The PHQ-9 and GAD-7 were completed by 913 men in the 2020 COVID-19 survey, and of these, 664 completed the measures in 2019
Summary
Severe Acute Respiratory Syndrome coronavirus-2 (SARSCoV-2), the cause of COVID-19, is highly transmissible through close proximity with an infected person (Guan et al, 2020; Guo et al, 2020). While the COVID19 pandemic presents mental health challenges for the general population, physical distancing restrictions may have specific impacts on gay and bisexual men (GBM), who typically have higher prevalence of mental ill-health than the general population (King et al, 2008; Meyer, 2003; Prestage et al, 2018). Cross-sectional research has documented emerging concerns about the mental health of GBM due to COVID-19, with studies during the COVID-19 period finding that just under one-third of GBM experienced depression or anxiety (Santos et al, 2020; Suen et al, 2020), that those who practiced physical distancing were more likely to feel anxious (Holloway et al, 2021), and another reporting that over half felt they needed help with a mental health problem (Brennan et al, 2020). In the context of pre-existing, disproportionate burden of mental ill-health among GBM, coupled with a higher likelihood of experiencing co-situated challenges such as stigma and discrimination (Victorian Agency for Health Information, 2020), mental health services (and funders) need to be cognisant of the unique needs of this population during the pandemic
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