Used and foregone of primary care in French university students

Abstract Background University students tend to find it difficult to ask for help especially when it comes to health issues. The objective of the study was to determine the health issues of general practitioner and the reasons of primary care foregone in university students. Methods A cross sectional study was conducted in 2018 in Normandy university students (France). The socio demographic characteristics of the university students were collected. The primary care seeking during the previous 12 months were assessed by the consultation to the general practitioner and categorized: acute physical issues (stomach aches, cough ...), chronic physical issues (asthma, diabetes...), mental health issues (stress, anxiety...) and preventive medicine (vaccine, certificate...). The foregone of primary care during the previous 12 months and the barriers to accessing primary health-care-seeking were also collected. Results 1179 university students (58.0% of women, age mean 20.4 years) were included. Frequency of health issues in the last 12 months were preventive issues (57.2%), acute physical issues (52.2%), chronic physical issues (16.7%) and psychological issues (18.4%). The foregone of primary care of the university students was reported by 20.5% of university students. The three main barriers reported by these students to accessing primary health-care-seeking behaviour were self-treatment (60.6%), lake of time (64.7%) and financial barriers (25.4%). Logistic regression showed that the foregone of primary care was positively associated with being female students AOR=1.69 CI95% (1.21-2.36), grant holder AOR=1.52 CI95% (1.10-2.02), and living in rented accommodation AOR=1.47 CI95% (1.03-2.02). Conclusions Half of university students consult the general practitioner for physical concerns and one fifth for psychological disorders. However with 20% of primary care foregone by university students, the access of primary care in the targeted population could be improved. Key messages One fifth of university students foregoes to primary care. Female students, grant holder and living in accommodation are the risk factors of foregone of primary care. </jats:sec

Depression, anxiety stress and associated factors among university students in France

Abstract Background Graduate education is associated with many life changes and stressful events for students, potentially causing depression, anxiety and stress. Prevalence of these disorders and potential associated factors are not clearly identified. Methods A cross-sectional study was conducted among university students in France. The students filled out a self-questionnaire recording depression anxiety and stress with the DASS21. High” and “very High” intensity symptoms were grouped into “presence” of depression, anxiety and stress and “moderate” “light” “normal” were grouped into “absence” of depression, anxiety and stress. Curriculum, perceived academic pressure, financial difficulties, smoking, binge drinking and eating disorders were also recording. Results A total of 1,202 students were included of which 17.8% were healthcare students. The sex ratio (M:F) was of 0.42 with a mean age of 20.0 years. Prevalence of depression, anxiety and stress were respectively 16.4%, 26.4% and 16.0%. After multivariate analysis, female gender was associated with presence of stress (AOR=1,41 IC 95% [1,03-1,93]). High level of perceived academic pressure (AOR=2,13 [1,61-2,82], 2,05 [1,57-2,68], 2,35 [1,72-3,22]) financial difficulties (AOR=1,33 [1,03-1,73], 1,54 [1,19-1,99], 1,37 [1,04-1,82]) and eating disorders (AOR=2,46 [1,83-3,31], 2,36 [1,75-3,19], 2,21 [1,63-23]) were associated with presence of depression, anxiety and stress. Binge drinking (AOR=1,48 [1,05-2,09]) and smoking (AOR=1,46 [1,01-2,13]) were associated with anxiety. Conclusions These results show prevalence of depressive, anxiety and stress symptoms among students. Poor mental health is related to academic and financial difficulties, and is associated especially with eating disorders. There is a pressing need to prioritize mental health of college students through the national public health policies. Additional studies are needed to better understand the relationships between these different factors. Key messages There is a significant prevalence of depression, anxiety and stress symptoms among Rouen students. Depression, anxiety and stress symptoms among students are associated with high level of perceived academic pressure, financial difficulties and presence of eating disorders. </jats:sec