ObjectivesTo estimate the effect of student status on mental health condition during COVID-19 general lockdown in France.DesignCross-sectional analysis comparing students and non-students recruited in the same study.SettingParticipants of the web-based CONFINS study implemented during the general lockdown in France in spring 2020.Participants2260 participants (78% women) including 1335 students (59%).Primary and secondary outcome measuresThrough an online questionnaire, participants declared if they have experienced suicidal thoughts, coded their perceived stress on a 10-points scale and completed validated mental health scales (Patient Health Questionnaire-9 for depressive symptoms, Generalised Anxiety Disorder-7 for anxiety symptoms) during the last 7 days. The effect of college student status on each mental health condition was estimated using multivariate logistic regression analyses. Stratified models for students and non-students were performed to identify population-specific factors.ResultsStudent status was associated with a higher frequency of depressive symptoms (adjusted OR (aOR)=1.58; 95% CI 1.17 to 2.14), anxiety symptoms (aOR=1.51; 95% CI 1.10 to 2.07), perceived stress (n=1919, aOR=1.70, 95% CI 1.26 to 2.29) and suicidal thoughts (n=1919, aOR=1.57, 95% CI 0.97 to 2.53). Lockdown conditions that could be potentially aggravating on mental health like isolation had a higher impact on students than on non-students.ConclusionsCollege students were at higher risk of mental health disturbances during lockdown than non-students, even after taking into account several potential confounding factors. A close follow-up and monitoring of students’ mental health status is warranted during lockdown periods in this vulnerable population.

Background Due to their impact on premature mortality and long-term disabilities, a better understanding of health risk behavior (HRB) determinants among college students is crucial in order to build the most appropriate prevention tools. Although selfesteem appears to be a relevant candidate, a clear picture summarizing its multiple links with HRB is lacking to guide clinicians and researchers. This study aims to provide a systematic review of the associations between health risk behavior and self-esteem among college students. Methods This search was performed in several databases on 02/02/17. Study eligibility criteria were original articles in peerreviewed journals, in English; observational quantitative studies; among college students; and investigated the association between self-esteem and HRB. The PRISMA statements were complied with. Results One hundred fifteen articles were included: 46 on substance use, 35 on sexual behavior, 11 on nutritional habits, 27 on physical activity, and 5 on other HRB. Most studies reported an association between higher self-esteem and healthier behavior. For alcohol consumption and number of sexual partners, both negative and positive associations have been reported. Directionality was investigated in a few studies suggesting potential bidirectional effects. Conclusions This review points out the need for consensus for the definition of self-esteem and HRB. There was high heterogeneity in (1) the measurement of self-esteem either in the concept measured (global vs. domain) or in the way to implement validated tools; and (2) the definition of HRB. Self-esteem seems to be a relevant target to intervene on HRB, especially alcohol abuse and physical activity. Trial Registration Registration number: PROSPERO (ID = CRD42017056599).

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ObjectivesThe aim of the study was to estimate the association between self-esteem and subsequent self-rated health during college years, taking into account a wide range of potential confounders.DesignProspective longitudinal study.SettingThe French i-Share cohort.ParticipantsThe sample consisted of 1011 college students.Primary and secondary outcome measuresThe association between self-esteem and later self-rated health was evaluated using multivariate modelling.Data regarding self-rated health, global self-esteem and demographic, educational, social, behavioural, environmental and financial characteristics were collected through an internet-based questionnaire.ResultsThe 1011 participants had a median age of 21.9 years and 79% (795/1011) were females. Self-rated health was assessed a median of 8 months after the self-esteem measurement. Twenty per cent of the students declared average to very poor health (203/1011). Students with higher levels of self-esteem were more likely to declare good or very good self-rated health (adjusted OR=1.40, 95% CI 1.15 to 1.72, p value=0.001). Other factors associated with good or very good self-rated health were low body mass index, a comfortable financial situation during childhood and three personality traits (low persistence and harm avoidance and high cooperativeness).ConclusionsThis study offers novel findings on the impact of self-esteem on self-rated health among college students. Interventions targeting self-esteem should be experimented during university years in order to improve health outcomes.

