Introduction
Since its outbreak in November 2019, the coronavirus disease (COVID-19) has caused the death of more than 500 thousand people while infecting more than 10 million individuals worldwide, and the numbers are rising steadily.[1] This pandemic has led to significant social, psychological, economic, and health problems for many individuals around the world. These problems, in turn, can lead to an increase in mental health problems among those who are vulnerable, as can be seen from similar infectious disease outbreaks in the past.[2] Extended lockdowns, prolonged isolation, economic crisis, lack of essential supply, loss of loved ones, and stigma in the society are among many contributory factors for the psychological distress in an individual.[3]
Some studies suggest that during COVID-19 pandemic and other past outbreaks, women have suffered greater psychological distress, anxiety, and depression than men.[2,4] A recent review suggests that populations with social inequality are more vulnerable to anxiety, depression, and psychological distress due to COVID-19 when facing social isolation and loneliness.[4] It has been seen that women have higher psychological distress compared to men and they are more vulnerable to stress.[5–7] Further, few studies suggest that during the pandemic, women’s mental health is more adversely affected in those sections of society where they do not have formal education.[8] There have been various factors behind this difference, some being nonmodifiable such as biological and inherent, but many being modifiable which can be addressed to decrease this gendered impact of an outbreak.[9,10] In addition, studies on the past outbreaks highlight that while making short-term and long-term responses to the outbreak, gender issues and women’s health were neglected, which exacerbated existing health inequities and social injustices that women were facing.[11] The current review aims to synthesize the literature available on women’s mental health during COVID-19. We have specifically focused on these topics such as pregnancy, lactation, sexual health of women, violence against women, women healthcare worker (HCW), and women with pre-existing mental and substance use disorders.
Methodology
The primary objective of this research was to assess the psychological effects and the burden of mental health issues in women during COVID-19 pandemic. All existing literature was searched using PubMed, Google Scholar, Medline, and databases (Research Square, BioRxiv, MedRxiv, SocArXiv, and PsyArXiv), and all cross-references were manually checked for all articles published on mental health aspects (including stress, burnout, depression, anxiety, and insomnia) of women during COVID-19 pandemic. The primary search was done using the following search terms: (“women” OR “female”) AND ((“pregnancy” OR “childbirth”) OR (“lactation” OR “breast feeding” OR breastfeeding OR “nursing”) OR (“healthcare workers” OR “healthcare professionals” OR “medical staff”) OR (“domestic abuse” OR “domestic violence” OR “DV” OR “intimate partner violence” OR “IPV”) OR (“refugee” OR “homeless”) OR (“sex worker” OR “PSW”) OR (“general population” OR “general public”)) AND (“mental health” OR “psychological” OR “stress” OR “burnout” OR “depression” OR “anxiety” OR “insomnia”) AND (“coronavirus” OR “SARS-CoV-2” OR “COVID-19”). Manual searching of reference lists and citation tracking was performed for each of the retrieved articles. We also included the studies assessing mental health aspects of COVID-19 not specific to any gender and manually searched for the gender-specific data. In case of missing gendered data, the corresponding author was contacted via e-mail, and any such response (if available) was also included in the review. Original articles, opinion papers, commentaries, and correspondences published in the English language till June 15, 2020, addressing the mental health issues of women during COVID 19, were considered for this review. Articles for which the complete document could not be retrieved were excluded from the review. Data were extracted by the authors from the selected articles about sample size, research methodology used, research instruments, and incidents of psychological issues reported by females in the general population and those subgroups of females at risk of mental health-related problems.
Results
A total of 7554 articles were found in the initial search. After removing duplicates and articles not related to COVID-19 pandemic, a total of 1340 articles were related to women’s health during COVID-19. Out of these, 659 articles were directly or indirectly related to the mental health issues of women during this pandemic [Figure 1]. However, the number of original articles was much lesser (n = 48). Summary of studies on mental health issues of women in the general population during COVID-19 is presented in Table 1.
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Figure 1: Modified PRISMA flow diagram for the review
Table 1: Mental health issues of women in general population during COVID-19
While some studies from China, Italy, Iran, and India have reported up to 1.4 times higher incidence of anxiety, stress, depression, and posttraumatic symptoms in women, some other studies from China and Japan reported no significant difference in the mental health impact of COVID-19 across the genders. One longitudinal study from China and one cross-sectional study from Ireland have reported a greater psychological impact of COVID-19 on men than on women. After initial search, following broad themes were identified: sexual health, contraception, pregnancy, lactation, child care, domestic abuse, physical and sexual violence, female healthcare works, women with pre-existing mental illness, women with pre-existing substance use disorders, homeless women, female refugees, and female sex workers.
Sexual health and contraception
Pandemic and associated widespread lockdown have pushed the circumstances which have a higher tendency to aggravate the emotional and social stressors of women. The inescapable sexual violence by the partner at home with a halt in contraceptive services may lead to a surge in unplanned pregnancies and may add to already existing psychological stress of women.[23,24] Lockdown has led to the shutdown of several drug manufacturing plants across the globe as well as disruptions in the supply chains of already manufactured medicines. As a result, there had been a shortage of contraceptives, sanitary pads, and other drugs to treat sexually transmitted infections (STIs) at the community level.[11,25,26] These all, in turn, could adversely affect the menstrual hygiene of women and girls. There have been reports of nonavailability of supply of sanitary pads through community health centers or schools, as these centers are either closed or re-routed for other emergency services.[11,27] This is especially important in certain communities, which are poor and dependent on these facilities. Even when some health services are running, women due to fear of contracting COVID-19 infection avoid visiting these health centers for contraceptive services. Consequently, there is a high chance of drastically increasing the number of unplanned pregnancies in countries like India, which has 357 million women in the reproductive age group,[28] and this is true for most other developing and poor Afro-Asian countries. This, in turn, could lead to long-term social and mental consequences on women who have unplanned pregnancies. Studies show that mothers having unplanned pregnancies are also more likely to experience psychological problems, such as postpartum depression, anxiety, and disorders.[29,30] Unplanned pregnancy results in a more stressful situation and a higher level of perceived stress than a planned pregnancy and, in turn, is likely to put additional stress on the conjugal life of those couples.[31]
