Unlike men, who are disproportionately affected by severe disease progression and mortality from COVID-19, women may be more affected by the economic, social and psychological consequences of the pandemic. Psychological distress and mental health problems are general risk factors for increases in the use of alcohol and other substances as a dysfunctional coping mechanism.
Methods: An analysis was carried out of the female subset (n = 2153) of a population-based, cross-sectional online survey (October-December 2020), covering the "second wave" of the COVID-19 pandemic in Germany.
Results: Among women, 23% increased their alcohol use, 28.4% increased their nicotine use and 44% increased their illicit substance use during the COVID-19 pandemic. Twenty percent reported major depressive symptoms and 23.4% symptoms of generalized anxiety. Generalized anxiety proved to be a significant predictor of increases in alcohol and nicotine use in logistic regression.
Discussion: The mental health burden remained high during the second wave of COVID-19 and alcohol, nicotine and other substance use increased. However, the association between mental health and substance use was weak. Psychological distress does not seem to be the main motivator of substance use.
Keywords: COVID-19; alcohol; cannabis; depression; mental health; substance use.