Contribution of perceived loneliness to suicidal thoughts among French university students during the COVID-19 pandemic

Restrictive measures during the COVID-19 epidemic have led to increased levels of loneliness, especially among university students, although the influence on suicidal thoughts remains unclear. In this cross-sectional study of 1913 French university students, those with the highest level of loneliness had a fourfold increased risk of suicidal thoughts. Perceived loneliness should be incorporated into suicide risk assessment, and assistance in coping with loneliness should be considered as a means of reducing suicidal risk in vulnerable groups, like university students.Epidémie à Coronavirus : Etude de L'Impact et des Profils à risque Suicidaire en population EtudiantePreparedness of health systems to reduce mental health and psychosocial concerns resulting from the COVID-19 pandemi

Front Public Health

Poor mental health among youth is a major public health issue that has risen to the forefront since the COVID-19 crisis, especially among post-secondary students and precarious populations. The objectives of this work were to evaluate the rate of major depressive disorder (MDD) among precarious post-secondary students in the greater Paris region, to describe its risk factors, and to identify determinants for not seeking care. We conducted a multi-site, cross-sectional survey of post-secondary students attending a selection of 13 student foodbanks in the greater Paris region (France) between 30 November 2021 and 27 January 2022. This study had two complementary epidemiological and sociological components: a quantitative description of MDD through completion of a questionnaire performed through face-to-face or telephone interviews, and a qualitative assessment of the factors underlying MDD through in-depth follow-up interviews conducted among a sub-selection of students who participated in the first phase. Among 456 students who participated in our survey, 35.7% presented with MDD. The risk of suffering from MDD was higher among women, students housed by third-parties, students reporting moderately to severely hungry and/or poor physical health. Students receiving material and/or social support were less likely to present with MDD. Among students who reported needing health care in the last year or since their arrival in France, 51.4% did not seek care. To address poor mental health among precarious students, policy action must jointly consider financial precarity, administrative barriers, housing, food security, physical health, and access to health services, especially mental health

A machine learning approach for predicting suicidal thoughts and behaviours among college students

Suicidal thoughts and behaviours are prevalent among college students. Yet little is known about screening tools to identify students at higher risk. We aimed to develop a risk algorithm to identify the main predictors of suicidal thoughts and behaviours among college students within one-year of baseline assessment. We used data collected in 2013-2019 from the French i-Share cohort, a longitudinal population-based study including 5066 volunteer students. To predict suicidal thoughts and behaviours at follow-up, we used random forests models with 70 potential predictors measured at baseline, including sociodemographic and familial characteristics, mental health and substance use. Model performance was measured using the area under the receiver operating curve (AUC), sensitivity, and positive predictive value. At follow-up, 17.4% of girls and 16.8% of boys reported suicidal thoughts and behaviours. The models achieved good predictive performance: AUC, 0.8; sensitivity, 79% for girls, 81% for boys; and positive predictive value, 40% for girls and 36% for boys. Among the 70 potential predictors, four showed the highest predictive power: 12-month suicidal thoughts, trait anxiety, depression symptoms, and self-esteem. We identified a parsimonious set of mental health indicators that accurately predicted one-year suicidal thoughts and behaviours in a community sample of college students.Program Initiative d’Excellenc

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

Genomics of perivascular space burden unravels early mechanisms of cerebral small vessel disease

Perivascular space (PVS) burden is an emerging, poorly understood, magnetic resonance imaging marker of cerebral small vessel disease, a leading cause of stroke and dementia. Genome-wide association studies in up to 40,095 participants (18 population-based cohorts, 66.3 ± 8.6 yr, 96.9% European ancestry) revealed 24 genome-wide significant PVS risk loci, mainly in the white matter. These were associated with white matter PVS already in young adults (N = 1,748; 22.1 ± 2.3 yr) and were enriched in early-onset leukodystrophy genes and genes expressed in fetal brain endothelial cells, suggesting early-life mechanisms. In total, 53% of white matter PVS risk loci showed nominally significant associations (27% after multiple-testing correction) in a Japanese population-based cohort (N = 2,862; 68.3 ± 5.3 yr). Mendelian randomization supported causal associations of high blood pressure with basal ganglia and hippocampal PVS, and of basal ganglia PVS and hippocampal PVS with stroke, accounting for blood pressure. Our findings provide insight into the biology of PVS and cerebral small vessel disease, pointing to pathways involving extracellular matrix, membrane transport and developmental processes, and the potential for genetically informed prioritization of drug targets.Etude de cohorte sur la santé des étudiantsStopping cognitive decline and dementia by fighting covert cerebral small vessel diseaseStudy on Environmental and GenomeWide predictors of early structural brain Alterations in Young student

