Factors Associated with Mental Health Disorders Among University Students in France Confined During the COVID-19 Pandemic
Open accessAbstract
Importance: 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. Objectives: 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. Design, Setting, and Participants: 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. Exposure: Living in France during the COVID-19 quarantine. Main Outcomes and Measures: 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. Results: 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; P < .001) or nonbinary gender (OR, 3.57; 95% CI, 2.99-4.27; P < .001), precariousness (loss of income: OR, 1.28; 95% CI, 1.22-1.33; P < .001; low-quality housing: OR, 2.30; 95% CI, 2.06-2.57; P < .001), history of psychiatric follow-up (OR, 3.28; 95% CI, 3.09-3.48; P < .001), symptoms compatible with COVID-19 (OR, 1.55; 95% CI, 1.49-1.61; P < .001), social isolation (weak sense of integration: OR, 3.63; 95% CI, 3.35-3.92; P < .001; low quality of social relations: OR, 2.62; 95% CI, 2.49-2.75; P < .001), and low quality of the information received (OR, 1.56; 95% CI, 1.49-1.64; P < .001). Conclusions and Relevance: 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.
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Undergraduate students in lockdown suffered increasing severity of anxiety and depressive symptoms, manifested in poorer sleep quality, poorer academic performance and increased suicidal thoughts.
“undergraduate students in lockdown, namely that they suffered increasing severity of anxiety and depressive symptoms [48], manifested in poorer sleep quality, poorer academic performance and increased suicidal thoughts in the university populations [49,50,51,52,53,54,55,56,57,58].”
From Relationships between psychopathology, psychological process variables, and sociodemographic variables and comparison of quarantined and non-quarantined groups of malaysian university students in the covid-19 pandemic (2021) · cites this paper as [51]
The Discussion reports a high prevalence of severe anxiety and depression symptoms among quarantined university students, supporting that part of the claim. It does not establish that symptoms increased during lockdown; the Limitations section explicitly says the study cannot establish a direct association between the high symptom rates and quarantine. Citation [48] is attached to the anxiety-and-depression statement, not the subsequent claims about sleep, academic performance, or suicidal thoughts. (LLM, conf=0.88)
Experimental — accuracy not yet measuredThe two French studies by Wathelet and colleagues found that living under quarantine was associated with high rates of mental health problems and probable PTSD among students.
“the current study extends on the two French studies by Wathelet and colleagues, who found living under quarantine was associated with high rates if mental health problems and probable PTSD among students.”
From Changes in mental health problems and suicidal behaviour in students and their associations with COVID-19-related restrictions in Norway: a national repeated cross-sectional analysis (2022) · cites this paper as [12]
The Discussion and Conclusions report high rates of mental health symptoms among French university students while they were quarantined. But the Discussion > Limitations says the study cannot establish a direct association with quarantine, and that its distress measure cannot diagnose PTSD. This paper also does not establish the claim about two studies. (LLM, conf=0.88)
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- Authors
- Wathelet, M., Duhem, S., Vaiva, G., Baubet, T., Habran, E., Veerapa, E., Debien, C., Molenda, S., Horn, M., Grandgenèvre, P., Notredame, C.-E., & D’Hondt, F.
- Affiliations
- Centre Hospitalier Universitaire de Lille (FR)
- Inserm (FR)
- Centre National de Ressources et de Résilience Lille-Paris, Lille, France
- Université Sorbonne Paris Nord (FR)
- Fédération Hospitalière de France (FR)
- Department of Psychiatry, Centre Hospitalier Universitaire de Lille, Lille, France
- Corresponding author
- D’Hondt, Fabien
- ORCID
- Venue
- JAMA Network Open
- Publisher
- American Medical Association (AMA)
- Published
- 2020-10-23
- Volume
- 3
- Issue
- 10
- Pages
- e2025591
- ISSN
- 2574-3805 (ISSN-L)
- PMC
- PMC7584927
- OpenAlex
- W3094311767
- Cited by
- 747
- References
- 26
- Citations by year
- 2026: 22 · 2025: 55 · 2024: 103 · 2023: 157 · 2022: 234 · 2021: 171 · 2020: 3 · 2019: 1
- FWCI
- 56.65
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- cc-by
- Locations
- JAMA Network Open (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- HAL (submittedVersion)
- HAL (submittedVersion, cc-by)
- Funders
- Sanofi
- Otsuka Pharmaceutical
- H. Lundbeck A/S
- Cilag
- Topics
- Social Sciences › Psychology › Clinical Psychology › COVID-19 and Mental Health
- Social Sciences › Psychology › Developmental and Educational Psychology › Student Stress and Coping
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Keywords
- COVID-19 pandemic, quarantine, university students, mental health, suicidal ideation, depression, anxiety, perceived stress, psychological distress, risk factors, precarity, care seeking, help-seeking, social environment, media use, France, Impact of Event Scale-Revised, Perceived Stress Scale, Beck Depression Inventory, State-Trait Anxiety Inventory, student mental health services
- MeSH terms
- Betacoronavirus, COVID-19, SARS-CoV-2, Adolescent, Adult, Anxiety, Anxiety Disorders, Mental Disorders, Depression, Depressive Disorder, Female, Humans, Male, Patient Acceptance of Health Care, Pneumonia, Viral, Quarantine, Surveys and Questionnaires, Social Isolation, Stress, Psychological, Students, Universities, Prevalence, Odds Ratio, Coronavirus Infections, Young Adult, Pandemics, Suicidal Ideation
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