Factors Associated With Mental Health Disorders Among University Students in France Confined During the COVID-19 Pandemic
Authors: Marielle Wathelet, Stéphane Duhem, Guillaume Vaiva, Thierry Baubet, Enguerrand Habran, Emilie Veerapa, Christophe Debien, Sylvie Molenda, Mathilde Horn, Pierre Grandgenèvre, Charles-Edouard Notredame, Fabien D’Hondt
Journal: JAMA Network Open (2020)

<h3>Importance</h3> The coronavirus disease 2019 (COVID-19) pandemic and quarantine measures have raised concerns regarding their psychological effects on populations. Among the general population, university students appear to be particularly susceptible to experiencing mental health problems. <h3>Objectives</h3> To measure the prevalence of self-reported mental health symptoms, to identify associated factors, and to assess care seeking among university students who experienced the COVID-19 quarantine in France. <h3>Design, Setting, and Participants</h3> This survey study collected data from April 17 to May 4, 2020, from 69 054 students living in France during the COVID-19 quarantine. All French universities were asked to send an email to their students asking them to complete an online questionnaire. The targeted population was approximately 1 600 000 students. <h3>Exposure</h3> Living in France during the COVID-19 quarantine. <h3>Main Outcomes and Measures</h3> The rates of self-reported suicidal thoughts, severe distress, stress, anxiety, and depression were assessed using the 22-item Impact of Events Scale–Revised, the 10-item Perceived Stress Scale, the 20-item State-Trait Anxiety Inventory (State subscale), and the 13-item Beck Depression Inventory, respectively. Covariates were sociodemographic characteristics, precariousness indicators (ie, loss of income or poor quality housing), health-related data, information on the social environment, and media consumption. Data pertaining to care seeking were also collected. Multivariable logistic regression analyses were performed to identify risk factors. <h3>Results</h3> A total of 69 054 students completed the survey (response rate, 4.3%). The median (interquartile range) age was 20 (18-22) years. The sample was mainly composed of women (50 251 [72.8%]) and first-year students (32 424 [47.0%]). The prevalence of suicidal thoughts, severe distress, high level of perceived stress, severe depression, and high level of anxiety were 11.4% (7891 students), 22.4% (15 463 students), 24.7% (17 093 students), 16.1% (11 133 students), and 27.5% (18 970 students), respectively, with 29 564 students (42.8%) reporting at least 1 outcome, among whom 3675 (12.4%) reported seeing a health professional. Among risk factors identified, reporting at least 1 mental health outcome was associated with female gender (odds ratio [OR], 2.10; 95% CI, 2.02-2.19;<i>P</i> &lt; .001) or nonbinary gender (OR, 3.57; 95% CI, 2.99-4.27;<i>P</i> &lt; .001), precariousness (loss of income: OR, 1.28; 95% CI, 1.22-1.33;<i>P</i> &lt; .001; low-quality housing: OR, 2.30; 95% CI, 2.06-2.57;<i>P</i> &lt; .001), history of psychiatric follow-up (OR, 3.28; 95% CI, 3.09-3.48;<i>P</i> &lt; .001), symptoms compatible with COVID-19 (OR, 1.55; 95% CI, 1.49-1.61;<i>P</i> &lt; .001), social isolation (weak sense of integration: OR, 3.63; 95% CI, 3.35-3.92;<i>P</i> &lt; .001; low quality of social relations: OR, 2.62; 95% CI, 2.49-2.75;<i>P</i> &lt; .001), and low quality of the information received (OR, 1.56; 95% CI, 1.49-1.64;<i>P</i> &lt; .001). <h3>Conclusions and Relevance</h3> The results of this survey study suggest a high prevalence of mental health issues among students who experienced quarantine, underlining the need to reinforce prevention, surveillance, and access to care.