Pregnancy
We could found 78 articles related to pregnancy and child birth-related issues during COVID-19, including 10 original articles [Table 2]. Studies around the world have shown an increase in stress and anxiety among pregnant females following the coronavirus pandemic, with most studies reporting nearly one-third to one-half of pregnant females having increased anxiety symptoms.[32,33,37] The worries are predominantly about their own health status, as well as about the risk of vertical transmission of coronavirus infection to their unborn children.[33,34] However, there is no evidence of vertical transmission of the COVID-19 infection.[39,42,43] Women in the third trimester were found to have more psychological stress related to COVID-19 pandemic than women in the first trimester.[32,39]
Table 2: Pregnancy and mental health during COVID-19
One large-scale study from China on 4124 pregnant females from 25 hospitals found that depressive symptoms were significantly higher among those assessed after the public announcement of COVID-19 as epidemic than those assessed before.[36] Another study from Canada among 1754 pregnant women also found higher levels of symptoms of depression, anxiety, posttraumatic stress disorder (PTSD), dissociative disorder, and negative affect among those who were recruited after COVID-19 pandemic than those who were recruited before the pandemic.[40] Primiparous women, younger women aged less than 35 years, those with pregestational body mass index (BMI) in the underweight range, those employed full time, and those having adequate living space were found to be more prone to depressive symptoms following the COVID-19 pandemic.[36,39,40]
Because of the fear of getting exposed to coronavirus, either on the way to the hospital or in a hospital environment, some pregnant females avoided going to the physicians. There is also concern that viral infection might affect embryogenesis and can lead to fetal malformations, especially in the first trimester, with some pregnant females wanting an early termination of pregnancy.[36,44] However, there is no evidence of any congenital malformations due to COVID-19 infection till now.[45] The other concerns of the pregnant females include restriction of transportation to health facilities, reduction in access to other caregivers in times of need, and concerns about postpartum care such as breastfeeding and neonatal care during this pandemic.[34,44] Many had changed their primary mode of transportation, started working from home, avoided crowded gatherings, and purchased bulks of hand sanitizers and toiletries to protect themselves from the pandemic.[34,35]
It has also been found that fear of COVID-19 among pregnant females is associated with depression and anxiety among their spouses.[44] Similarly, the fear of COVID-19 among spouses has been associated with depression and anxiety among pregnant wives.[46] While there are no studies targeting pregnant females with pre-existing mental illness specifically, we can speculate that social isolation due to the lockdown could lead to a major negative impact on this population. Furthermore, there is an increased risk of exposure to domestic violence with poor external support among those who already had been facing intimate partner violence.[47]
Domestic abuse and intimate partner violence
The pandemic and the associated lockdown have not only increased the stress and already existing gender inequalities but also have placed the women and girls at higher risk of gender -based violence, sexual exploitation, and physical and sexual abuse.[10] There have been reports of increased incidence of intimate partner violence during the COVID-19 pandemic, with an increase in domestic violence-related help-seeking all across the globe. Table 3 summarizes findings from nine original articles addressing the issue of domestic abuse and intimate partner violence during COVID-19. Services available to deal with such domestic violence are already scarce, but restricted movement and fear of getting infection have further decreased their usage.[11,57] Sexual violence survivors may be more reluctant to come to the clinic for postviolence care and counseling for fear of being labeled a suspect case and transferred to emergency care with other COVID-19 patients, which have been studied in previous pandemics also.[11]
Table 3: Domestic abuse and intimate partner violence during COVID-19
There are very few studies that have assessed the adverse mental health effects of domestic violence on women during the pandemic. However, the available studies suggest an increased risk of developing PTSD, suicidal thoughts, anxiety, and depression.[58] Mental health problems and suicidality following partner violence have been seen in many past studies from both developing and developed countries.[58–61]
COVID-19 pandemic has created a situation of economic downturn, more so in areas of lower socioeconomic capacities, which may force families to resort to negative coping mechanisms, such as requiring girls to engage in transactional sex or arrange forced, early marriages for money.[10] Relationship between the emergence of sudden economic constraints with domestic violence has been studied in some of the previous studies which suggest that 1% increase in male unemployment is associated with a 0.50 percentage point (2.5%) increase in physical partner violence for women.[62] Not only is the home environment stressful and unsafe for women during the pandemic, but physical and sexual violence can also occur even at the quarantine camps as found in some past pandemic studies. Quarantine camps can lead to increased exposure to perpetrators, living in containment with decreased freedom, and privacy, under circumstances of physical and psychological stress.[63,64] Such incidents can have adverse effects on mental health and may persist for years postpandemic. Figure 2 depicts the pathways linking pandemic with violence against women.
Figure 2: Pathways linking pandemics and violence against
women and children. Pathways can be both direct and indirect, and are likely to interact, reinforcing existing vulnerabilities (inequalities). Adopted with permission from O’Donnell et al., 2020
[ 65 ]Since most countries around the world are currently prioritizing their medical resources COVID-19, there may be limited resources available for psychological services and interventions. Therefore, this may further worsen the psychological impacts of domestic violence.
Female healthcare workers
Healthcare professionals have a major role to play both during and after the pandemic progression. Being in the frontline, healthcare providers pose a higher risk of infection, so do the risk of mental health issues such as insomnia, anxiety, depression, and PTSD. In most countries, female representatives among HCWs were reportedly more (60%–90%) than the male counterpart both in developed and developing countries.[66,67] We found a total of 74 articles with 14 original studies addressing the mental health issues of women HCWs during COVID-19 pandemic [Table 4]. All except two (from India) were from the various provinces of China. A recent study on 4369 female HCWs from China has shown a higher incidence of depression (14.2%), anxiety (25.2%), and acute stress symptoms (31.6%) in frontline female HCWs than general population prevalence.[68] Most larger sample studies have shown significantly higher rates of stress, anxiety, insomnia, and other psychological symptoms among female medical staff as compared to the male staff.
