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European Journal of Psychotraumatology logoLink to European Journal of Psychotraumatology
. 2022 Nov 18;13(2):2141510. doi: 10.1080/20008066.2022.2141510

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

Evaluación de la salud mental de estudiantes universitarios ante diferentes confinamientos durante la pandemia, un estudio transversal repetido

疫情期间面临不同封锁的大学生心理健康评估，一项重复性横断面研究

Aziz Essadek a,CONTACT, Florence Gressier b,c, Typhaine Krebs a, Emmanuelle Corruble b,c, Bruno Falissard d,e, Thomas Rabeyron a,f
PMCID: PMC9677981  PMID: 38872601

ABSTRACT

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.

KEYWORDS: COVID-19, university students, depression, anxiety, distress, suicidal ideation

1. Introduction

Since the end of 2019, coronavirus (COVID-19) has spread rapidly around the whole world, infecting more than 500 million people and causing more than 6 million deaths (Ritchie et al., 2020). In order to limit its spread, lockdown measures were taken in many countries to deal with the different waves following the emergence of variants. There are numerous consequences of this pandemic on different populations, and very early on, scientific and medical communities warned of the risk of deterioration in mental health (Brooks et al., 2020). Several studies carried out on the general population have thus highlighted the impact of the pandemic on mental health (Daly et al., 2020; González-Sanguino et al., 2021; Pierce et al., 2020; Shanahan et al., 2020). Anxiety, depression and distress symptoms scores increased significantly during the periods of epidemic peaks and lockdown (González-Sanguino et al., 2021; Gopal et al., 2020; Kikuchi et al., 2020; Niedzwiedz et al., 2021), as well as the suicidal ideation rate (Shi et al., 2021).

Certain populations seem to be more at risk of developing psychological disorders in the context of the current pandemic and therefore need special attention. Young adults (Ayuso-Mateos et al., 2021), in particular women and people in vulnerable situations, are considered to be more exposed to depression and anxiety (Gopal et al., 2020; Kwong et al., 2020; McGinty et al., 2020; Pierce et al., 2020; Savolainen et al., 2021; Wang et al., 2020). Therefore, it would seem that particular attention should be paid to this young population. Many studies underlined the psychological distress of young adults during the first lockdown, in particular within the student population (Essadek & Rabeyron, 2020; Ma et al., 2020; Patsali et al., 2020; Son et al., 2020; Wathelet et al., 2020), with symptoms of depression observed in 34% of students and 32% for symptoms of anxiety (Deng et al., 2021). Social isolation, a sedentary lifestyle and lack of physical activity appeared to be most related to levels of anxiety, distress symptoms and depression in students (Elmer et al., 2020; Essadek & Rabeyron, 2020; Huckins et al., 2020; Zhang et al., 2020), as well as exposure to information about the pandemic spread by the media (Chen et al., 2020; Ma et al., 2020; Wang et al., 2020). Finally, worries about their health and that of their loved ones, and significant concerns about their academic performance and their futures are seen among the main factors of distress symptoms, depression and anxiety (Elmer et al., 2020; Kecojevic et al., 2020; Sundarasen et al., 2020). Online distance learning has also been linked to increased anxiety among students (Sundarasen et al., 2020; Wang et al., 2020). Indeed, the COVID-19 pandemic and blockages forced higher education systems around the world, but also in France, to adapt and solve technical difficulties, resource issues, and restructure the online education system (Maqsood et al., 2021), which may have resulted in adjustment difficulties for students. However, the positive approach to the use of technology and online library services among medical students has been shown to enable them to pursue their educational goals (Rahmat et al., 2022). This invites reflection on adaptive strategies. While a number of factors have therefore been brought to our attention to understand the psychological distress of students, it is important to understand the impact of successive lockdowns on the evolution of these factors. Studies have shown that people's mental health tended to deteriorate during a lockdown period compared to a pre-pandemic period (Winkler et al., 2020). After the first lockdown, a significant decrease in mental health problems also seemed to appear (Amendola et al., 2021; Planchuelo-Gómez et al., 2020; Richter et al., 2021; Wang et al., 2020), with the exception of distress symptoms scores which worsened one month after the lockdown (Wathelet et al., 2021). However, these results need to be extended and confirmed with regards to their evolution throughout the pandemic. Assessing the mental health of a student population at different times of the pandemic would allow us to clarify the strategies necessary to better support these students against the impact of COVID-19 and the different lockdowns put into place. With this in mind, we conducted a study which assesses and compares the mental health of students according to three stages: first lockdown, lifting of lockdown, and second lockdown. The objective of this study was as follows: (1) to assess the mental health of students at different times of the pandemic, over a period of 9 months including 2 lockdowns; (2) to determine which subgroups of students were the most exposed to deteriorating mental health.

