College students' mental distress still high 15 months after COVID pandemic began

College student deep in thought

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A survey of nearly 45,000 college students in France reveals a high prevalence of stress, anxiety, depression, suicidal thoughts, and post-traumatic stress disorder (PTSD) 15 months after the COVID-19 pandemic began.

A team led by a researcher from the Centre Hospitalo-Universitaire de Lille fielded the third of three online mental health surveys among 44,898 university students at 82 French universities from Jul 21 to Aug 31, 2021.

High prevalence of anxiety, PTSD

Most respondents (70.7%) were women, and the median age was 19 years. The first survey was conducted after the first pandemic lockdown (T1), and the second was sent 1 month after the lockdown ended (T2).

Half of the students (50.6%) were in their first year of college, 81.9% were bachelor students, and 2.0% were in the sixth year or more. A total of 7.3% reported being from another country, 1.5% had children, 44.3% lived in an urban area, 26.3% resided in a suburb, and 29.4% lived in a rural setting.

About 1 in 8 students reported having major financial difficulties (13.0%), a figure that rose to 1 in 3 (35.3%) when considering both major and moderate financial difficulties. A total of 8.9% of respondents said they had a history of psychiatric illness, 10.5% said they had a chronic condition, 27.0% said they previously had COVID-19, 4.5% of respondents said they were socially isolated, and the median score of quality of COVID-19 information they had been given was 5 out of 10.

There was a high prevalence of stress (20.6%), anxiety (23.7%), depression (15.4%), suicidal thoughts (13.8%), and PTSD (29.7%) 15 months after the pandemic began (T3). Relative to rates at T2, stress, anxiety, and depression rose by 2.5%, 13.9%, and 22.2%, respectively, by T3. The rate of suicidal thoughts continued to rise from T1 (10.6%) to T3 (13.8%), and the prevalence of suspected PTSD climbed from 1 in 5 students to 1 in 3 from T2 to T3.

'Severe long-lasting consequences'

Those most at risk for all poor outcomes at T3 were women and nonbinary respondents, those without children and living in an urban area, and those with financial problems, an underlying medical condition, a history of psychiatric problems and/or COVID-19 infection, social isolation, and a low view of the information received or seen in the media on SARS-CoV-2. The lower the perceived quality of COVID-19 information, the higher the risk for severe mental health issues.

For example, odds ratios (ORs) ranged from 1.25 for PTSD to 1.36 for suicidal thoughts if they rated the quality of COVID-19 information with a score between 4 and 5 rather than a score greater than 6 and from 1.57 for suicidal thoughts to 1.80 for PTSD if they gave the materials a score less than 4.

The lower the perceived quality of COVID-19 information received, the higher the risk for severe mental health issues.

The adjusted OR for stress among women was 2.18, while it was 5.09 for suicidal thoughts among nonbinary students, 0.68 for anxiety among students with children, and 0.80 for depression among those living in a rural area.

"These results suggest severe long-lasting consequences associated with the pandemic on the mental health of students," the researchers wrote. "Prevention and care access should be a priority."

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