Table 4: Mental health issues of women healthcare workers during coronavirus disease-19
Women with preexisting mental illness
There were no original studies that addressed the psychological issues in women during COVID-19 with pre-existing mental illness, except for few editorial and opinion papers, even though women are twice more likely to be suffering from mental illness such as depression and anxiety. Thus, those with pre-existing mental illness are effectively more susceptible because of worldwide gender disparities in the context of mental health. Women with pre -existing mental illness are prone to psychological vulnerabilities during crisis situations (including the global pandemic) not only because of their compromised coping but also because of many other complex interrelated factors. Higher stigma for women with mental illness, HPA axis overdrive, menstrual and pregnancy-related concerns, poor help-seeking, along with sleep disturbances, prolonged isolation, hospitalization, loss of a job, loss of loved ones, poor psychosocial support, and fear of contracting of COVID-19 are among many already detectable causes of a further worsening of pre-existing mental illness or having another episode.[82,83]
Women with a substance use disorder
Coronavirus pandemic and associated lockdown are extremely likely to have exacerbated the existing gender gap in help-seeking and adequate treatment for women with substance use disorders. While there are studies that have mentioned the prevalence of smoking among patients with coronavirus infection, there are no studies that have focused on the prevalence of smoking among female patients specifically. A total of seven articles (with 3 original studies) were found addressing the substance use and related problems during COVID-19, none specifically for women. A study among university students found that females had a higher fear of COVID-19 than males and quarantine led to increased substance use among those who experienced worsening of their psychological and emotional condition. As females are more prone to stress, there is a higher risk of worsening of substance use problems due to the lockdown.[84] A study by Australian National University among 329 respondents found that around 22.8% of females had increased alcohol use during the pandemic, while 27.5% of females had decreased alcohol use during the pandemic. The increase was highest among females in the age group of 35–44 years. The study also reported that illicit drug use also increased during the pandemic although the exact prevalence among all females included was not clear.[85]
Homeless women
The last time, a global survey was attempted by the United Nations in 2005 – an estimated 100 million people were homeless worldwide.[86,87] This number is now have expected to grow up to 150 million.[88,89] Homeless people usually sleep on roadside, pavements, under flyovers, or in night shelters and face problems in even basic amenities such as water, sanitary facilities, and food.[90]
There are a limited number of studies around the world on the prevalence of COVID-19 among people living in homeless shelters, with the studies showing either lesser prevalence among female compared to males[91,92] or no significant difference based on gender.[93] Many homeless people in developing countries like India do not prefer to stay in night shelters due to various reasons, such as unavailability of basic services, uncleanliness, and safety issues.[94,95] However, the exact impact of COVID-19 infection among people staying outside these shelters is not known. With lack of proper accommodation and even basic facilities, it is difficult for this population to follow social isolation and hand hygiene measures required to prevent the spread of coronavirus infections and in turn is at higher risk of the infection.[96] Homeless people are already at a higher risk of physical and mental health.[97] The pandemic is more likely to aggravate these problems further due to difficulty in accessing healthcare services. With the lockdown, a large number of migrant laborers including female laborers lost jobs and due to inability to pay rent became homeless. A survey of around 3196 migrant workers in India during the lockdown found a large amount of distress, with people expressing their anguish, helplessness, and desperation to the study team members.[98] The sudden change in their life has pushed them into more deprivation, which in turn can precipitate mental illness among those vulnerable. As it was a qualitative study, the prevalence of stress among females specifically could not be ascertained. In addition, there are no studies specifically addressing the mental health issues of homeless women during the current pandemic of COVID 19.
Refugees
There are around 26 million refugees around the world.[99] They often live in overcrowded settlements and due to their uncertain legal status are often excluded from welfare programs and have financial problem.[100] Further, most of the refugees live in lower and middle-income countries, which already have limited healthcare facilities.[101] The pandemic has aggravated these problems.[102] Overcrowding and limited resources lead to difficulty in social isolation and maintaining hygienic practices to prevent the spread of coronavirus infection. Refugees also face challenges due to sociocultural differences and language barriers, leading to difficulty in accessing information.[103] There have also been reports of an increase in stigma and discrimination against them.[104] Volunteers and nongovernmental organizations working to help these individuals also faced difficulty in accessing the refugee camps due to lockdown, thus disrupting the supply of relief materials such as food, medicines, and aid workers.[105] Female refugees have to face even more problems due to the lockdown, with reports of increased domestic violence for the female refugees.[106] All these factors pose a very high risk of psychiatric illness among these vulnerable populations.[103]
Female sex workers
Current pandemic has significantly affected the work and shelters of sex workers. Many provinces have ordered hotels, massage parlors, and spas to shut down causing the closure of many safe locations for work for female sex workers.[107,108] COVID-19 concerns have also reduced demand, and sex workers’ incomes have been impacted drastically, especially affecting those who are involved in survival sex work, which means that they rely on this work to pay for food, rent, or the maintenance level of illegal drugs.[109] Existing mental health problems are likely to be exacerbated by anxiety over income, food, and housing, alongside concerns about infection from continuing to work in the absence of social protection. The inability to work, reduced access to health services (many are on antiretroviral treatment), and increased isolation are likely to result in poorer health outcomes and increased inequalities, particularly where individuals are largely excluded from formal social protection schemes. Reforms of social and legal policies, including decriminalization of sex work, can reduce discrimination and marginalization of sex workers and enable the provision of vital health and social services. This need becomes more acute as existing health and social challenges are exacerbated by the COVID-19 crisis.[108] Although many authors have highlighted the mental health and related issues of sex workers during COVID-19, we could not find any studies that specifically addressed the psychological issues of female sex workers during the current pandemic.
Other issues related to women during pandemic
Apart from HCWs, other working mothers also face significant difficulty during the pandemic and associated lockdown. Due to the lockdown, schools have been cancelled and children are at home. As other support systems such as day-care are also closed, mothers often have to reduce their work timings so that they can take care of their children. A German survey in April 2020 found that more mothers had reduced working hours than fathers.[110,111] Similarly, in the academic field, while male researchers get freedom from administrative activities due to lockdown and have more time for independent work, mothers with small children have to devote more time doing household chores or taking care of their children. All these can increase the already present gender disparity, which in turn can lead to a significant amount of stress for working females.[112]
Single mothers have to bear even more brunt as they have to face more emotional and financial responsibilities, with relatively less social support, during the lockdown.[113] However, none of the studies during the current pandemic have tried to focus on the mental health aspects of working mothers, other than that of HCWs.
Discussion
The present review suggests that COVID-19 pandemic has resulted in a significant impact on women. Women are more likely to have anxiety, depression, and stress due to the pandemic. Infected pregnant women and lactating mothers may be deeply concerned about transmission of the virus to their neonates. Domestic abuse and violence are additional concerns for women in families. As seen in the past pandemics, scarcity of food and essential services can result into exploitative stressful relationships which increases the exposure of women to unsafe and risky settings, including exposure to sexual violence and harassment during procurement of basic goods, including food, firewood, and water.[62,114–117] Such incidents could lead to long-term consequences on the mental health of people who are facing it.
Higher psychological burden in female HCWs may be explained by higher hormonal sensitivity to stress-related response in women and greater empathy, in general, toward the infected patients and colleagues. Other psychosocial factors such as fear of spreading the infection to the child and/or other family members, gender inequality, and disproportionate resource allocation may also have played their role to cause a higher burden of psychological ill health among female HCWs.[66,118] All these may highlight the increased need and, at the same time, the possibility of a greater impact of psychological interventions for women involved in the frontline healthcare delivery.
Women with substance use disorder are a special population who have to face not only the various physical complications due to substance use disorder but also the added stigma and discrimination from the society because of their drug use problems.[119] They are also more likely to experience physical and sexual abuse and have poor social support. Women with substance use disorders already face various barriers in accessing treatment and for remaining in the treatment for substance use disorders.[120] Similarly, women with pre-existing mental health issues may face exacerbation of the condition and difficulty in accessing treatment.[121] Vulnerable women such as those who are refugees, homeless, or practicing sex work are likely to face adverse circumstances which may impair their mental health.
