Attention deficit hyperactivity disorder symptoms and cannabis use after 1 year among students of the i-Share cohort

ADHD; Cannabis; StudentsTDAH; Canabis; EstudiantesTDAH; Cànnabis; EstudiantsBackground Cannabis use in university students is associated with academic achievement failure and health issues. The objective of the study was to evaluate the association between attention deficit hyperactivity disorder (ADHD) symptoms and cannabis use after 1 year among students according to previous cannabis use. Methods Students in France were recruited from February 2013 to July 2020 in the i-Share cohort. 4,270 participants were included (2,135 who never used cannabis at inclusion and 2,135 who did). The Adult ADHD Self-Report Scale (ASRS) was used to assess ADHD symptoms at inclusion. Cannabis use frequency was evaluated 1 year after inclusion. Multinomial regressions were conducted to assess the association between inclusion ADHD symptoms and cannabis use after 1 year. Results Increase in ASRS scores was linked with a greater probability to use cannabis after 1 year and to have a higher cannabis use frequency (once a year—once a month adjusted odds ratio [OR]: 1.24 (1.15–1.34), more than once a month adjusted OR: 1.43 (1.27–1.61)). Among participants who never used cannabis at inclusion, this association disappeared (once a year—once a month adjusted OR: 1.15 (0.95–1.39), more than once a month adjusted OR: 1.16 (0.67–2)) but remained in participants who ever used cannabis at inclusion (once a year—once a month adjusted OR: 1.17 (1.06–1.29), more than once a month adjusted OR: 1.35 (1.18–1.55)). Conclusions High levels of ADHD symptoms in students could lead to continued cannabis use rather than new initiations.The preparation and initiation of the i-Share project was funded by the program ‘Invest for future’ (reference ANR-10-COHO-05). The i-Share Project is currently supported by an unrestricted grant from the Nouvelle-Aquitaine Regional Council (Conseil Régional Nouvelle-Aquitaine) (grant number: 4370420) and by the Bordeaux ‘Initiatives d’excellence’ (IdEx) program of the University of Bordeaux (ANR-10-IDEX-03-02). It has also received grants from the Nouvelle-Aquitaine Regional Health Agency (Agence Régionale de Santé Nouvelle-Aquitaine, grant N°6066R-8 R-8), Public Health France (Santé Publique France, grant number: 19DPPP023–0), the National Cancer Institute (Insitut national du cancer, grant number: INCa_11502), and the Medical Research Foundation (Fondation pour la recherche)

BMJ Open

OBJECTIVES: The aim of the study was to estimate the association between self-esteem and subsequent self-rated health during college years, taking into account a wide range of potential confounders. DESIGN: Prospective longitudinal study. SETTING: The French i-Share cohort. PARTICIPANTS: The sample consisted of 1011 college students. PRIMARY AND SECONDARY OUTCOME MEASURES: The association between self-esteem and later self-rated health was evaluated using multivariate modelling.Data regarding self-rated health, global self-esteem and demographic, educational, social, behavioural, environmental and financial characteristics were collected through an internet-based questionnaire. RESULTS: The 1011 participants had a median age of 21.9 years and 79% (795/1011) were females. Self-rated health was assessed a median of 8 months after the self-esteem measurement. Twenty per cent of the students declared average to very poor health (203/1011). Students with higher levels of self-esteem were more likely to declare good or very good self-rated health (adjusted OR=1.40, 95% CI 1.15 to 1.72, p value=0.001). Other factors associated with good or very good self-rated health were low body mass index, a comfortable financial situation during childhood and three personality traits (low persistence and harm avoidance and high cooperativeness). CONCLUSIONS: This study offers novel findings on the impact of self-esteem on self-rated health among college students. Interventions targeting self-esteem should be experimented during university years in order to improve health outcomes

Mental health condition of college students compared to non-students during COVID-19 lockdown: the CONFINS study