BMC Psychiatry

BACKGROUND: Suicidal ideation and suicidal risk assessment are major concerns for health professionals. The perception of a low level of parental support is a risk factor for suicidal tendencies among adolescents, but little is known about its long-term impact on the vulnerability to suicidal behavior in young adults. We investigated whether the perceived level of parental support during childhood and adolescence was associated with current suicidal ideation in young adults. METHODS: We retrieved data collected in the i-Share study from February 1st, 2013 through January 30, 2017. This cross-sectional study included 10,015 French students, aged 18-24 years that completed an on-line self-reported questionnaire about suicidal ideation in the last 12 months and their perceived parental support in childhood and adolescence. We performed multinomial logistic regressions and sensitivity analyses to assess associations between the degree of perceived parental support and the frequency suicidal thoughts, after adjusting for the main known risk factors of suicidal ideation. We employed multiple imputations to account for missing data. RESULTS: The study sample included 7539 female (75.7%) and 2436 male (24.3%) students (mean [SD] age 20.0 [1.8] years). About one in five students reported occasional suicidal thoughts (n = 1775, 17.7%) and 368 students (3.7%) reported frequent suicidal thoughts. The adjusted multinomial logistic regression revealed a significant negative association between perceived parental support and suicidal thoughts. A lack of perceived parental support in childhood and adolescence was associated with > 4-fold elevated risk of occasional (adjusted OR, 4.55; 95% CI: 2.97-6.99) and nearly 9-fold elevated risk of frequent (adjusted OR, 8.58; 95% CI: 4.62-15.96) suicidal thoughts, compared to individuals that perceived extremely strong parental support. This association was strongest among students with no personal history of depression or suicide attempts. CONCLUSIONS: Students that perceived low levels of past parental support had a higher risk of suicidal ideation. Past perceived parental support appeared to be a potent marker of suicidal risk in young adults. This marker should be routinely collected in studies on suicidal risk in young adults, and it could be considered an additional screening tool

Les conduites suicidaires chez les étudiants : analyse et modélisation du risque dans la cohorte i-Share.