Objective: To estimate the association between ADHD symptoms and suicidal ideation in college students, and to test mediation by depressive symptoms or self-esteem. Method: Based on the i-Share cohort (prospective cohort of 2,331 college students in France). Self-reported measures included ADHD symptoms at baseline, self-esteem and depressive symptoms at 3 months, and suicidal ideation at 1-year follow-up. We conducted path analysis to estimate total, direct, and indirect effect. Results: Participants with high ADHD symptoms were more likely to report suicidal ideation 1 year later ( p < .0001). Indirect effects through depressive symptoms ( p < .0001) and self-esteem ( p < .0001) explained 44% and 25% of this association, respectively. An indirect pathway via a combination of self-esteem, then depressive symptoms, was also identified ( p < .0001), explaining 19% of the total effect. The direct effect was not significant ( p = .524). Conclusion: ADHD symptoms seem to have no direct but indirect effect through both self-esteem and depressive symptoms on suicidal ideation.

A poorer CD4 cell increase during first-line cART was observed in HIV-2+ patients, even after adjusting for pretreatment pVL and other potential confounders. Our results underline the need to identify more potent therapeutic regimens or strategies against HIV-2.

Background This study investigates the association between self‐esteem assessed either in adolescence or in adulthood with adult academic and psychosocial outcomes. Method One hundred and thirty‐one junior high school students were selected based on their experience of academic difficulty or success, and both groups were selected equally from regular or low‐performing schools. Ten years later, 100 of these individuals participated in a follow‐up assessment of academic, socioprofessional, and health‐related outcomes. Logistic and linear regression models were performed to estimate the association of self‐esteem (measured by the Rosenberg Self‐Esteem Scale) at baseline and at follow‐up, as well as change in self‐esteem categories (high vs. low) on all outcomes. Results Fifty‐four percent of adolescents were consistently high in self‐esteem over the 10‐year period, 17% experienced an improvement, 21% a decrease, and 8% stayed at a low level. Outcomes at follow‐up were more consistently associated with young adult self‐esteem than adolescent self‐esteem. Self‐esteem was associated with several outcomes (i.e., personal goals, life satisfaction, alcohol, and health outcomes) and its effects were different depending on the period considered and categories of self‐esteem change. Conclusions The self‐esteem difficulties which are common in adolescence raise concerns about their potential impact on important outcomes later in life. However, self‐esteem difficulties in young adulthood were more associated with negative outcomes at this phase of life (whether low self‐esteem persisted into adulthood, or emerged only during adulthood). Relative to outcomes in young adulthood, the period of greatest interest for improving well‐being may be concentrated in the years immediately surrounding the studied outcomes. Key Practitioner Message Self‐esteem change from adolescent to adulthood is associated with a large diversity of outcomes. Less is known concerning the extent to which adolescent self‐esteem may independently determine outcomes in young adulthood as compared to more temporally proximal self‐esteem levels. Only self‐esteem difficulties in young adulthood were associated with negative outcomes at this phase of life (whether they persisted from adolescence into adulthood, or emerged for the first time during adulthood). Targeting self‐esteem difficulties that are temporally proximal to the period of interest may improve mental health and well‐being.

Background: Covid-19 pandemic and its consequences have raised fears of its psychological impact. The objective of this study was to estimate the effect of student status on mental health conditions during Covid-19 general lockdown among adults in France. Methods: Using cross-sectional data of the Confins cohort, we estimated the effect of student status on depressive and anxiety symptoms, suicidal thoughts and perceived stress using multivariate logistic regression analyses. Stratified models for college students and non-students were performed to identify associated population-specific factors. Results: Among the 2260 included participants, students represented 59% (n=1335 vs 925 non-students) and 78% of the total sample were female. Student status was more frequently associated with depressive symptoms (adjusted OR(aOR)=1.58; 95%CI 1.17;2.14), anxiety symptoms (aOR=1.51; 95%CI 1.10;2.07), perceived stress (n=1919, aOR=1.70, 95%CI 1.26;2.29) and frequent suicidal thoughts (n=1919, aOR=1.57, 95%CI 0.97;2.53). Lockdown conditions that could be potentially aggravating on mental health like isolation had a higher impact on students than non-students. Limitations: Participants were volunteers, which could limit generalisation of the findings. The cross-sectional design did not allow determining if lockdown impacted directly mental health or if there is another cause. However, we adjusted analyses with the history of psychiatric disorders, and factors related to lockdown conditions were associated with mental health disturbances. Conclusions: College student's mental health is of great importance in the context of the general lockdown set up during the pandemic. Follow-up and interventions should be implemented especially for those at high-risk (younger people and those with history of psychiatric disorders).