2. Methodology and statistical analysis

An online survey, using Lime Survey, was completed by 19,150 students from the University of Lorraine in the Grand Est region of France, the French region most heavily affected by the pandemic. This study was approved by the University of Lorraine and is registered on the research register with the number 2020-115. The study was performed in accordance with the Helsinki Declaration. All participants provided an on-line informed consent. The students completed the questionnaire for the first time during the 6th week of the first lockdown over a period of 4 days (27 April–30 April) (T1). The second time, the students were invited to complete the same questionnaire 7 weeks after the lifting of the lockdown. The questionnaire was opened over a period of 7 days (2 July–9 July) (T2). Then a third time, during the 5th week of the second lockdown (23 November 23–30 November) (T3). Our data systematically studies the mental health of students a week after the deadliest peak seen during the lockdowns.

Socio-demographic data was collected at each stage concerning age, sex, level of studies, financial situation (precarious or not), housing (alone or with other people) and work. Data on exposure to COVID-19 was also assessed: contact with a person positive for COVID-19, symptoms of COVID-19 and COVID-19 diagnosis (by a doctor or with a PCR test). We also questioned the frequency of their outings during these periods, never, rarely (≤1 time per week) or often (≥2 times per week).

Students were also asked to complete three mental health scales, validated in French, to measure the levels of depression (Patient health questionnaire, PHQ-9; range 0-27) anxiety (Generalised Anxiety Disorder, GAD-7; range 0-21) and distress symptoms (Event Impact Scale – Revised, IES-R; range 0-88). The questionnaires were anonymous to ensure the confidentiality and reliability of the data. The threshold was determined for the scores for depression (10)(Manea et al., 2012), anxiety (8) (Plummer et al., 2016) and distress symptoms (26) (Lai et al., 2020). We also wanted to study the rate and frequency of suicidal thoughts. For this, we paid particular attention to question 9 of PHQ-9 (‘Over the last two weeks, how often have you been bothered by thoughts that you would be better off dead, or of hurting yourself in some way’). The possible responses are ‘not at all’, ‘several days’, ‘more than half the days’ and ‘almost every day’. The participant is considered as having suicidal thoughts if they respond ‘several days’, ‘more than half the days’ and ‘almost every day’ (Rossom et al., 2017).

The measurements were carried out in a repeated and cross-sectional way. First, we constructed the weighting system to adjust the specific sample according to sex, precariousness, but also time to compensate for T2 where we obtained fewer participants (Supplementary Material 1). These weights were applied to all calculations of proportions and associations. For the weighting, the Icarus library was used. We then calculated the descriptive characteristics of the sample at each period (T1, T2 and T3) and for the sample as a whole. The values are expressed as numbers and percentages (%) for the non-continuous variables and as averages with standard deviations [SD] for the continuous variables. We then examined the weighted proportion with depression, anxiety, distress symptoms and suicidal ideation at each period of the pandemic stratified by subgroups, based on the socio-demographic characteristics. The results are presented here in the form of percentages with 95% confidence intervals. Finally, we carried out adjusted logistic regressions with T1 as a comparator, in order to assess the risks of increase or decrease in symptoms of depression, anxiety, distress symptoms and suicidal ideation during of the different periods of the pandemic. All variables were considered for the adjusted logistic regression model. The statistical analyses were carried out using R software (4.0.1) and the libraries used are ggplot2, dplyr, corrplot. The rate of significance was defined at p = .05.

3. Results

The characteristics of the entire cohort at each time, without application of the weights are presented in Table 1. The average age of participants was 20 years old (SD, 4.22). Overall, the participants are mainly women (67.72%), study at an undergraduate level (71.01%), live with other people (81.69%), say they are in a precarious situation (57.83%), are unemployed (78.71%), without having had symptoms of COVID-19 (85.08%), without being in contact with people who had contracted COVID-19 (66.53%) and rarely leaving their homes (44.40%) (Table 1). We requested theoretical hexogen data on the University's student population from the University's presidency. Our research highlights an overrepresentation of women and precarious students in our study, which is why we have created a specific weighting system for this data (Supplementary Material 1).

Table 1.

