{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T01:35:14Z","timestamp":1777944914307,"version":"3.51.4"},"reference-count":29,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2021,1,1]],"date-time":"2021-01-01T00:00:00Z","timestamp":1609459200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Womens Health (Lond Engl)"],"published-print":{"date-parts":[[2021,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Several studies have assessed the impact of the COVID-19 pandemic on anxiety and depression, but have not focused on the role of sex and gender. This study compared changes in the levels of anxiety and depression (pre- and post-COVID) experienced by individuals of various sexes and genders.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>We used a cross-sectional online survey that assessed pre- and post-COVID symptoms of anxiety (Generalized Anxiety Disorder-2) and depression (Patient Health Questionnaire-9). General linear modeling (fixed model factorial analysis of variance) was used to evaluate changes in anxiety and depression between pre- and post-pandemic periods and explore differential effects of sex and gender on those changes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Our study included 1847 participants from 43 countries and demonstrated a percentage increase of 57.1% and 74.2% in anxiety and depression, respectively. For the Generalized Anxiety Disorder-2 scale (maximum score 6), there was a mean increase in anxiety by sex for male, female, and other of 1.0, 1.2, and 1.4, respectively; and by gender for man, woman, and others of 0.9, 1.3, and 1.6, respectively. For the Patient Health Questionnaire-9 (maximum score 27), there was a mean increase in depressive symptoms by sex for male, female, and other of 3.6, 4.7, and 5.5 respectively; and by gender for man, woman, and others of 3.3, 4.8, and 6.5, respectively.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>During COVID-19, there was an increase in anxiety and depressive symptoms for all sexes and genders, with the greatest increases reported by those identifying as non-male and non-men.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/17455065211062964","type":"journal-article","created":{"date-parts":[[2021,11,30]],"date-time":"2021-11-30T14:50:32Z","timestamp":1638283832000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":3,"title":["The role of sex and gender in the changing levels of anxiety and depression during the COVID-19 pandemic: A cross-sectional study"],"prefix":"10.1177","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2773-4947","authenticated-orcid":false,"given":"Hoda","family":"Seens","sequence":"first","affiliation":[{"name":"Health and Rehabilitation Sciences, Elborn College, Western University, London, ON, Canada"},{"name":"Windsor University School of Medicine, Cayon, St. Kitts"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shirin","family":"Modarresi","sequence":"additional","affiliation":[{"name":"Health and Rehabilitation Sciences, Elborn College, Western University, London, ON, Canada"},{"name":"School of Physical Therapy, Western University, London, ON, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"James","family":"Fraser","sequence":"additional","affiliation":[{"name":"School of Physical Therapy, Western University, London, ON, Canada"},{"name":"Department of Computer Science, University of Guelph, Guelph, ON, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joy C","family":"MacDermid","sequence":"additional","affiliation":[{"name":"Health and Rehabilitation Sciences, Elborn College, Western University, London, ON, Canada"},{"name":"School of Physical Therapy, Western University, London, ON, Canada"},{"name":"Roth McFarlane Hand and Upper Limb Centre, St. Joseph\u2019s Health Care London, London, ON, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David M","family":"Walton","sequence":"additional","affiliation":[{"name":"Health and Rehabilitation Sciences, Elborn College, Western University, London, ON, Canada"},{"name":"School of Physical Therapy, Western University, London, ON, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ruby","family":"Grewal","sequence":"additional","affiliation":[{"name":"Roth McFarlane Hand and Upper Limb Centre, St. Joseph\u2019s Health Care London, London, ON, Canada"},{"name":"Schulich School of Medicine and Dentistry, Western University, London, ON, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2021,11,30]]},"reference":[{"key":"bibr1-17455065211062964","unstructured":"World Health Organization. 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WHO Director-General\u2019s opening remarks at the media briefing on COVID-19 - 11 March 2020, 2020, https:\/\/www.who.int\/director-general\/speeches\/detail\/who-director-general-s-opening-remarks-at-the-media-briefing-on-covid-19\u201411-march-2020 (accessed 9 April 2020)."},{"key":"bibr3-17455065211062964","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMp2008017"},{"key":"bibr4-17455065211062964","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph17051729"},{"key":"bibr5-17455065211062964","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph17093165"},{"key":"bibr6-17455065211062964","doi-asserted-by":"publisher","DOI":"10.1136\/gpsych-2020-100213"},{"key":"bibr7-17455065211062964","unstructured":"Centre for Addiction and Mental Health. 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