The next logical step is to think of the remedies available to address the situation. With the advent of telepsychiatry, attempts can be made to increase the outreach to the population of women with substance use disorders, with the help of outreach workers.[122] It is necessary to have harm reduction services for females that are gender-sensitive, the continuation of sexual and reproductive health services, psychological aid, and services to protect women from domestic violence.
Call-on governments and global health institutions to consider the sex and gender effects of the COVID-19 outbreak, both direct and indirect, and analyze the gendered impacts of the multiple outbreaks, incorporating the voices of women on the front line of the response to COVID-19 and of those most affected by the disease within preparedness and response policies or practices going forward.[122,123]
Timely attention toward the possible mental health consequences is the need of the hour. Mental health professionals need to take a leadership role in providing necessary interventions during various phases of the pandemic to the general public and specifically to the vulnerable groups (HCWs, extremes of age, persons with mental illness or substance use disorders, homeless and refugees, etc.) to limit the loss. Some suggestions to reduce the violence toward women during this pandemic are presented in Figure 3.
Figure 3: Suggested policies and program responses to curb violence against
women. Adopted with permission from O’Donnell et al., 2020
[ 65 ]This review is unique in many senses. This is the first review addressing the global issue of the gender-specific impact of COVID-19 pandemic on an individual’s mental health. This review has attempted to look at many known risk factors for poor women’s mental health, including both gender-specific and gender nonspecific factors that are available literature to date. Finally, possible remedies and the professional role of mental healthcare are suggested. However, like every study, this study has its own limitations. A paucity of gender-specific data in most studies leads to exclusion from the review. Literature is also sparse on few aspects such as women with pre-existing illness or effect of COVID-19 on mother–child bonding when either of them is infected. Information is provided in a descriptive format rather than a systematic review to bring focus on different relevant aspects of the mental health of women. Further, quantitative synthesis was not attempted as a part of the review.
Conclusion
This scoping review presents the impact of COVID 19 on various aspects of women’s mental health. Attention to women’s mental health is important to take measures to reduce the impact of the pandemic on vulnerable populations. The vulnerability may be higher in refugee and homeless women and those involved in sex work. Attempts to reduce the mental health consequences and distress due to COVID-19, especially focusing on women mental health, may lead to swifter amelioration of the impact of the pandemic on the societies and communities. Future literature and research endeavor can look at whether and to what extent are various professional and nonprofessional interventions work to improve the mental well-being of women. Impact of changes in women’s mental health on social and community functioning can also be looked at. In addition, the impact of changes in policies and provision of formal and nonformal care to the marginalized women population affected by COVID-19 can be looked into.
Financial support and sponsorship
Nil.
Conflicts of interest
There are no conflicts of interest.
References
1. Coronavirus Update (Live). Coronavirus Update (Live): 10,927,025 Cases and 521,512 Deaths from
COVID-19 Virus
Pandemic – Worldometer 2020. Available from:
https://www.worldometers.info/coronavirus/. Last accessed on 2020 Jul 03.
2. Brooks SK, Webster RK, Smith LE, Woodland L, Wessely S, Greenberg N, et al. The psychological impact of quarantine and how to reduce it: Rapid review of the evidence. Lancet 2020; 395:912–20.
3. Kato TA, Sartorius N, Shinfuku N. Forced social isolation due to
COVID-19 and consequent
mental health problems: Lessons from hikikomori. Psychiatry Clin Neurosci 2020; 74:506–7.
4. Holmes EA, O'Connor RC, Perry VH, Tracey I, Wessely S, Arseneault L, et al. Multidisciplinary research priorities for the
COVID-19 pandemic: A call for action for
mental health science. Lancet Psychiatry 2020; 7:547–60.
5. Sareen J, Erickson J, Medved MI, Asmundson GJ, Enns MW, Stein M, et al. Risk factors for post-injury
mental health problems. Depress
Anxiety 2013; 30:321–7.
6. Chou LP, Li CY, Hu SC. Job
stress and burnout in hospital employees: Comparisons of different medical professions in a regional hospital in Taiwan. BMJ Open 2014; 4:e004185.
7. Qiu J, Shen B, Zhao M, Wang Z, Xie B, Xu Y. A nationwide survey of psychological distress among Chinese people in the
COVID-19 epidemic: Implications and policy recommendations. Gen Psychiatr 2020; 33:e100213.
8. Wang C, Pan R, Wan X, Tan Y, Xu L, Ho CS, et al. Immediate Psychological Responses and Associated Factors during the Initial Stage of the 2019 Coronavirus Disease (
COVID-19) Epidemic among the General Population in China. Int J Environ Res Public Health 2020; 17:1729.
9. Davies SE, Bennett B. A gendered human rights analysis of Ebola and Zika: Locating
gender in global health emergencies. Int Affairs 2016; 92:1041–60.
10. Fuhrman S, Kalyanpur A, Friedman S, Tran NT. Gendered implications of the
COVID-19 pandemic for policies and programmes in humanitarian settings. BMJ Glob Health 2020; 5:e002624.
11. Chattu VK, Yaya S. Emerging infectious diseases and outbreaks: Implications for
women's reproductive health and rights in resource-poor settings. Reprod Health 2020; 17:43.
12. Huang Y, Zhao N. Generalized
anxiety disorder, depressive symptoms and sleep quality during
COVID-19 outbreak in China: A web-based cross-sectional survey. Psychiatry Res 2020; 288:112954.
13. Chakraborty K, Chatterjee M. Psychological impact of
COVID-19 pandemic on general population in West Bengal: A cross-sectional study. Indian J Psychiatry 2020; 62:266–72.
14. Ueda M, Stickley A, Sueki H, Matsubayashi T.
Mental health status of the general population in Japan during the
COVID-19 pandemic. Psychiatry Clin Neurosci 2020; 74:505–506.
15. Wang C, Pan R, Wan X, Tan Y, Xu L, McIntyre RS, et al. A longitudinal study on the
mental health of general population during the
COVID-19 epidemic in China. Brain Behav Immun 2020; 87:40–8.
16. Zhu Z, Liu Q, Jiang X, Manandhar U, Luo Z, Zheng X, et al. The psychological status of people affected by the
COVID-19 outbreak in China. J Psychiatr Res 2020; 129:1–7.
17. Gao J, Zheng P, Jia Y, Chen H, Mao Y, Chen S, et al.
Mental health problems and social media exposure during
COVID-19 outbreak. PLoS One 2020; 15:e0231924.
18. Mazza C, Ricci E, Biondi S, Colasanti M, Ferracuti S, Napoli C, et al. A Nationwide Survey of Psychological Distress among Italian People during the
COVID-19 Pandemic: Immediate Psychological Responses and Associated Factors. Int J Environ Res Public Health 2020; 17:3165.