Description T1, T2, T3 and all participant sample (unweighted).

Characteristic 1st lockdown (T1)
N = 8004
n (%) or median [SD]		 Intra-lockdown (T2)
N = 3611
n (%) or median [SD]		 2nd lockdown (T3)
N = 7535
n (%) or median [SD]		 All participant
N = 19150
n (%) or median [SD]
Age 21 [4.2] 21 [4.7] 20 [3.89] 20 [4.22]
Gender        
 Male 2604 (32.53) 1177 (32.59) 2401 (31.86) 6282 (32.28)
 Female 5400 (67.47) 2434 (67.41) 5134 (68.14) 12968 (67.72)
Level        
 Undergrate 5622 (70.24) 2335(64.66) 5642 (74.88) 13599 (71.01)
 Master 2292 (28.64) 1214(33.62) 1835 (24.35) 5341 (27.89)
 PhD student 90 (1.12) 62 (1.72) 58 (0.77) 210 (1.1)
Housing        
 House 4836 (60.42) 1905 (52.76) 3826 (50.78) 10567 (55.18)
 Apartment 2787 (34.82) 1473 (40.79) 3228 (42.84) 7488 (39.1)
Student residence 381 (4.76) 233 (6.45) 481 (6.38) 1095 (5.72)
 Live Alone        
 No 6881 (85.97) 2887 (79.95) 5876 (77.98) 15644 (81.69)
 Yes 1123 (14.03) 724 (20.05) 1659 (22.02) 3506 (18.31)
Precarious        
 No 4735 (59.16) 2163 (59.9) 4176 (55.42) 11074 (57.83)
 Yes 3269 (40.84) 1448 (40.1) 3359 (44.58) 8076 (42.17)
Job        
 No 6673 (83.37) 2226 (61.64) 6174 (81.94) 15073 (78.71)
 Yes 1331 (16.63) 1385 (38.36) 1361 (18.06) 4077 (21.29)
COVID        
 No 6742 (84.23) 3075 (85.15) 6476 (85.94) 16293 (85.08)
 Symptoms not confirmed 1031 (12.88) 432 (11.96) 636 (8.44) 2099 (10.96)
 Confirmed 231 (2.88) 104 (2.88) 423 (5.61) 758 (3.96)
COVID contact        
 No 6073 (75.87) 2392 (66.24) 4276 (56.75) 12741 (66.53)
 Yes 1931 (24.12) 1219 (33.76) 3259 (43.25) 6409 (33.47)
Leaving Home        
 Never 2018 (25.21) 60 (1.88) 744 (9.87) 2830 (14.78)
 Rarely 4042 (50.5) 800 (22.15) 3661 (48.59) 8503 (44.40)
 Often 1944 (24.28) 2743 (75.96) 3130 (41.54) 7517 (40.82)
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A detailed comparison of the prevalence at T1, T2 and T3 of depression, anxiety, distress symptoms and suicidal ideation is presented in Table 2 and by socio-demographic sub-stratification in Supplementary Material 2 (Tables 1–4). At T1 (first lockdown), 40.4% (CI = 39.2–41.5) of students showed symptoms of depression, 30.4% (C1 = 28.9–31.9) symptoms of anxiety, 39.3% (CI = 38.1–40.4) of distress symptoms and 14.2% (CI = 13.5–15.1) suicidal ideation. At T2 (first lifting of the lockdown), we can see a decrease of 10% in symptoms of depression (30.4%, CI = 28.9–31.9), 4.7% in symptoms of anxiety (30.9%, CI = 29.4–32.5), and 16.1% in distress symptoms (23.2%, CI = 21.9–24.6). However, there was no decrease in suicidal ideation during the lifting of lockdown and on the contrary, we see a very slight increase to 0.7% (14.9%, CI = 13.7–16.1). At T3 (second lockdown) we see an increase in the proportion of students showing symptoms of depression by 10.5% (50.9%, CI = 49.7–52.1), symptoms of anxiety by 10.6% (46.2%, CI = 45.1–47.4), and suicidal ideation by 6.7% (20.9%, CI = 19.9–21.8) compared to T1. However, there was no increase in distress symptoms (38.4%, CI = 37.3–39.6) (Table 2). A graphical representation of the assessments at each T is shown in Figure 1.

Table 2.

Prevalence of psychological symptoms by period.

