Abstract
Gender differences (GD) in mental health have come under renewed scrutiny during the COVID-19 pandemic. While rapidly emerging evidence indicates a deterioration of mental health in general, it remains unknown whether the pandemic will have an impact on GD in mental health. To this end, we investigate the association of the pandemic and its countermeasures affecting everyday life, labor, and households with changes in GD in aggression, anxiety, depression, and the somatic symptom burden. We analyze cross-sectional data from 10,979 individuals who live in Germany and who responded to the online survey “Life with Corona” between October 1, 2020 and February 28, 2021. We estimate interaction effects from generalized linear models. The analyses reveal no pre-existing GD in aggression but exposure to COVID-19 and COVID-19 countermeasures is associated with sharper increases in aggression in men than in women. GD in anxiety decreased among participants with children in the household (with men becoming more anxious). We also observe pre-existing and increasing GD with regards to the severity of depression, with women presenting a larger increase in symptoms during the hard lockdown or with increasing stringency. In contrast to anxiety, GD in depression increased among participants who lived without children (women > men), but decreased for individuals who lived with children; here, men converged to the levels of depression presented by women. Finally, GD in somatic symptoms decreased during the hard lockdown (but not with higher stringency), with men showing a sharper increase in symptoms, especially when they lived with children or alone. Taken together, the findings indicate an increase in GD in mental health as the pandemic unfolded in Germany, with rising female vulnerability to depression and increasing male aggression. The combination of these two trends further suggests a worrying mental health situation for singles and families. Our results have important policy implications for the German health system and public health policy. This public health challenge requires addressing the rising burden of pandemic-related mental health challenges and the distribution of this burden between women and men, within families and for individuals who live alone.
Highlights
More than 1 year has passed since the beginning of the COVID19 pandemic and evidence on its profound psychological impacts is emerging rapidly from around the world (Wang C. et al, 2020; Williams et al, 2020)
We show that Gender differences (GD) in aggression and depression increased as a consequence of stricter COVID19 countermeasures in Germany
We find GD in anxiety and somatization but the results do not indicate that these increased due to COVID-19 exposure, COVID-19 countermeasures or household characteristics
Summary
More than 1 year has passed since the beginning of the COVID19 pandemic and evidence on its profound psychological impacts is emerging rapidly from around the world (Wang C. et al, 2020; Williams et al, 2020). Anxiety and mood disorders have been shown to be more prevalent among women than men (Rosenfield and Mouzon, 2013), while externalizing behavior or aggression and substance use disorders are more prevalent among men than women (Seedat et al, 2009; Boyd et al, 2015) To varying extents, these differences are assumed to be the result of sex-specific genetic (Kang et al, 2020), epigenetic (Hodes et al, 2017), neural (Stewart et al, 2010), reproductive (Li and Graham, 2017), and social factors, e.g., social roles and gender norms (Alon et al, 2020). To date, we have limited evidence about the pandemic-related stressors that affect gender roles differentially, and how they impact GD in mental health
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