19. Varshney M, Parel JT, Raizada N, Sarin SK. Initial psychological impact of
COVID-19 and its correlates in Indian Community: An online (FEEL-COVID) survey. PLoS One 2020; 15:e0233874.
20. Tian F, Li H, Tian S, Yang J, Shao J, Tian C. Psychological symptoms of ordinary Chinese citizens based on SCL-90 during the level I emergency response to
COVID-19. Psychiatry Res 2020; 288:112992.
21. Moghanibashi-Mansourieh A. Assessing the
anxiety level of Iranian general population during
COVID-19 outbreak. Asian J Psychiatr 2020; 51:102076.
22. Hyland P, Shevlin M, McBride O, Murphy J, Karatzias T, Bentall R, et al.
Anxiety and
Depression in the Republic of Ireland During the
COVID-19 Pandemic. 2020 Available from:
https://osf.io/8yqxr. Last accessed on 2020 Jul 03.
23. UN News UN.
COVID-19 Could Lead to Millions of Unintended Pregnancies, New UN-Backed Data Reveals. UN News 2020. Available from:
https://news.un.org/en/story/2020/04/1062742. Last accessed on 2020 Jun 23.
24. Burki T. The indirect impact of
COVID-19 on
women. Lancet Infect Dis 2020; 20:904–5.
25. Riley T, Sully E, Ahmed Z, Biddlecom A. Estimates of the potential impact of the
COVID-19 pandemic on sexual and reproductive health in low-and middle-income countries. Int Perspect Sex Reprod Health 2020; 46:73–6.
26. Nanda K, Lebetkin E, Steiner MJ, Yacobson I, Dorflinger LJ. Contraception in the era of
COVID-19. Glob Health Sci Pract 2020; 8:166–8.
27. Tran NT, Tappis H, Spilotros N, Krause S, Knaster S. Inter-Agency Working Group on Reproductive Health in Crises. Not a luxury: A call to maintain sexual and reproductive health in humanitarian and fragile settings during the
COVID-19 pandemic. Lancet Glob Health 2020; 8:e760–e761.
28. Santoshini S. Family Planning Efforts Upended by the Coronavirus. Foreign Policy 2020. Available from:
https://foreignpolicy.com /2020/05/13/india-family-planning-upended-coronavirus- women-sexual-reproductive-health/. Last accessed on 2020 Jun 23.
29. Leathers SJ, Kelley MA. Unintended pregnancy and depressive symptoms among first-time mothers and fathers. Am J Orthopsychiatry 2000; 70:523–31.
30. Bouchard G. Adult couples facing a planned or an unplanned pregnancy: Two realities. J Fam Issues 2005; 26:619–37.
31. Orr ST, Miller CA. Unintended pregnancy and the psychosocial well-being of pregnant
women. Womens Health Issues 1997; 7:38–46.
32. Saadati N, Afshari P, Boostani H, Beheshtinasab M, Abedi P. Health
Anxiety of Pregnant
Women and Its Related Factors During the
Pandemic of Corona Virus 2020. Available from:
https://www.researchsquare.com/article/rs-26840/v1. Last accessed on 2020 Jul 03.
33. Saccone G, Florio A, Aiello F, Venturella R, De Angelis MC, Locci M, et al. Psychological impact of coronavirus disease 2019 in pregnant
women. Am J Obstet Gynecol 2020; 223:293–5.
34. Corbett GA, Milne SJ, Hehir MP, Lindow SW, O'connell MP. Health
anxiety and behavioural changes of pregnant
women during the
COVID-19 pandemic. Eur J Obstet Gynecol Reprod Biol 2020; 249:96–7.
35. Hossain N, Samuel M, Sandeep R, Imtiaz S, Zaheer S. Perceptions, Generalized
Anxiety and Fears of Pregnant
women about Corona Virus infection in the heart of
Pandemic 2020. Available from:
https://www.researchsquare.com/article/rs-322 35/v1. Last accessed on 2020 Nov 13.
36. Wu Y, Zhang C, Liu H, Duan C, Li C, Fan J, et al. Perinatal depressive and
anxiety symptoms of pregnant
women during the coronavirus disease 2019 outbreak in China. Am J Obstet Gynecol 2020; 223:240.e1–240.e9.
37. Durankuş F, Aksu E. Effects of the
COVID-19 pandemic on
anxiety and depressive symptoms in pregnant
women: a preliminary study. J Matern Fetal Neonatal Med 2020. Ahead-of-print: 1-7. Available from:
https://doi.org/10.1080/14767058.2020.1763946. Last accessed on 2020 Nov 13.
38. Yassa M, Birol P, Yirmibes C, Usta C, Haydar A, Yassa A, et al. Near-term pregnant
women's attitude toward, concern about and knowledge of the
COVID-19 pandemic. J Matern Fetal Neonatal Med 2020; 33:3827–34.
39. Chen S, Zhuang J, Chen Q, Tan X. Psychological Investigation on Pregnant
Women during the Outbreak of
COVID-19 2020. Available from:
https://www.resear chsquare.com/article/rs-28455/v. Last accessed on 2020 Nov 13.
40. Berthelot N, Lemieux R, Garon-Bissonnette J, Drouin-Maziade C, Martel É, Maziade M. Uptrend in distress and psychiatric symptomatology in pregnant
women during the coronavirus disease 2019
pandemic. Acta Obstet Gynecol Scand 2020; 99:848–55.
41. Lebel C, MacKinnon A, Bagshawe M, Tomfohr-Madsen L, Giesbrecht G. Elevated
depression and
anxiety symptoms among pregnant individuals during the
COVID-19 pandemic. J Affect Disord 2020; 277:5–13. Erratum in: J Affect Disord. 2020; 279: 377-379.
42. Dashraath P, Wong JLJ, Lim MXK, Lim LM, Li S, Biswas A, et al. Coronavirus disease 2019 (
COVID-19)
pandemic and pregnancy. Am J Obstet Gynecol 2020; 222:521–31.
43. Qiao J. What are the risks of
COVID-19 infection in pregnant
women?. Lancet 2020; 395:760–2.
44. Rashidi Fakari F, Simbar M. Coronavirus
pandemic and worries during pregnancy;a letter to editor. Arch Acad Emerg Med 2020; 8:e21.
45. Yang H, Wang C, Poon LC. Novel coronavirus infection and pregnancy. Ultrasound Obstet Gynecol 2020; 55:435–7.
46. Ahorsu DK, Imani V, Lin CY, Timpka T, Broström A, Updegraff JA, et al. Associations Between Fear of
COVID-19,
Mental Health, and Preventive Behaviours Across Pregnant
Women and Husbands: An Actor-Partner Interdependence Modelling. Int J Ment Health Addict 2020. Ahead of print: 1-15. Available from:
https://doi.org/10.1007/s11469-020-00340-x. Last accessed on 2020 Nov 13.