In France, suicide is the second leading cause of death among young people aged between 15 and 24 years. Although the risk of suicide during adolescence is well documented, only a paucity of studies has investigated mental health and suicidal behaviours in French university students. Yet, student life is accompanied by a number of important changes known to increase risks for psychiatric disorders. The main objective of this thesis was to model suicidal behaviours among French University to identify individuals at risk. Our objectives were two-fold: 1) to study the association between suicidal behaviours and self-reported factors in childhood and adolescence such as perceived parental support, peer victimization and/or parental maltreatment; 2) to develop a predictive model of suicidal behaviours in students using machine learning methods. We conducted analyses using data from the i-Share cohort, a prospective longitudinal study that has included student volunteers since 2013. We report four main findings: 1) about one in five students (21%) reported suicidal thoughts in the past 12 months and 6%, lifetime suicide attempts; 2) compared to students who reported high levels of parental support, those who perceived a total lack of support in childhood and adolescence had a four to nine fold higher probability of having occasional (adjusted odds ratio aOR: 4.55; 95% confidence interval CI: 2.97-6.99) or multiple suicidal thoughts (aOR: 8.58; 95% CI: 4.62-15.96); 3) students who reported being victimized by peers, without associated parental maltreatment, were more likely to present suicidal ideation without (aOR: 1.62; 95% CI: 1.26-2.09) or with suicide attempts (aOR: 2.70; 95% CI: 1.51-4.85); 4) among more than 70 predictors measured at baseline, four showed high predictive power for suicidal behaviours: previous suicidal thoughts, trait anxiety, depressive symptoms and self-esteem. In secondary analyses using data from the CONFINS cohort, we showed that students were more likely than non-students to experience mental health problems, in particular during COVID-19 lockdowns. Overall, our results highlight the frailty of students and the need to implement mental health preventive interventions in this population. Specifically, the results suggest that parental support programs and school bullying prevention programs could reduce the long-term suicidal risk among young adults. Interventions to strengthen self-esteem among university students could provide contextual support to those at risk. Suicidal behaviours are common among students and further research is needed to develop and evaluate screening tools that can be used routinely, for example at university entrance, to identify the most vulnerable students.En France, le suicide est la deuxième cause de mortalité chez les 15-24 ans. Si le risque suicidaire au cours de l’adolescence est bien documenté, peu de données sont disponibles en France sur la santé mentale des étudiants et sur les conduites suicidaires en particulier. La vie étudiante s’accompagne pourtant d’un certain nombre de changements qui surviennent dans une période de transition vers l’âge adulte, connue comme représentant une période sensible pour le développement de troubles psychiatriques. L’objectif principal de cette thèse était d’analyser et de modéliser le risque suicidaire chez les étudiants, afin d’identifier les individus à risque, à travers deux objectifs spécifiques : 1) étudier l’association entre les conduites suicidaires et des facteurs auto-déclarés dans l’enfance et l’adolescence que sont le soutien parental perçu, la victimisation par les pairs et/ou la maltraitance parentale ; 2) développer un modèle de prédiction des comportements suicidaires chez les étudiants en utilisant des méthodes d’apprentissage automatique. Des analyses, menées à partir des données de la cohorte i-Share, étude prospective longitudinale qui inclut des étudiants volontaires depuis 2013, ont montré les résultats suivants : 1) un étudiant sur cinq (21%) a rapporté des pensées suicidaires au cours des 12 derniers mois et 6% ont déclaré des tentatives de suicide au cours de la vie ; 2) l’absence de soutien parental perçu dans l'enfance et l'adolescence était associée à une probabilité quatre à neuf fois plus élevée de présenter des pensées suicidaires occasionnelles (rapport des cotes ajusté RCa : 4,55 ; intervalle de confiance IC 95% : 2,97-6,99) ou multiples (RCa : 8,58 ; IC 95% : 4,62-15,96), par rapport aux individus qui ont perçu un soutien parental très important ; 3) les étudiants qui ont déclaré être victimisés par leurs pairs, sans maltraitance parentale associée, étaient plus susceptibles de présenter des idées suicidaires sans (RCa : 1,62 ; IC à 95% : 1,26-2,09) ou avec tentative de suicide (RCa : 2,70 ; IC à 95% : 1,51-4,85) ; 4) parmi plus de 70 prédicteurs mesurés à l’inclusion dans l’étude, quatre ont montré le pouvoir prédictif le plus élevé de conduites suicidaires : les précédentes pensées suicidaires, l’anxiété-trait, les symptômes de dépression et l'estime de soi. Dans des analyses secondaires menées à partir des données de la cohorte CONFINS, nous avons montré que les étudiants étaient plus susceptibles que les non-étudiants de présenter des troubles de santé mentale au cours de l’épidémie de COVID-19, notamment en période de confinements. Ces travaux soulignent la fragilité de la population étudiante et la nécessité d’y porter une plus grande attention. Plus spécifiquement, nos résultats montrent l’intérêt de renforcer des programmes portant sur le soutien à la parentalité et la lutte contre le harcèlement scolaire pour réduire le risque suicidaire à long terme du jeune adulte et ils ouvrent la voie à de nouvelles stratégies d’interventions, en lien avec le renforcement de l’estime de soi à l’université. Les conduites suicidaires sont fréquentes chez les étudiants et les recherches doivent être poursuivies afin de développer et évaluer des outils de dépistage pouvant être utilisés en routine, par exemple à l’entrée à l’université, pour identifier les étudiants les plus vulnérables

Suicidal behaviours among students : risk analysis and modelling in the i-Share cohort.