OBJECTIVES: To estimate the effect of student status on mental health condition during COVID-19 general lockdown in France. DESIGN: Cross-sectional analysis comparing students and non-students recruited in the same study. SETTING: Participants of the web-based CONFINS study implemented during the general lockdown in France in spring 2020. PARTICIPANTS: 2260 participants (78% women) including 1335 students (59%). PRIMARY AND SECONDARY OUTCOME MEASURES: Through an online questionnaire, participants declared if they have experienced suicidal thoughts, coded their perceived stress on a 10-points scale and completed validated mental health scales (Patient Health Questionnaire-9 for depressive symptoms, Generalised Anxiety Disorder-7 for anxiety symptoms) during the last 7 days. The effect of college student status on each mental health condition was estimated using multivariate logistic regression analyses. Stratified models for students and non-students were performed to identify population-specific factors. RESULTS: Student status was associated with a higher frequency of depressive symptoms (adjusted OR (aOR)=1.58; 95% CI 1.17 to 2.14), anxiety symptoms (aOR=1.51; 95% CI 1.10 to 2.07), perceived stress (n=1919, aOR=1.70, 95% CI 1.26 to 2.29) and suicidal thoughts (n=1919, aOR=1.57, 95% CI 0.97 to 2.53). Lockdown conditions that could be potentially aggravating on mental health like isolation had a higher impact on students than on non-students. CONCLUSIONS: College students were at higher risk of mental health disturbances during lockdown than non-students, even after taking into account several potential confounding factors. A close follow-up and monitoring of students' mental health status is warranted during lockdown periods in this vulnerable population

Attention deficit hyperactivity disorder symptoms and cannabis use after one year among students of the i-Share cohort

International audienceBackground. Cannabis use in university students is associated with academic achievement failure and health issues. The objective of the study was to evaluate the association between attention deficit hyperactivity disorder (ADHD) symptoms and cannabis use after 1 year among students according to previous cannabis use.Methods. Students in France were recruited from February 2013 to July 2020 in the i-Share cohort. 4,270 participants were included (2,135 who never used cannabis at inclusion and 2,135 who did). The Adult ADHD Self-Report Scale (ASRS) was used to assess ADHD symptoms at inclusion. Cannabis use frequency was evaluated 1 year after inclusion. Multinomial regressions were conducted to assess the association between inclusion ADHD symptoms and cannabis use after 1 year.Results. Increase in ASRS scores was linked with a greater probability to use cannabis after 1 year and to have a higher cannabis use frequency (once a year-once a month adjusted odds ratio [OR]: 1.24 (1.15-1.34), more than once a month adjusted OR: 1.43 (1.27-1.61)). Among participants who never used cannabis at inclusion, this association disappeared (once a year-once a month adjusted OR: 1.15 (0.95-1.39), more than once a month adjusted OR: 1.16 (0.67-2)) but remained in participants who ever used cannabis at inclusion (once a year-once a month adjusted OR: 1.17 (1.06-1.29), more than once a month adjusted OR: 1.35 (1.18-1.55)). onclusions. High levels of ADHD symptoms in students could lead to continued cannabis use rather than new initiations

L’estime de soi chez les étudiants à l’université : liens avec les comportements de santé et les problèmes de santé mentale et physique

