Gender differences in mental health outcomes during the first COVID-19 pandemic lockdown in South Africa

Background While the COVID-19 pandemic affected everyone in society, it was women who bore the brunt during the first hard lockdown in South Africa. This study examined the gender differences in mental health outcomes during the first COVID-19 pandemic lockdown in the country. Methods A cross-sectional, survey-based study was done, with a total of 327 participants recruited in South Africa via convenience sampling using online platforms such as Facebook, Twitter, university websites, WhatsApp, forums, and emails. The participants completed socio-demographic and COVID-19 threat- and stress-related questions. The Patient Health Questionnaire (PHQ-9) was completed as a measure of depression. The chi-squared test and Analysis of Variance (ANOVA) were applied during analysis. All analyses were conducted using IBM SPSS Statistics version 20 (IBM Corporation, Armonk, NY, USA), with a level of significance set at 0.05, two-tailed. Results The study found that fear of COVID-19 disease impacted stress and depression levels in both genders, with a significantly greater impact among women. A higher proportion of women than men reported stress related to the lockdown (62.9% versus 23%, p = 0.01). Subjective risk at work, work stress, and being required to continue work during lockdown were significantly associated with depression among women. Conclusions The study highlights the differential effect of stress, fear, and worry during the pandemic lockdown on vulnerability to depression, by gender. This has major implications for mental health interventions post-pandemic. It brings an opportunity to reduce gender difference in mental health through providing tailored care services, especially to working women during times of high stress.