Characteristic 1st lockdown (T1) Intra-lockdown (T2) 2nd lockdown (T3)
Depression symptoms (PHQ-9) 40.4 (39.2-41.5) 30.4 (28.9-31.9) 50.9 (49.7-52.1)
Anxiety symptoms (GAD-7) 35.6 (34.5-36.7) 30.9 (29.4-32.5) 46.2 (45.1-47.4)
Distress symptoms (IES-R) 39.3 (38.1-40.4) 23.2 (21.9-24.6) 38.4 (37.3-39.6)
Ideation suicidal 14.2 (13.5-15.1) 14.9 (13.7-16.1) 20.9 (19.9-21.8)
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Note. The results are expressed as weighted proportions (%) with weighted 95% CIs.

Abbreviation: PHQ-9, 9-item Patient Health Questionnaire; GAD-7, 7-item Generalized Anxiety Disorder; IES-R, 22-item Impact of Event Scale-Revised.

Figure 1.

Figure 1.

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Prevalence of psychological symptoms in the student population between first lockdown, intra-lockdown and second lockdown.

The main results of the logistic regression are shown in Table 3 and the results by symptom and by sub-stratification are shown in Supplementary Material 3. During the lifting of lockdown, we can see a significant decrease in the risk of depression symptoms (aOR = 0.64 (0.59–0.70) p < .001); anxiety symptoms (aOR = 0.81 (0.74–0.88) p < .001); and distress symptoms (aOR = 0.47 (0.43–0.51) p < .001). However, there was no decrease in suicidal ideation (aOR = 1.05 (0.94–1.18) p = .07). Overall, we see a consistent reduction in depression symptoms in the different subgroups during the lifting of lockdown. Students living in student housing are those who had the greatest reduction (aOR = 0.48 (0.34–0.58) p < .001) during the lifting of lockdown. Conversely, there was no significant reduction in depression symptoms for PhD students (aOR = 1.11 (0.48–2.52) p = .812) and students who has contracted COVID-19 (aOR = 0.89 (0.55–1.44) p = .629). We find the same trend for both the consistent reduction of anxiety symptoms, suicidal ideation and distress symptoms, but also for the lack of reduction for PhD students and students confirmed positive for COVID-19 (Supplementary Material 3).

Table 3.

Risk of psychological symptoms and suicidal ideation during Intra-lockdown and the second lockdown of the COVID-19 pandemic compared to the first lockdown in the sample.

Characteristic Intra-lockdown (T2) p Value 2nd lockdown (T3) p Value
Depression symptoms (PHQ-9)        
 Unadjusted 0.60 (0.56-0.66) < .001 1.52 (1.43-1.62) < .001
 Adjusted 0.64 (0.59-0.70) < .001 1.53 (1.43-1.64) < .001
Anxiety symptoms (GAD-7)        
 Unadjusted 0.74 (0.68-0.80) < .001 1.55 (1.45-1.65) < .001
 Adjusted 0.81 (0.74-0.88) < .001 1.56 (1.45-1.67) < .001
Distress symptoms (IES-R)        
 Unadjusted 0.43 (0.39-0.47) < .001 0.93 (0.87-0.99) p = 0.027
 Adjusted 0.47 (0.43-0.51) < .001 0.96 (0.90-1.03) p = 0.080
Ideation suicidal        
 Unadjusted 1.01 (0.91-1.13) p = 0.80 1.57 (1.45-1.71) < .001
 Adjusted 1.05 (0.94-1.18) p = 0.07 1.59 (1.45-1.73) < .001
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Note. Weighted unadjusted and adjusted odds ratios (OR) with 95% confidence intervals (CI).

Abbreviation: PHQ-9, 9-item Patient Health Questionnaire; GAD-7, 7-item Generalized Anxiety Disorder; IES-R, 22-item Impact of Event Scale-Revised.

During the second lockdown, we saw a significant increase in depression symptoms (aOR = 1.53 (1.43–1.64) p < .001); anxiety symptoms (aOR = 1.56 (1.45–1.67) p < .001); and suicidal ideation (aOR = 1.57 (1.45–1.71) p < .001) compared to the first lockdown. However, distress symptoms remained stable and did not increase (aOR = 0.96 (0.90–1.03) p = .303). Among the different student populations, we found that PhD students show the most significant increase in depression symptoms (aOR = 2.78 (1.28–6.03) p < .001), anxiety symptoms (aOR = 1.92 (1.62–2.26) p < .001), and suicidal ideation (aOR = 4.37 (1.41–13.54) p = .01). Furthermore, only employed students had a significant increase in distress symptoms compared to the first lockdown (aOR = 1.26 (1.07–1.49) p = .006). The subgroups of students with the least significant evolution of distress symptoms are students living in student housing (aOR = 1 (0.75–1.33) p = .997) and students whose diagnosis of COVID-19 has been confirmed (aOR = 1.09 (0.77–1.55) p = .616). We also find this trend for anxiety symptoms, and these same groups are those who had the most significant reduction of distress symptoms during the second lockdown; Student housing (aOR = 0.63 (0.47–0.84) p = .002); COVID (aOR = 0.65 (0.46–0.92) p = .02).

