Borja Joshua B, Patten Scott B
Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, 3280 Hospital Dr. NW, Calgary, AB T2N 4Z6, Canada.
Mathison Centre for Mental Health Research & Education, Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, 3280 Hospital Dr. NW, Calgary, AB T2N 4Z6, Canada.
Healthcare (Basel). 2025 Jan 23;13(3):224. doi: 10.3390/healthcare13030224.
There have been consistent concerns about a greater impact of COVID-19 on the mental health of younger people and females. We aimed to explore the potential synergistic effect of various pandemic-related stressors with age and sex on the mental health of the general Canadian household population during the COVID-19 pandemic.
Using cross-sectional data from the Statistics Canada 2022 Mental Health and Access to Care Survey (MHACS), frequencies for major depressive episode (MDE), generalized anxiety disorder (GAD), general psychological distress, and various pandemic-related and demographic factors were estimated. Odds ratios were estimated using binary logistic regression models. These estimates used a replicate bootstrapping procedure recommended by Statistics Canada. Finally, Relative Excess Risk due to Interaction (RERI) models were used for each outcome to evaluate the interactions of each pandemic-related stressor with age and sex on an additive scale.
Past-12-month MDE and GAD, psychological distress, and the various COVID-19 stressors were more prevalent in young people and females. Overall, the stressors were confirmed to be associated with these outcomes. There were greater-than-additive interactions between age and difficulty accessing healthcare, loneliness, physical health problems, household relationship challenges, and work stress; and between sex and severe illness of a loved one, loneliness, work stress, LGBTQ2+ status, marital status, difficulty accessing healthcare, physical health problems, job/income loss, and financial difficulties. Generally, evidence of synergy was found between age and pandemic-related stressors and sex and pandemic-related stressors.
Greater-than-additive interactions of pandemic-related stressors with age and sex may indicate synergistic vulnerabilities within females and young people. Future pandemics, via corresponding stressors, may be associated with increased mental health vulnerability in females, youth, and especially young females.
一直有人担心新冠病毒病（COVID-19）对年轻人和女性的心理健康影响更大。我们旨在探讨在COVID-19大流行期间，各种与大流行相关的压力源与年龄和性别对加拿大普通家庭人口心理健康的潜在协同效应。
利用加拿大统计局2022年心理健康与医疗服务可及性调查（MHACS）的横断面数据，估计了重度抑郁发作（MDE）、广泛性焦虑障碍（GAD）、一般心理困扰以及各种与大流行相关和人口统计学因素的发生率。使用二元逻辑回归模型估计比值比。这些估计采用了加拿大统计局推荐的重复自抽样程序。最后，对每个结局使用交互作用导致的相对超额风险（RERI）模型，以评估每个与大流行相关的压力源与年龄和性别在相加尺度上的相互作用。
过去12个月的MDE、GAD、心理困扰以及各种COVID-19压力源在年轻人和女性中更为普遍。总体而言，这些压力源被证实与这些结局相关。年龄与获得医疗服务困难、孤独感、身体健康问题、家庭关系挑战和工作压力之间；以及性别与亲人患重病、孤独感、工作压力、LGBTQ2+身份、婚姻状况、获得医疗服务困难、身体健康问题、工作/收入损失和经济困难之间存在大于相加的相互作用。一般而言，在年龄与与大流行相关的压力源之间以及性别与与大流行相关的压力源之间发现了协同作用的证据。
与大流行相关的压力源与年龄和性别之间大于相加的相互作用可能表明女性和年轻人存在协同脆弱性。未来的大流行，通过相应的压力源，可能与女性、青年尤其是年轻女性心理健康脆弱性增加有关。
