Changes in sex differences in mental health over time: the moderating effects of educational status and loneliness.

Background: Limited evidence exists regarding how sex differences in mental health are changing over time, especially in the context of recent health and economic adversities.

Aims: To examine the temporal shifts in mental health issues among males and females, and explore the influence of education and loneliness on these trends.

Methods: Data were utilized from the 2020 to 2023 Monitor study, a repeated cross-sectional survey of adults 18 years and older in Ontario, Canada. The study employed a Qualtrics-based web panel survey ( = 5,317). Mental health was assessed using Kessler-6 questionnaire, and analyses were performed using Generalized Linear Model (GLM) with gamma distribution.

Results: The results showed that there was a significant three-way interaction effect between sex, time and education with psychological distress ( = 0.014), suggesting that psychological distress increased between 2020 and 2023 among males who had less than college education. However, it remained stable among males with college/university degrees and females overall. Interaction between sex and feeling lonely on psychological distress was also evident ( = 0.004).

Conclusions: Mental health issues remained a significant public health challenge among adults, especially psychological distress increasing among males with less than a college education. This underscores the importance of targeted interventions addressing males' mental health.