key: cord-274554-vtg6l651
authors: Essadek, Aziz; Rabeyron, Thomas
title: Mental health of French students during the Covid-19 pandemic
date: 2020-08-25
journal: J Affect Disord
DOI: 10.1016/j.jad.2020.08.042
sha: 
doc_id: 274554
cord_uid: vtg6l651

This study evaluates the impact of Covid-19 on the mental health of 8004 French students in the East part of France, which has been the first and hardest hit region by the Covid-19 pandemic. This is, to our knowledge, the largest study conducted on mental health of students during the pandemic. Our results show that students suffer from particularly high level of anxiety, depression and distress. A significant proportion of students might require psychological support, especially because the high distress scores suggest that the epidemic and confinement have favored the emergence of post-traumatic stress symptoms.

pandemic. This study was more precisely conducted from April 27 to April 30, 10 days after the peak of the mortality rate during the pandemic in France.

Method: An online survey was sent by email, using Lime Survey, to the 59,931 students of the University of Lorraine. The data collected focused on sex, housing (alone or with others), Covid-19 symptoms (with or without diagnosis), financial situation (with or without scholarship) and work. Three mental health scales, previously validated in French, were used to measure the level of depression (Patient Health Questionnaire, PHQ-9 ≥ 10), anxiety (Generalized Anxiety Disorder, GAD-7 ≥ 7) and distress (Impact of Event Scale-Revised, IES-R ≥ 26). PHQ-9 and GAD-7 has been chosen because they are the most widely used in primary care and symptoms detection 3 4 5 , while the IES-R is an easily self-administered questionnaire very frequently use to assess post-traumatic symptoms. Logistic regressions were used to analyze the results with R software (3.6.3) and are presented in the form of oddratios (OR) with a 95% confidence interval. This study has been approved by the University of Lorraine and is registered with the number 2020-115. Being employed was weakly, but negatively, correlated with depression (p = -0.147; P < 0.001), anxiety (p =-0.156; P < 0.001) and stress (p =-0.146; P < 0.001). There was no other significant correlations between the different variables.

Discussion: According to our results, approximately 3% of students were diagnosed with Covid-19 and almost 12% developed symptoms of the disease, which corroborates recent epidemiological results 7 . Depression (43%), anxiety (39.19%) and distress (42.94%) scores were much higher than those normally observed in student population 8 9 . More precisely, being a female, living alone, in a precarious financial situation and having been in contact with people who had contracted Covid-19 significantly increased levels of depression, anxiety and distress. Also note that 47.2% of students reported difficulty concentrating and 14.86% reported self-harming or suicidal thoughts. Conversely, working appeared to be protective for these states. Finally, being infected by Covid-19 strongly increase depression, anxiety and distress scores, which underlines the psychological impact of Covid-19 on the population. This study has nevertheless several limitations. First, it was conducted during only four days and lacked a longitudinal follow-up. Therefore, the long-term psychological impact of Covid-19 on the student population would deserve further study. Second, although the response rate for this study was 13.36%, a response bias is possible if, for example, non-respondents were too stressed -or, at the opposite, not stressed enough -to be interested in taking part in the study.

Conclusion: A significant proportion of students probably required psychological support during the Covid-19 pandemic, especially because the high distress scores suggest that the virus and the confinement have favored the emergence of post-traumatic stress symptoms 10 .

The various indicators highlighted in this study could guide the detection and the counselling of students most at risk in this type of situation. Future studies may evaluate the evolution of these indicators after the pandemic and assess the impact of care set up to help students. 

Mental Health and the Covid-19 pandemic

The psychological impact of quarantine and how to reduce it: rapid review of the evidence

Accuracy of Patient Health Questionnaire-9 (PHQ-9) for screening to detect major depression: individual participant data meta-analysis

Validation and utility of a self-report version of PRIME-MD: the PHQ primary care study. Primary Care Evaluation of Mental Disorders. Patient Health Questionnaire

Psychometric properties of the general anxiety disorder 7-Item (GAD-7) scale in a heterogeneous psychiatric sample

Validation de contenu de la version francophone du ques-tionnaire Impact of Event Scale-Revised selon les critères du DSM-5

Estimating the burden of SARS-Cov-2 in France

Psychiatry disorders in students in six French universities: 12-Month prevalence, comorbidity, impairment and help-seeking

A systematic review of studies of depression prevalence in university students

The Mental Health Consequences of COVID-19 and Physical Distancing: The Need for Prevention and Early Intervention

The first author (Aziz Essadek) conducted the study and analyzed the data. Specifically, he participated in the design, formal analysis, writing, rewriting and editing. The second author (Thomas Rabeyron) oversaw the conduct of the study. Specifically, he participated in the design, formal analysis, writing, rewriting and editing. *REFERENCE