4. Discussion

The objective of this study was to assess the evolution of students’ mental health at three different stages of the pandemic (lockdown, the lifting of lockdown, second lockdown). Our results show a significant reduction in depression, anxiety and distress symptoms during the lifting of lockdown. More specifically, the proportion of students with a score of depression is 30.4%, and of anxiety 30.9% during the lifting of lockdown, which is lower than the results of a meta-analysis on the first lockdown (Deng et al., 2021). When interpreting the results for the lifting of lockdown, we must take into consideration that the period during which we collected the data corresponds to a university holiday and therefore may be influenced by the fact that exams were finished. Our results differ from those described in several studies which underline the lack of reduction in psychological distress, especially in Spain (Planchuelo-Gómez et al., 2020) and in China (Li et al., 2021). However, our results confirm those obtained during different studies also conducted in China (Wang et al., 2020) and Switzerland (Amendola et al., 2021; Volken et al., 2021), where the studies were carried out during and just after the lockdowns, without being during a holiday period. They also confirm the results of the review by Richter (Richter (Richter et al., 2021) which highlights a slight decrease in mental health problems during the lifting of lockdown). This decrease can be explained particularly by the relaxation of restrictions which allowed for the return of a more normal social life for students. However, the level of students with suicidal thoughts did not decrease, which confirms the results of a Spanish study (Ayuso-Mateos et al., 2021). High scores of suicidal ideation during the lifting of lockdown can be explained by the relation between distress symptoms and suicidal ideation (Panagioti et al., 2011). In fact, a French study showed that 78.8% of students showed probable distress symptoms one month after the lifting of lockdown (Wathelet et al., 2021).

Our results also show a decrease in psychological distress for all subgroups at T2 (Supplementary Material 2), except for PhD students and students who had a diagnosis of COVID-19. This seems to confirm the strong impact on psychological distress from contracting COVID-19, which was highlighted in studies during the first wave (Browning et al., 2021; Cao et al., 2020; Essadek & Rabeyron, 2020; Ma et al., 2020; Tang et al., 2020). Our study also showed that PhD students did not see their mental health improve during the lifting of the lockdown. In fact, they show scores for depression, anxiety and distress symptoms at the same level as during the first lockdown. The mental health of PhD students before the pandemic was already known to be fragile, as was shown particularly in a study carried out in the USA highlighting high scores for depression (41%) and anxiety (39%) (Evans et al., 2019). The difficulty in being able to conduct their research and interact with their research supervisors in a pandemic context has probably promoted this psychological deterioration in PhD students. This hypothesis has also been highlighted for post-doctoral researchers (Ahmed et al., 2020) who are, like PhD students, in precarious positions and therefore exposed to psychological distress (Satinsky et al., 2021). We can also question the impact of the work continuity of PhD students, which means that they do not have the same evaluation deadlines and holidays as other students.

During the second lockdown (T3), we see deterioration in students’ mental health compared to the first lockdown. Thus, our results demonstrate a significant increase in scores for depression (40.4% vs 50.9%), anxiety (35.6% vs 46.2%) and suicidal thoughts (14.2% vs 20.9%). The risks of depression, anxiety and suicidal ideation therefore appear to be greatly increased during this second lockdown. We note on the other hand that the rate of distress symptoms remained at the same level as that obtained during the first lockdown. These results add to those of other studies which show psychological distress follows the dynamic of the pandemic, without being correlated to the deadliest peak (Volken et al., 2021). Therefore, other factors seem to come into play to explain this increase in psychological distress. Thus, the repetition of the lockdowns could have amplified the students’ uncertainties and worries, the importance of which had already been highlighted by studies during the first lockdown (Moreno et al., 2020).