Self-esteem is defined by the « feeling of self-appreciation ». It is built in childhood then evolves with the social environment and life events. College years corresponding generally to the period of young adulthood and is a particular developmental period due to changes in the social environment and frequent problems of mental health and substance use. It is also a period of vulnerability for self-esteem. College years could therefore be an interesting period to investigate the specific links between self-esteem and health. The purpose of this thesis was to conduct epidemiological studies to estimate the links between self-esteem and health behaviors, physical and mental health among university students.First, a systematic review of the literature synthesized empirical evidence on the relationships between self-esteem and health-related behaviors (i.e. substance use, sexual behavior, physical activity, and nutrition). High self-esteem was associated with more physical activity and less extreme health-related behaviors (extreme alcohol consumption, use of condoms). However, mixed results regarding alcohol consumption and number of sexual partners and a lack of research for smoking, drug use and nutrition have been highlighted. Next, two studies were conducted on a sub-sample of the i-Share cohort; a prospective French longitudinal study following nearly 15,000 volunteers studying at the university since 2013. Thus, the second study of this thesis aimed at estimating the association between self-esteem and self-rated health one year after. Of the 1,011 participants included in the study, 20% reported having average or poor health. Students with higher self-esteem were more likely to have a better perception of their health (odds ratio = 1.4, 95% confidence interval = 1.2 to 1.7). A third study aimed to investigate the mediating role of self-esteem in the link between ADHD symptoms and suicidal thoughts. Of the 2,631 participants included in the study, 17% reported having suicidal thoughts at one-year follow-up. ADHD symptoms were associated with suicidal thoughts (beta = 0.2, 95% confidence interval = 0.1 to 0.2). Self-esteem mediated 44% of the total effect and was involved in 60% of the total effect when depression was also a mediator.Self-esteem is a factor of interest in youth health and interventional research could target this psychological factor. Furthermore, because the concept of self-esteem is complex and the study population was specific, further researches could be conducted to confirm these results with different measurement tools of self-esteem (especially to reveal multidimensional aspect) and representative populations.L’estime de soi est définie par le « sentiment que chacun a de sa propre valeur ». Elle se construit dans l’enfance puis évolue avec l’environnement social et les évènements de vie. Les études universitaires correspondent généralement à la période de jeune adulte et constitue une période développementale particulière en raison des modifications de l’environnement social et des problèmes fréquents de santé mentale et de consommation de substances. C’est aussi une période de vulnérabilité pour l’estime de soi. Les études universitaires pourraient donc représenter une période intéressante pour investiguer les liens spécifiques entre l’estime de soi et la santé. Cette thèse d’université avait pour objectif de mener des études épidémiologiques afin d’estimer les liens entre l’estime de soi et les comportements liés à la santé, la santé physique et la santé mentale chez des étudiants à l’université.Tout d’abord, une revue systématique de la littérature a permis de synthétiser les données empiriques sur les relations entre l’estime de soi et les comportements liés à la santé (i.e. consommation de substances, comportement sexuel, activité physique et nutrition). Une haute estime de soi était associée à une activité physique plus élevée et moins de comportements extrêmes liés à la santé (consommation extrême d’alcool, utilisation de préservatifs). Cependant, des résultats mixtes concernant la consommation d’alcool et nombre de partenaires sexuels et un manque de recherche pour la consommation de tabac, de drogues et la nutrition ont été mis en évidence. Ensuite, deux études ont été menées sur un sous-échantillon de la cohorte i-Share ; une étude française prospective longitudinale suivant près de 15000 volontaires étudiants à l’université depuis 2013. Ainsi, la deuxième étude de cette thèse avait pour objectif d’estimer l’association entre l’estime de soi et la santé perçue par l’étudiant un an après. Sur les 1011 participants inclus dans l’étude, 20% déclaraient avoir une santé moyenne ou mauvaise. Les étudiants avec une estime de soi plus élevée avaient une probabilité plus importante d’avoir une meilleure perception de leur santé (Rapport de côtes=1,4, intervalle de confiance à 95%=1,2 à 1,7). Une troisième étude avait pour objectif d’investiguer le rôle de médiateur de l’estime de soi dans le lien entre les symptômes du TDA/H et les pensées suicidaires. Parmi les 2631 participants inclus dans l’étude, 17% avaient déclaré avoir eu des pensées suicidaires lors du suivi à un an. Les symptômes du TDA/H étaient associés aux pensées suicidaires (béta=0,2, intervalle de confiance à 95%=0,1 à 0,2). L’estime de soi médiait 44% de l’effet total et était impliquée dans 60% de l’effet total quand la dépression était également médiateur.L’estime de soi est un facteur d’intérêt dans le cadre de la santé des jeunes et des recherches interventionnelles pourraient cibler ce facteur psychologique. D’autre part, le concept d’estime de soi étant complexe et la population d’étude étant spécifique, des recherches pourraient être menées afin de confirmer ces résultats avec des échelles de mesure de l’estime de soi différentes (notamment pour capter l’aspect multidimensionnel) et sur des populations représentatives

