LAUSR

BACKGROUND Reported traditional gender role attitudes (GRAs) have been related to worse mental health in western countries. This study examined the link of GRAs with symptoms of depression and generalised anxiety disorder (GAD) in two Russian cities. METHODS We used interview data from the cross-sectional Know Your Heart Study conducted among 5099 adults aged 35-69 in the Russian cities of Arkhangelsk and Novosibirsk between 2015 and 2017. Attitudes about gender inequality and division of labour between women and men at home or in the public sphere were measured by single items. Binary variables indicating presence of symptoms of depression and GAD were defined by a cut-off of ≥ 5 of the PHQ-9 and GAD-7 scores respectively. Multivariable logistic regression was used to determine crude and adjusted associations. RESULTS There was evidence that all types of GRAs were associated with symptoms of depression and GAD consistent with a U-shape after controlling for confounding with stronger evidence for all relationships for depression than for GAD. Odds of depressive symptoms were elevated among participants strongly agreeing to gender inequality and gender division of labour. There was good evidence for effect measure modification by age. LIMITATIONS The possibilities of measurement error of the exposure and outcomes, residual confounding and reverse causality are important limitations of this study. CONCLUSIONS Agreeing to gender inequality and gender division of labour was associated with reporting symptoms of common mental disorders in Russia. This study adds evidence for a link of GRAs with mental health from a non-western context.