47. Ryan GA, Purandare NC, McAuliffe FM, Hod M, Purandare CN. Clinical update on
COVID-19 in pregnancy: A review article. J Obstet Gynaecol Res 2020; 46:1235–45.
48. Rashid SF, Aktar B, Farnaz N, Theobald S, Ali S, Alam W, et al. Fault-Lines in the Public Health Approach to
Covid-19: Recognizing Inequities and Ground Realities of Poor Residents Lives in the Slums of Dhaka City, Bangladesh. SSHO-D-20-00412; 2020. Available from:
https://papers.ssrn.com/abstract=3608577. Last accessed on 2020 Jul 03.
49. Pfitzner N, Fitz-Gibbon K, True J. Responding to the 'Shadow
Pandemic': Practitioner Views on the Nature of and Responses to Violence Against
Women in Victoria, Australia During the
COVID-19 Restrictions. Monash University 2020. Available from:
https://bridges.monash.edu/articles/Responding_to_the_shadow_pandemic_practitioner_views_on_the_nature_of_and_responses_to_violence_against_women_in_Victoria_Australia_during_the_COVID-19restrictions/12433517. Last accessed on 2020 Jun 26.
50. Foster H, Fletcher A. Impact of
COVID-19 on
Women and Children Experiencing Domestic and Family Violence and Frontline Domestic and Family Violence Services.
WOMEN'S SAFETY NSW 2020. Available from:
https://www.womenssafetynsw.org.au/wp-content/uploads/2020/03/COVID-19-DV-Responses_WSNSW-Survey.pdf. Last accessed on 2020 Jun 26.
51. Sibley CG, Greaves LM, Satherley N, Wilson MS, Overall NC, Lee CHJ, et al. Effects of the
COVID-19 pandemic and nationwide lockdown on trust, attitudes toward government, and well-being. Am Psychol 2020; 75:618–630. Available from http://dx.doi.org/10.1037/amp0000662. Last accessed on 2020 Nov 13.
52. Lätsch D, Eberitzsch S, Brink IO. Social Assistance and Child Protection During the
COVID-19 Pandemic in Switzerland: A Survey of Social Services 2020. Available from:
https://digitalcollection.zhaw.ch/handle/11475/20039. Last accessed on 2020 Jun 26.
53. Beland LP, Brodeur A, Haddad J, Mikola D.
COVID-19, Family
Stress and Domestic Violence: Remote Work, Isolation and Bargaining Power 2020.
54. Leslie E, Wilson R. Sheltering in place and domestic violence: Evidence from calls for service during
COVID-19. J Public Econ 2020; 189:104241. Available from https://doi.org/10.1016/j.jpubeco.2020.104241. Last accessed on 2020 Nov 13.
55. Mohler G, Bertozzi AL, Carter J, Short MB, Sledge D, Tita GE, et al. Impact of social distancing during
COVID-19 pandemic on crime in Los Angeles and Indianapolis. J Crim Justice 2020; 68:101692.
56. Payne JL, Morgan A.
COVID-19 and Violent Crime: A comparison of recorded offence rates and dynamic forecasts (ARIMA) for March 2020 in Queensland, Australia. SocArXiv 2020. Published online. Available from:
https://ideas.repec.org/p/osf/socarx/g4kh7.html. Last accessed on 2020 Nov 13.
57. Usher K, Bhullar N, Durkin J, Gyamfi N, Jackson D. Family violence and
COVID-19: Increased vulnerability and reduced options for support. Int J Ment Health Nurs 2020; 29:549–52.
58. Roberton T, Carter ED, Chou VB, Stegmuller AR, Jackson BD, Tam Y, et al. Early estimates of the indirect effects of the
COVID-19 pandemic on maternal and child mortality in low-income and middle-income countries: A modelling study. Lancet Glob Health 2020; 8:e901–8.
59. Breiding MJ, Smith SG, Basile KC, Walters ML, Chen J, Merrick MT. Prevalence and characteristics of sexual violence, stalking, and intimate partner violence victimization--national intimate partner and sexual violence survey, United States, 2011. MMWR Surveill Summ 2014; 63:1–8.
60. Iovine-Wong PE, Nichols-Hadeed C, Thompson Stone J, Gamble S, Cross W, Cerulli C, et al. Intimate partner violence, suicide, and their overlapping risk in
women veterans: A review of the literature. Mil Med 2019; 184:e201–10.
61. Brown S, Seals J. Intimate partner problems and suicide: Are we missing the violence?. J Inj Violence Res 2019; 11:53–64.
62. Peterman A, Potts A, O'Donnell M, Thompson K, Shah N, Oertelt-Prigione S, et al. Pandemics and violence against
women and children. Center for Global Development working paper 2020 528.
63. Horn R. Responses to intimate partner violence in Kakuma refugee camp: Refugee interactions with agency systems. Soc Sci Med 2010; 70:160–8.
64. Wako E, Elliott L, De Jesus S, Zotti ME, Swahn MH, Beltrami J. Conflict, Displacement, and IPV: Findings from two Congolese refugee camps in Rwanda. Violence Against
Women 2015; 21:1087–101.
65. O'Donnell M, Peterman A, Potts A. A
Gender Lens on
COVID-19: Pandemics and Violence against
Women and Children. Center For Global Development. Retrieved May 2020; 11:2020. Available from
https://www.cgdev.org/blog/gender-lens-covid-19-pandemics-and-violence-against-women-and-children. Last accessed on 2020 Nov 13.
66. Gupta N, Diallo K, Zurn P, Dal Poz MR. Assessing human resources for health: What can be learned from labour force surveys?. Hum Resour Health 2003; 1:5.
67. Shannon G, Jansen M, Williams K, Cáceres C, Motta A, Odhiambo A, et al.
Gender equality in science, medicine, and global health: Where are we at and why does it matter?. Lancet 2019; 393:560–9.
68. Li G, Miao J, Wang H, Xu S, Sun W, Fan Y, et al. Psychological impact on
women health workers involved in
COVID-19 outbreak in Wuhan: A cross-sectional study. J Neurol Neurosurg Psychiatry 2020; 91:895–7.
69. Lai J, Ma S, Wang Y, Cai Z, Hu J, Wei N, et al. Factors associated with
mental health outcomes among health care workers exposed to coronavirus disease 2019. JAMA Netw Open 2020; 3:e203976.
70. Kang L, Ma S, Chen M, Yang J, Wang Y, Li R, et al. Impact on
mental health and perceptions of psychological care among medical and nursing staff in Wuhan during the 2019 novel coronavirus disease outbreak: A cross-sectional study. Brain Behav Immun 2020; 87:11–7.