Self-esteem among college students : relations between health-related behaviors, mental and physical health problems

L’estime de soi est définie par le « sentiment que chacun a de sa propre valeur ». Elle se construit dans l’enfance puis évolue avec l’environnement social et les évènements de vie. Les études universitaires correspondent généralement à la période de jeune adulte et constitue une période développementale particulière en raison des modifications de l’environnement social et des problèmes fréquents de santé mentale et de consommation de substances. C’est aussi une période de vulnérabilité pour l’estime de soi. Les études universitaires pourraient donc représenter une période intéressante pour investiguer les liens spécifiques entre l’estime de soi et la santé. Cette thèse d’université avait pour objectif de mener des études épidémiologiques afin d’estimer les liens entre l’estime de soi et les comportements liés à la santé, la santé physique et la santé mentale chez des étudiants à l’université.Tout d’abord, une revue systématique de la littérature a permis de synthétiser les données empiriques sur les relations entre l’estime de soi et les comportements liés à la santé (i.e. consommation de substances, comportement sexuel, activité physique et nutrition). Une haute estime de soi était associée à une activité physique plus élevée et moins de comportements extrêmes liés à la santé (consommation extrême d’alcool, utilisation de préservatifs). Cependant, des résultats mixtes concernant la consommation d’alcool et nombre de partenaires sexuels et un manque de recherche pour la consommation de tabac, de drogues et la nutrition ont été mis en évidence. Ensuite, deux études ont été menées sur un sous-échantillon de la cohorte i-Share ; une étude française prospective longitudinale suivant près de 15000 volontaires étudiants à l’université depuis 2013. Ainsi, la deuxième étude de cette thèse avait pour objectif d’estimer l’association entre l’estime de soi et la santé perçue par l’étudiant un an après. Sur les 1011 participants inclus dans l’étude, 20% déclaraient avoir une santé moyenne ou mauvaise. Les étudiants avec une estime de soi plus élevée avaient une probabilité plus importante d’avoir une meilleure perception de leur santé (Rapport de côtes=1,4, intervalle de confiance à 95%=1,2 à 1,7). Une troisième étude avait pour objectif d’investiguer le rôle de médiateur de l’estime de soi dans le lien entre les symptômes du TDA/H et les pensées suicidaires. Parmi les 2631 participants inclus dans l’étude, 17% avaient déclaré avoir eu des pensées suicidaires lors du suivi à un an. Les symptômes du TDA/H étaient associés aux pensées suicidaires (béta=0,2, intervalle de confiance à 95%=0,1 à 0,2). L’estime de soi médiait 44% de l’effet total et était impliquée dans 60% de l’effet total quand la dépression était également médiateur.L’estime de soi est un facteur d’intérêt dans le cadre de la santé des jeunes et des recherches interventionnelles pourraient cibler ce facteur psychologique. D’autre part, le concept d’estime de soi étant complexe et la population d’étude étant spécifique, des recherches pourraient être menées afin de confirmer ces résultats avec des échelles de mesure de l’estime de soi différentes (notamment pour capter l’aspect multidimensionnel) et sur des populations représentatives.Self-esteem is defined by the « feeling of self-appreciation ». It is built in childhood then evolves with the social environment and life events. College years corresponding generally to the period of young adulthood and is a particular developmental period due to changes in the social environment and frequent problems of mental health and substance use. It is also a period of vulnerability for self-esteem. College years could therefore be an interesting period to investigate the specific links between self-esteem and health. The purpose of this thesis was to conduct epidemiological studies to estimate the links between self-esteem and health behaviors, physical and mental health among university students.First, a systematic review of the literature synthesized empirical evidence on the relationships between self-esteem and health-related behaviors (i.e. substance use, sexual behavior, physical activity, and nutrition). High self-esteem was associated with more physical activity and less extreme health-related behaviors (extreme alcohol consumption, use of condoms). However, mixed results regarding alcohol consumption and number of sexual partners and a lack of research for smoking, drug use and nutrition have been highlighted. Next, two studies were conducted on a sub-sample of the i-Share cohort; a prospective French longitudinal study following nearly 15,000 volunteers studying at the university since 2013. Thus, the second study of this thesis aimed at estimating the association between self-esteem and self-rated health one year after. Of the 1,011 participants included in the study, 20% reported having average or poor health. Students with higher self-esteem were more likely to have a better perception of their health (odds ratio = 1.4, 95% confidence interval = 1.2 to 1.7). A third study aimed to investigate the mediating role of self-esteem in the link between ADHD symptoms and suicidal thoughts. Of the 2,631 participants included in the study, 17% reported having suicidal thoughts at one-year follow-up. ADHD symptoms were associated with suicidal thoughts (beta = 0.2, 95% confidence interval = 0.1 to 0.2). Self-esteem mediated 44% of the total effect and was involved in 60% of the total effect when depression was also a mediator.Self-esteem is a factor of interest in youth health and interventional research could target this psychological factor. Furthermore, because the concept of self-esteem is complex and the study population was specific, further researches could be conducted to confirm these results with different measurement tools of self-esteem (especially to reveal multidimensional aspect) and representative populations