The worry of reliving a lockdown may have been a catalyst for anxiety and depression disorders. Worry about life situations has been thought of as the cardinal symptom of anxiety disorders (Crocq, 2017; Tye et al., 2011). Whilst the lifting of lockdown, the return of festivities and the end of health restrictions could have given students the illusion of the end of the epidemic, the second lockdown was therefore able to reactivate a deep feeling of uncertainty, already linked to a deterioration in mental health (Rettie & Daniels, 2021). Financial uncertainty, uncertainty in their studies (Crawford et al., 2020; Franchi, 2020), but also uncertainty as to the duration of the pandemic and of the restriction measures, are all factors that can influence a deterioration in students’ mental health and explain the significant increase in depression and anxiety scores during the second lockdown.

Added to this is the collapse of social connections with the second lockdown and the more systematic establishment of distance classes. However, social support is an essential element in stopping suicidal thoughts and behaviours (Calati et al., 2019; Klonsky et al., 2016) because it offers students a feeling of belonging to meaningful interactions which seem to be a protective factor during the lockdown (Ayuso-Mateos et al., 2021; Gratz et al., 2021; Joiner et al., 2005).

During the second lockdown, the categories of students the most at risk are almost the same as during the first lockdown: being a woman, living alone and in a situation of financial insecurity, which confirms the results of several studies (Browning et al., 2021; Debowska et al., 2020; Elmer et al., 2020; Essadek & Rabeyron, 2020; Kecojevic et al., 2020; Wathelet et al., 2020). The situation in which a great number of students thus find themselves seems to produce a cumulative effect of anxiety and depression symptoms. We also see that PhD students, who were not identified as a population at risk during the first lockdown, saw their situation deteriorate significantly and to a greater extent than all the other subgroups during the second lockdown.

Conversely, students who contracted COVID, did not show an increase in anxiety symptoms, nor distress. This suggests that after contracting COVID, the increased safety provided by containment may have been a relief for students who were aware that COVID was a real risk, but also that containment limited the risk of transmission, especially to family members (Ferreira et al., 2021).

Finally, it should be noted that this study has several limitations. Even though the data was collected within the same university, the sampled student population is not completely identical at T1, T2 and T3. Being unable to match the respondents, we did not measure individual changes, but only measured the global trend. Therefore, no causal inference can be offered. Moreover, despite a high number of students who responded, the sample only represents 13% of the overall student population, with variations in their levels of participation (some students responded more in periods of lockdown than in the lifting of lockdown). Thus, certain groups are poorly represented, in particular PhD students (210), which limits the generalisation of the results. Finally, it should be noted that there are certain potential biases in the recruitment of participants. For example, participants suffering psychologically may have had a tendency to respond more (to speak about their suffering) or on the contrary, respond less (because of living with depression).

5. Conclusion

These results consistently show a significant increase in depression, anxiety and suicidal ideation during the second lockdown despite less strict conditions than the first. The different indicators highlighted in this study make it possible to identify the socio-demographic subgroups of students most at risk, which allows us to better understand the need for psychological support at the university and to put that support into place. These results highlight the importance of paying more attention to the mental health of PhD students who appear in this study to be the population that has deteriorated the most. From a preventative perspective, maintaining certain face-to-face classes with barrier measures could allow students to maintain sufficient social connections. It would also be pertinent to set up a mentoring system among students to ensure that they feel like they belong to the student community. And for PhD students, maintaining seminars between students during the lockdown and guidance by academic supervisors would avoid them finding themselves in a situation of isolation again. In addition to these preventative elements, in order to respond to care needs, the creation of psychological support spaces for students would allow them to turn towards appropriate help. In this context, a study among students on the use of care services would allow us to understand the impact and effectiveness of different forms of support offered.

Ethical approval

This study was approved by the University of Lorraine and is registered in the research register under number 2020-115.

Supplementary Material

Supplemental Material
Click here for additional data file. (664.5KB, pdf)

Acknowledgements

Concept and design: AE and TR; Statistical analysis: AE; Acquisition, analysis, or interpretation of data: All authors; Drafting the manuscript: AE, FG, TR; Critical revision of the manuscript for important intellectual content: All authors; Supervision: AE, FG, TR, BF

Disclosure statement

No potential conflict of interest was reported by the author(s).

Data availability statement

The datasets used and/or analyzed during the current study available from the corresponding author on reasonable request.

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Associated Data

This section collects any data citations, data availability statements, or supplementary materials included in this article.

Supplementary Materials

Supplemental Material
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Data Availability Statement

The datasets used and/or analyzed during the current study available from the corresponding author on reasonable request.

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