71. Jizheng H, Mingfeng H, Tengda L, Ake R, Xiaoping Z.
Mental health survey of 230 medical staff in a tertiary infectious disease hospital for
COVID-19. Chin J Industrial Hygiene Occup Dis 2020; 38:E001.
72. Zhang C, Yang L, Liu S, Ma S, Wang Y, Cai Z, et al. Survey of insomnia and related social psychological factors among medical staff involved in the 2019 novel coronavirus disease outbreak. Front Psychiatry 2020; 11:306.
73. Zhang WR, Wang K, Yin L, Zhao WF, Xue Q, Peng M, et al.
Mental health and psychosocial problems of medical health workers during the
COVID-19 epidemic in China. Psychother Psychosom 2020; 89:242–50.
74. Cai W, Lian B, Song X, Hou T, Deng G, Li H. A cross-sectional study on
mental health among health care workers during the outbreak of Corona Virus Disease 2019. Asian J Psychiatr 2020; 51:102111.
75. Li X, Yu H, Bian G, Hu Z, Liu X, Zhou Q, et al. Prevalence, risk factors, and clinical correlates of insomnia in volunteer and at home medical staff during the
COVID-19. Brain Behav Immun 2020; 87:140–1.
76. Wang S, Xie L, Xu Y, Yu S, Yao B, Xiang D. Sleep disturbances among medical workers during the outbreak of COVID-2019. Occup Med (Lond) 2020; 70:364–9.
77. Du J, Dong L, Wang T, Yuan C, Fu R, Zhang L, et al. Psychological symptoms among frontline healthcare workers during
COVID-19 outbreak in Wuhan. Gen Hosp Psychiatry 2020. S0163-834330045-1. Advance online publication. Available from: https://doi.org/10.1016/j.genhosppsych.2020.03.011. Last accessed on 2020 Nov 13.
78. Chen Y, Zhou H, Zhou Y, Zhou F. Prevalence of self-reported
depression and
anxiety among pediatric medical staff members during the
COVID-19 outbreak in Guiyang, China. Psychiatry Res 2020; 288:113005.
79. Cai H, Tu B, Ma J, Chen L, Fu L, Jiang Y, et al. Psychological impact and coping strategies of frontline medical staff in Hunan between January and march 2020 during the outbreak of coronavirus disease 2019 (
COVID-19) in Hubei, China. Med Sci Monit 2020; 26:e924171.
80. Chatterjee SS, Bhattacharyya R, Bhattacharyya S, Gupta S, Das S, Banerjee BB. Attitude, practice, behavior, and
mental health impact of
COVID-19 on doctors. Indian J Psychiatry 2020; 62:257–65.
81. Khanna RC, Honavar SG, Metla AL, Bhattacharya A, Maulik PK. Psychological impact of
COVID-19 on ophthalmologists-in-training and practising ophthalmologists in India. Indian J Ophthalmol 2020; 68:994–8.
82. Khan N, Kausar R, Khalid A, Farooq A.
Gender differences among discrimination &stigma experienced by depressive patients in Pakistan. Pak J Med Sci 2015; 31:1432–6.
83. Das N. Psychiatrist in post-
COVID-19 era Are we prepared?. Asian J Psychiatr 2020; 51:102082.
84. Gritsenko V, Skugarevsky O, Konstantinov V, Khamenka N, Marinova T, Reznik A, et al. COVID 19 Fear,
Stress,
Anxiety, and Substance Use Among Russian and Belarusian University Students [published online ahead of print, 2020 May 21]. Int J Ment Health Addict 2020. Ahead of print: 1-7. Available online from: https://doi.org/10.1007/s11469-020-00330-z. Last accessed on 2020 Nov 13.
85. Biddle N, Edwards B, Sollis K. Alcohol consumption during the COVID- 19 Period: May 2020. Australian National University. Centre for Social Research and Methods 2020 1–17.
86. OHCHR. OHCHR Annual Reports Adequate Housing 2015. Available from:
https://www.ohchr.org/EN/Is sues/Housing/Pages/AnnualReports.aspx. Last accessed on 2020 Jul 04.
87. Homeless World Cup. Global Homelessness Statistics. Homeless World Cup 2020. Available from:
https://homelessworldcup.org/homelessness-statistics/. Last accessed on 2020 Jul 04.
88. Affordable Housing Database OECD. Available from:
https://www.oecd.org/social/affordable-housing-database/. Last accessed on 2020 Jul 04.
89. Chamie J. As Cities Grow, So Do the Numbers of Homeless YaleGlobal Online 2017. Available from:
https://yaleglobal.yale.edu/content/cities-grow-so-do-numbers- homeless. Last accessed on 2020 Jul 04.
90. Tingal D, Pande V, Chaudhry S. The Unsung City Makers: A Study of the Homeless Residents of Delhi. Indo-Global Social Service Society (IGSSS) 2012. Available from:
https://ighhub.org/resource/unsung-citymakers-study-homeless-residents-delhi. Last acessed on 2020 Jul 04.
91. Baggett TP, Keyes H, Sporn N, Gaeta JM. Prevalence of SARS-CoV-2 infection in residents of a large homeless shelter in Boston. JAMA 2020; 323:2191–2.
92. Ly TD, Hoang VT, Goumballa N, Louni M, Canard N, Dao TL, et al. Screening of SARS-CoV-2 among homeless people, asylum seekers and other people living in precarious conditions in Marseille, France, March April 2020. medRxiv 2020. Available from https://doi.org/10.1101/2020.05.05.20091934. Last accessed on 2020 Nov 13.
93. Samuels EA, Karb R, Vanjani R, Trimbur MC, Napoli A. Congregate shelter characteristics and prevalence of asymptomatic SARS-CoV-2. medRxiv 2020. Available online from https://doi.org/10.1101/2020.05.21.20108985. Last accessed on 2020 Nov 13.
94. Vikas RM. Shelter for homeless: Ethnography of invisibility and self-exclusion Vijay D, Varman R Alternative Organisations in India: Undoing Boundaries. Cambridge: Cambridge University Press; 2017: 95–124. Available from:
https://www.cambridge.org/core/books/alternative-organisations-in-india/shelter-for-homeless-ethnography-of-invisibility-and-selfexclusion/ 998FBFE8BA331618D3BCD08A9343281C. Last accessed on 2020 Jul 03.
95. Goel G, Ghosh P, Ojha MK, Shukla A. Urban homeless shelters in India: Miseries untold and promises unmet. Cities 2017; 71:88–96.
