Trajectories of mental distress and quality of life during Ramadan fasting in young Israeli Muslims are gender-specific

There is a knowledge gap concerning mental health changes across the Ramadan period. In a study of 284 young Israeli Muslim adults, we explored within-subject changes in global distress (GD), specific symptoms (depression, anxiety, stress), and quality of life (QoL) across five assessments spanning Ramadan fast. Using repeated-measures general linear modeling, significant effects were found for GD [F(4) = 20.890, p < 0.001], demonstrating a two-stage reduction in scores: an initial decrease during the first week of Ramadan, followed by a further decrease post-Ramadan. Females consistently reported higher GD scores [F(1) = 12.656, p < 0.001], though no significant time-point×sex interactions were found. However, during Ramadan, females exhibited a transient GD increase [F(1) = 4.053, p = 0.046], which was not observed in males. Subscale analyses revealed significant reductions in Depression [F(4) = 12.260, p < 0.001], Anxiety [F(4) = 16.388, p < 0.001], and Stress [F(4) = 20.583, p < 0.001]. Improvements in Depression and Anxiety scores occurred during the first week of Ramadan. Post-Ramadan reductions in Anxiety and Stress scales were observed. Despite these symptom improvements, subjective quality of life declined during Ramadan, particularly among females, but recovered post-Ramadan. Participants reported increased social commitments during Ramadan, expressing a preference to reduce these pressures while maintaining the spiritual aspects of the fast. Our findings highlight that Ramadan fast is associated with short-term improvements in mental health symptoms, though the temporal pattern of change varies by sex. However, social obligations may have introduced a temporary trade-off, negatively impacting self-reported quality of life, especially for women. These insights may inform culturally sensitive interventions that maximize Ramadan’s mental health benefits while mitigating temporary quality of life declines.