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

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.