En France, le suicide est la deuxième cause de mortalité chez les 15-24 ans. Si le risque suicidaire au cours de l’adolescence est bien documenté, peu de données sont disponibles en France sur la santé mentale des étudiants et sur les conduites suicidaires en particulier. La vie étudiante s’accompagne pourtant d’un certain nombre de changements qui surviennent dans une période de transition vers l’âge adulte, connue comme représentant une période sensible pour le développement de troubles psychiatriques. L’objectif principal de cette thèse était d’analyser et de modéliser le risque suicidaire chez les étudiants, afin d’identifier les individus à risque, à travers deux objectifs spécifiques : 1) étudier l’association entre les conduites suicidaires et des facteurs auto-déclarés dans l’enfance et l’adolescence que sont le soutien parental perçu, la victimisation par les pairs et/ou la maltraitance parentale ; 2) développer un modèle de prédiction des comportements suicidaires chez les étudiants en utilisant des méthodes d’apprentissage automatique. Des analyses, menées à partir des données de la cohorte i-Share, étude prospective longitudinale qui inclut des étudiants volontaires depuis 2013, ont montré les résultats suivants : 1) un étudiant sur cinq (21%) a rapporté des pensées suicidaires au cours des 12 derniers mois et 6% ont déclaré des tentatives de suicide au cours de la vie ; 2) l’absence de soutien parental perçu dans l'enfance et l'adolescence était associée à une probabilité quatre à neuf fois plus élevée de présenter des pensées suicidaires occasionnelles (rapport des cotes ajusté RCa : 4,55 ; intervalle de confiance IC 95% : 2,97-6,99) ou multiples (RCa : 8,58 ; IC 95% : 4,62-15,96), par rapport aux individus qui ont perçu un soutien parental très important ; 3) les étudiants qui ont déclaré être victimisés par leurs pairs, sans maltraitance parentale associée, étaient plus susceptibles de présenter des idées suicidaires sans (RCa : 1,62 ; IC à 95% : 1,26-2,09) ou avec tentative de suicide (RCa : 2,70 ; IC à 95% : 1,51-4,85) ; 4) parmi plus de 70 prédicteurs mesurés à l’inclusion dans l’étude, quatre ont montré le pouvoir prédictif le plus élevé de conduites suicidaires : les précédentes pensées suicidaires, l’anxiété-trait, les symptômes de dépression et l'estime de soi. Dans des analyses secondaires menées à partir des données de la cohorte CONFINS, nous avons montré que les étudiants étaient plus susceptibles que les non-étudiants de présenter des troubles de santé mentale au cours de l’épidémie de COVID-19, notamment en période de confinements. Ces travaux soulignent la fragilité de la population étudiante et la nécessité d’y porter une plus grande attention. Plus spécifiquement, nos résultats montrent l’intérêt de renforcer des programmes portant sur le soutien à la parentalité et la lutte contre le harcèlement scolaire pour réduire le risque suicidaire à long terme du jeune adulte et ils ouvrent la voie à de nouvelles stratégies d’interventions, en lien avec le renforcement de l’estime de soi à l’université. Les conduites suicidaires sont fréquentes chez les étudiants et les recherches doivent être poursuivies afin de développer et évaluer des outils de dépistage pouvant être utilisés en routine, par exemple à l’entrée à l’université, pour identifier les étudiants les plus vulnérables.In France, suicide is the second leading cause of death among young people aged between 15 and 24 years. Although the risk of suicide during adolescence is well documented, only a paucity of studies has investigated mental health and suicidal behaviours in French university students. Yet, student life is accompanied by a number of important changes known to increase risks for psychiatric disorders. The main objective of this thesis was to model suicidal behaviours among French University to identify individuals at risk. Our objectives were two-fold: 1) to study the association between suicidal behaviours and self-reported factors in childhood and adolescence such as perceived parental support, peer victimization and/or parental maltreatment; 2) to develop a predictive model of suicidal behaviours in students using machine learning methods. We conducted analyses using data from the i-Share cohort, a prospective longitudinal study that has included student volunteers since 2013. We report four main findings: 1) about one in five students (21%) reported suicidal thoughts in the past 12 months and 6%, lifetime suicide attempts; 2) compared to students who reported high levels of parental support, those who perceived a total lack of support in childhood and adolescence had a four to nine fold higher probability of having occasional (adjusted odds ratio aOR: 4.55; 95% confidence interval CI: 2.97-6.99) or multiple suicidal thoughts (aOR: 8.58; 95% CI: 4.62-15.96); 3) students who reported being victimized by peers, without associated parental maltreatment, were more likely to present suicidal ideation without (aOR: 1.62; 95% CI: 1.26-2.09) or with suicide attempts (aOR: 2.70; 95% CI: 1.51-4.85); 4) among more than 70 predictors measured at baseline, four showed high predictive power for suicidal behaviours: previous suicidal thoughts, trait anxiety, depressive symptoms and self-esteem. In secondary analyses using data from the CONFINS cohort, we showed that students were more likely than non-students to experience mental health problems, in particular during COVID-19 lockdowns. Overall, our results highlight the frailty of students and the need to implement mental health preventive interventions in this population. Specifically, the results suggest that parental support programs and school bullying prevention programs could reduce the long-term suicidal risk among young adults. Interventions to strengthen self-esteem among university students could provide contextual support to those at risk. Suicidal behaviours are common among students and further research is needed to develop and evaluate screening tools that can be used routinely, for example at university entrance, to identify the most vulnerable students

Les conduites suicidaires chez les étudiants : analyse et modélisation du risque dans la cohorte i-Share.

