Assessment of mental health of university students faced with different lockdowns during the coronavirus pandemic, a repeated cross-sectional study

Abstract

Background: Studies have highlighted the impact of the COVID-19 pandemic on the mental health of university students. However, little is known about the psychological impact of successive lockdowns on this population. Objectives: To assess the prevalence of psychological distress in a student population during the first two lockdowns linked to the COVID-19 pandemic, and to stratify them by subgroup. Methods: We used a repeated cross-sectional study of a university student population in France during the first lockdown, the unlockdown, and the second lockdown. We measured rates of depression, anxiety, distress and suicidal ideation. A weighted prevalence was calculated with 95% confidence intervals. Predictors of symptom progression were measured using adjusted logistic regression. Results: 19,150 university students responded to the surveys. Our results suggest a significant decrease in the scores for depression (aOR = 0.64; CI%: 0.59–0.70), anxiety (aOR = 0.81; CI%: 0.74–0.88), and distress symptoms (aOR = 0.47; CI%: 0.43–0.51) between the first lockdown and the lifting of the lockdown. However, a significant increase in symptoms of depression (aOR = 1.53; CI%: 1.43-1.64), anxiety (aOR = 1.56; CI%: 1.45–1.67) and suicidal ideation (aOR = 1.59; CI%: 1.45–1.73) between the first and second lockdown is highlighted. The most impacted students are PhD students, they show a significant increase (aOR = 4.37; CI%: 1.41–13.54) in suicidal ideation. Conclusion: Mental health professionals will need to be vigilant about this population, both to provide care for psychological distress, but also to reduce the risk of PhD students dropping out. HIGHLIGHTS Successive lockdowns have a significant impact on the mental health of university students. PhD students have experienced the most significant deterioration in their mental health. The rate of suicidal ideation has increased significantly across the university student population.

On the path to recovery: traumatic stress research during the COVID-19 pandemic 2021–2023

“…While the mental health impact of the COVID-19 pandemic on healthcare workers has been a focal point of investigation, other at-risk populations including students (Ali et al, 2021 ; Bountress et al, 2022 ; Essadek et al, 2022 ; Pat-Horenczyk et al, 2021 ), refugees (Akhtar et al, 2021 ; Liddell, Murphy, et al, 2021 ; Liddell, O'Donnell, et al, 2021 ), persons exposed to violence (Birkeland et al, 2021 ; Gibert et al, 2021 ) or past childhood adversity (Clemens et al, 2021 ), and military personnel (Richardson et al, 2022 ) have also been a nidus for research on mental health outcomes. A multitude of studies and reviews have highlighted the ubiquitous negative mental health effects of the pandemic (Nochaiwong et al, 2021 ; Zhao et al, 2021 ) and lockdowns (Chen et al, 2022 ), including PTSD (Bonati et al, 2022 ; (Laurent et al, 2022 ) Yuan, et al, 2021 ), adjustment disorders (Ajdukovic et al, 2021 ; Dragan et al, 2021 ; Liddell, O'Donnell, et al, 2021 ; Lotzin et al, 2021 ; Shiffman et al, 2023 ), substance use disorders (Patel et al, 2023 ), and even transient psychoses (Loehde & Novakovic, 2021 ).…”

“…Factors such as low family socioeconomic status, living in rural areas, knowing someone who was infected with COVID-19, and being a family member or friend to a healthcare worker, were strongly associated with poorer mental health outcomes (Elharake et al, 2023 ). In a survey early in the pandemic of more than 19,000 French university students, conducted over three successive stages (lockdown, the lifting of lockdown, and second lockdown), successive lockdowns worsened mental health, especially among PhD students; in contrast, there was a significant reduction in depression, anxiety, and psychological distress when the lockdown was lifted (Essadek et al, 2022 ). Once again, these findings underline the importance of identifying risk groups for early preventative efforts.…”

“… 6. Essadek et al ( 2022 ). Assessment of mental health of university students faced with different lockdowns during the coronavirus pandemic, a repeated cross-sectional study A repeated cross-sectional study of a university student population in France found decreases in the scores for depression, anxiety, and distress symptoms between the first lockdown and the lifting of the lockdown.…”

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