Étude CONFINS sur la santé mentale des étudiants français lors du confinement en lien avec la COVID-19

International audienc

Personality and Individual Differences

The aim of the present study was to investigate self-esteem associated factors related to childhood/adolescence or young-adulthood in male and female college students. Based on the i-Share cohort, childhood/adolescence and young-adulthood related factors were collected at study enrolment. Three months later, global self-esteem was evaluated through the Rosenberg Self-esteem Scale. Linear regression models were performed for the different time period factors (childhood/adolescence factors, young-adulthood factors) and R-squared were computed for each model. Among the 6602 college students included, 78.8 % were female with a mean age of 20.7 (SD = 2.2) and mean self-esteem score of 27.6 (SD = 5.7) for females and 30.3 (SD = 5.7) for males. Low self-esteem was associated with factors related to childhood/adolescence (weak parental support, life events, parents with depression or anxiety problems) and young adulthood (freshmen year, high BMI, dissatisfaction with social life, not practicing sports or extra-university activities). Factors related to young adulthood seem to explain more variability among males than factors related to childhood/adolescence (9 % versus 5 %), whereas the opposite was observed for females (5 % versus 7 %). Interventions targeting self-esteem should address several factors that consider period of life and gender to intervene efficiently (during childhood/adolescence for females and young-adulthood for males). © 2023 Elsevier Lt

Adverse childhood experiences and substance use among university students: a systematic review

Objective To perform a critical review of studies examining the relation between adverse childhood experiences (ACEs) and substance use (SU) among university students. Methods Observational studies reporting SU of university students for whom ACEs were assessed were identified using PubMed, CINAHL, PsycINFO & ERIC and Web of Science from January 1998 to September of 2021. The study protocol was registered with PROSPERO: CRD42021277882. Results Of 450 articles screened, 16 met inclusion criteria, including 53,433 university students with and without ACEs exposure from 17 countries. University students reporting ACEs had an increased risk of alcohol, tobacco, marijuana, prescription-medication, and illicit drug consumption compared to students not reporting ACEs. Having four or more ACEs heightened likelihood of SU. A dose-response relationship between ACEs and SU was reported for each substance. The relationship between ACE type and SU is presented. Conclusions University students with higher levels of ACEs have increased probability of SU. The relationship between ACEs and substance type varies, with ACEs having the greatest association with tobacco and illicit drug use. Findings underline that university students may benefit from ACE screening to help identify those at higher risk of SU and engage them in preventive or therapeutic strategies

Correction to : Factors related to increased alcohol misuse by students compared to nonstudents during the first Covid-19 lockdown in France: the confins study

International audienc