96. Lima NN, de Souza RI, Feitosa PW, Moreira JLS, da Silva CG, Neto ML. People experiencing homelessness: Their potential exposure to
COVID-19. Psychiatry Res 2020; 288:112945.
97. Tsai J, Wilson M.
COVID-19: A potential public health problem for homeless populations. Lancet Public Health 2020; 5:e186–7.
98. Venugopal A, Parvathy J, Samuel E, Kidwai A. Voices of the Invisible Citizens: A Rapid Assessment on the Impact of the
COVID-19 Lockdown on Internal Migrant Workers;Recommendations for the State. New Delhi, India: Industry and Philanthropies; 2020. Available from:
https://ruralindiaonline.org /library/resource/voices-of-the-invisible-citizens/. Last accessed on 2020 Jul 03.
99. UNHCR. Figures at a Glance. United Nations High Commissioner for Refugees 2020. Available from:
https://www.unhcr.org/en-in/figures-at-a-glance.html. Last accessed on 2020 Jul 04.
100. Kluge HHP, Jakab Z, Bartovic J, D'Anna V, Severoni S. Refugee and migrant health in the
COVID-19 response. Lancet 2020; 395:1237–9.
101. Hopman J, Allegranzi B, Mehtar S. Managing
COVID-19 in low- and Middle-income countries. JAMA 2020; 323:1549–50.
102. Lau LS, Samari G, Moresky RT, Casey SE, Kachur SP, Roberts LF, et al.
COVID-19 in humanitarian settings and lessons learned from past epidemics. Nat Med 2020; 26:647–8.
103. Júnior JG, de Sales JP, Moreira MM, Pinheiro WR, Lima CKT, Neto MLR. A crisis within the crisis: The
mental health situation of refugees in the world during the 2019 coronavirus (2019-nCoV) outbreak. Psychiatry Res 2020; 288:113000.
104. Shanker R, Malik S. Gendered
Pandemic: Refugee
Women in India Left Highly Vulnerable in Lockdown. The News Minute 2020. Available from:
https://www.thenewsminute.com/article/gendered-pandemic-refugee-women-india-left-highly-v ulnerable-lockdown-125193. Last accessed on 2020 Jul 04.
105. Bhopal RS.
COVID-19: Immense necessity and challenges in meeting the needs of minorities, especially asylum seekers and undocumented migrants. Public Health 2020; 182:161–2.
106. UNHCR. Displaced and Stateless
Women and Girls at Heightened Risk of
Gender-Based Violence in the Coronavirus
Pandemic. United Nations High Commissioner for; 2020. Available from:
https://www.unhcr.org/en-in/news/press/2020/4/5e998aca4/isplaced-stateless-women-girls-he ightened-risk-gender-based-violence-coronavirus.html. Last ace ssed on 2020 Jul 04.
107. Clayton M, Amon J, Mokgethi J, Shen T. Rights in the Time of
COVID-19 —Lessons from HIV for an Effective, Community-Led Response. Geneva, Switzerland: HIV/AIDS Section, United Nations Office on Drugs and Crime; 2020. Available from:
https://www.unaids.org/en/resources/documents/2020/human-rights-and-covid-19. Last accessed on 2020 Nov 13.
108. Platt L, Elmes J, Stevenson L, Holt V, Rolles S, Stuart R. Sex workers must not be forgotten in the
COVID-19 response. Lancet 2020; 396:9–11.
109. Jozaghi E, Bird L.
COVID-19 and sex workers: human rights, the struggle for safety and minimum income. Can J Public Health 2020; 111:406–7. Available from
https://doi.org/10.17269/s41997-020-00350-1. Last accessed on 2020 Nov 13.
110. Deutsche Welle. Coronavirus Burdens Working Moms Twice as Much as dads, Study Finds DW 14.05.2020.DW. COM 2020. Available from:
https://www.dw.com/en/c oronavirus-burdens-working-moms-twice-as-much-as-dads- study-finds/a-53440510. Last accessed on 2020 Jul 04.
111. Kohlrausch B, Zucco A. Die Corona-Krise trifft Frauen doppelt. WSI Policy Brief (40) 2020.
112. Staniscuaski F, Reichert F, Werneck FP, de Oliveira L, Mello-Carpes PB, Soletti RC, et al. Impact of
COVID-19 on academic mothers. Science 2020; 368:724.
113. Armstrong M. The Hidden Impact of
Covid-19 on Single Motherhood. Discover Society 2020. Available from:
https://discoversociety.org /2020/04/18/the-hidden-impact-of-covid-19-on-single-motherh ood/. Last accessed on 2020 Jul 04.
114. First JM, First NL, Houston JB. Intimate partner violence and disasters: A framework for empowering
women experiencing violence in disaster settings. Affilia 2017; 32:390–403.
115. Araujo JO, Souza FM, Proença R, Bastos ML, Trajman A, Faerstein E. Prevalence of sexual violence among refugees: A systematic review. Rev Saude Publica 2019; 53:78.
116. Bermudez LG, Stark L, Bennouna C, Jensen C, Potts A, Kaloga IF, et al. Converging drivers of interpersonal violence: Findings from a qualitative study in post-hurricane Haiti. Child Abuse Negl 2019; 89:178–91.
117. Castañeda Carney I, Sabater L, Owren C, Boyer AE.
Gender-based violence and environment linkages: The violence of inequality Wen J. Gland, Switzerland: IUCN, International Union for Conservation of Nature; 2020. Available from:
https://portals.iucn.org/libr ary/node/48969. Last accessed on 2020 Jun 24.
118. Kim MS, Kim T, Lee D, Yook J, Hong YC, Lee SY, et al. Mental disorders among workers in the healthcare industry: 2014 national health insurance data. Ann Occup Environ Med 2018; 30:31. Available online from: https://doi.org/10.1186/s40557-018-0244-x. Last accessed on 2020 Nov 13.
119. Lee N, Boeri M. Managing stigma:
Women drug users and recovery services. Fusio 2017; 1:65–94.
120. Mandal P, Dhawan A. Interventions in individuals with specific needs. Indian J Psychiatry 2018; 60:S553–8.
121. Das N, Narnoli S, Kaur A, Sarkar S.
Pandemic, panic, and psychiatrists What should be done before, during, and after
COVID-19?. Asian J Psychiatr 2020; 53:102206.
122. Das N. Telepsychiatry during
COVID-19 A brief survey on attitudes of psychiatrists in India. Asian J Psychiatr 2020; 53:102387.
123. Das N, Narnoli S, Kaur A, Sarkar S, Balhara YP. Attitude to telemedicine in the times of
COVID-19 pandemic: Opinion of medical practitioners from India. Psychiatry Clin Neurosci 2020; 74:560–562. Available from:
https://doi.org/10.1111/pcn.13109. Last accessed on 2020 Nov 13.
