Gender differences in the prevalence and impact factors of adolescent dissociative symptoms during the coronavirus disease 2019 pandemic

The purpose of this study was to explore the differences between the prevalence and impact factors of adolescent dissociative symptoms (ADSs) by using sex-stratification during the coronavirus disease 2019 (COVID-19) pandemic. A school-based, two-center cross-sectional study was conducted in Hangzhou City, China, between January 1, 2021 and April 30, 2022. The sample included 1,916 adolescents aged 13–18 years that were randomly selected using a multiphase, stratified, cluster sampling technique. A two-stage assessment procedure was used to find out the ADSs. We used a multivariate logistic regression analysis to assess the impact factors of ADSs during the COVID-19 pandemic. The adolescent dissociative scores (t = 4.88, P < 0.001) and positive ADSs rate (Chi-square = 15.76, P < 0.001) in males were higher than in females. Gender-stratified, stepwise multiple logistic regression analysis revealed that the conflict relationship of teacher-student [adjusted odds ratio (AOR) 1.06, 95% confidence interval (CI) 1.01–1.10], family expressiveness (AOR 0.87, 95% CI 0.78–0.98), family conflict (AOR 1.15, 95% CI 1.05–1.27), family organization (AOR 0.88, 95% CI 0.78–0.99), and family cohesion (AOR 0.87, 95% CI 0.77–0.99) were linked to ADSs only in males, while individual psychological states of somatic complaint (AOR 1.04, 95% CI 1.00–1.08) and paranoid ideation (AOR 1.09, 95% CI 1.01–1.19) were associated with female ADSs only. The ADSs seemed to be prevalent in Hangzhou City, studied during the COVID-19 pandemic. Gender differences in the prevalence and impact factors of dissociative symptoms seem to be significant among adolescents. Thus, gender-specific intervention programs against ADSs should be considered as reducing this risk.