Gender differences in the prevalence and correlates of COVID-19 fear among mental health professionals: a network perspective based on a national survey in China Running head: Fear of COVID-19 among mental health professionals

Shuying Rao^1,2,3*Mu-Rui Zheng Zheng³Feng-Rong An^4,5Feng Yuan^4,5Zhaohui Su⁶Teris Cheung^7,8Gabor Ungvari⁹Chee H Ng¹⁰Gang Wang⁶Yu-Tao Xiang^3*

• ¹University of Macau, Taipa, China
• ²Unit of Psychiatry, Department of Public Health and Medicinal Administration, & Institute of Translational Medicine, Faculty of Health Sciences, Macau, China
• ³1. Unit of Psychiatry, Department of Public Health and Medicinal Administration, & Institute of Translational Medicine, Faculty of Health Sciences, macau, China
• ⁴National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China, Beijing, China
• ⁵Beijing Anding Hospital, Beijing, China
• ⁶Southeast University, Nanjing, China
• ⁷Hong Kong Polytechnic University, Hong Kong, China
• ⁸Hong Kong Polytechnic University, Hongkong, Hong Kong, SAR China
• ⁹University of Notre Dame Australia, Fremantle, Australia
• ¹⁰University of Melbourne, Victoria, Australia

Background: Gender differences in COVID-19-related fear among mental health professionals (MHPs) have been inadequately studied. This study compared the gender differences in prevalence, correlates and network structure of COVID-19 fear among MHPs in China in the post-pandemic era.Methods: A nationwide cross-sectional study was conducted between January 22 and February 10, 2023. Binary logistic regression was used to identify factors associated with COVID-19 fear. Expected Influence was used to identify the most central (influential) symptoms in gender-specific networks, while network comparison tests were conducted to assess the differences between male and female models.Results: Among 7,199 MHPs, the overall prevalence of COVID-19 fear was 63.5% (95% CI: 62.3%-64.6%), with 61.7% (95% CI: 58.9%-64.4%) in males and 65.0% (95% CI: 63.7%-66.2%) in females. For male MHPs, factors associated with COVID-19 fear included having married status (OR: 1.39; 95% CI: 1.02-1.90; P = 0.037), poorer economic status (poor vs. good: OR: 1.91; 95% CI: 1.23-2.98; P = 0.004), more severe insomnia (OR: 1.04; 95% CI: 1.01-1.07; P = 0.018), and depression (OR: 1.09; 95% CI: 1.05-1.12; P < 0.001). For female MHPs, the significant factors included having married status (OR: 1.21; 95% CI: 1.06-1.37; P = 0.004), poorer economic status (poor vs. good: OR: 1.39; 95% CI: 1.11-1.73; P = 0.004), more severe insomnia (OR: 1.05; 95%