In France, suicide is the second leading cause of death among young people aged between 15 and 24 years. Although the risk of suicide during adolescence is well documented, only a paucity of studies has investigated mental health and suicidal behaviours in French university students. Yet, student life is accompanied by a number of important changes known to increase risks for psychiatric disorders. The main objective of this thesis was to model suicidal behaviours among French University to identify individuals at risk. Our objectives were two-fold: 1) to study the association between suicidal behaviours and self-reported factors in childhood and adolescence such as perceived parental support, peer victimization and/or parental maltreatment; 2) to develop a predictive model of suicidal behaviours in students using machine learning methods. We conducted analyses using data from the i-Share cohort, a prospective longitudinal study that has included student volunteers since 2013. We report four main findings: 1) about one in five students (21%) reported suicidal thoughts in the past 12 months and 6%, lifetime suicide attempts; 2) compared to students who reported high levels of parental support, those who perceived a total lack of support in childhood and adolescence had a four to nine fold higher probability of having occasional (adjusted odds ratio aOR: 4.55; 95% confidence interval CI: 2.97-6.99) or multiple suicidal thoughts (aOR: 8.58; 95% CI: 4.62-15.96); 3) students who reported being victimized by peers, without associated parental maltreatment, were more likely to present suicidal ideation without (aOR: 1.62; 95% CI: 1.26-2.09) or with suicide attempts (aOR: 2.70; 95% CI: 1.51-4.85); 4) among more than 70 predictors measured at baseline, four showed high predictive power for suicidal behaviours: previous suicidal thoughts, trait anxiety, depressive symptoms and self-esteem. In secondary analyses using data from the CONFINS cohort, we showed that students were more likely than non-students to experience mental health problems, in particular during COVID-19 lockdowns. Overall, our results highlight the frailty of students and the need to implement mental health preventive interventions in this population. Specifically, the results suggest that parental support programs and school bullying prevention programs could reduce the long-term suicidal risk among young adults. Interventions to strengthen self-esteem among university students could provide contextual support to those at risk. Suicidal behaviours are common among students and further research is needed to develop and evaluate screening tools that can be used routinely, for example at university entrance, to identify the most vulnerable students.En France, le suicide est la deuxième cause de mortalité chez les 15-24 ans. Si le risque suicidaire au cours de l’adolescence est bien documenté, peu de données sont disponibles en France sur la santé mentale des étudiants et sur les conduites suicidaires en particulier. La vie étudiante s’accompagne pourtant d’un certain nombre de changements qui surviennent dans une période de transition vers l’âge adulte, connue comme représentant une période sensible pour le développement de troubles psychiatriques. L’objectif principal de cette thèse était d’analyser et de modéliser le risque suicidaire chez les étudiants, afin d’identifier les individus à risque, à travers deux objectifs spécifiques : 1) étudier l’association entre les conduites suicidaires et des facteurs auto-déclarés dans l’enfance et l’adolescence que sont le soutien parental perçu, la victimisation par les pairs et/ou la maltraitance parentale ; 2) développer un modèle de prédiction des comportements suicidaires chez les étudiants en utilisant des méthodes d’apprentissage automatique. Des analyses, menées à partir des données de la cohorte i-Share, étude prospective longitudinale qui inclut des étudiants volontaires depuis 2013, ont montré les résultats suivants : 1) un étudiant sur cinq (21%) a rapporté des pensées suicidaires au cours des 12 derniers mois et 6% ont déclaré des tentatives de suicide au cours de la vie ; 2) l’absence de soutien parental perçu dans l'enfance et l'adolescence était associée à une probabilité quatre à neuf fois plus élevée de présenter des pensées suicidaires occasionnelles (rapport des cotes ajusté RCa : 4,55 ; intervalle de confiance IC 95% : 2,97-6,99) ou multiples (RCa : 8,58 ; IC 95% : 4,62-15,96), par rapport aux individus qui ont perçu un soutien parental très important ; 3) les étudiants qui ont déclaré être victimisés par leurs pairs, sans maltraitance parentale associée, étaient plus susceptibles de présenter des idées suicidaires sans (RCa : 1,62 ; IC à 95% : 1,26-2,09) ou avec tentative de suicide (RCa : 2,70 ; IC à 95% : 1,51-4,85) ; 4) parmi plus de 70 prédicteurs mesurés à l’inclusion dans l’étude, quatre ont montré le pouvoir prédictif le plus élevé de conduites suicidaires : les précédentes pensées suicidaires, l’anxiété-trait, les symptômes de dépression et l'estime de soi. Dans des analyses secondaires menées à partir des données de la cohorte CONFINS, nous avons montré que les étudiants étaient plus susceptibles que les non-étudiants de présenter des troubles de santé mentale au cours de l’épidémie de COVID-19, notamment en période de confinements. Ces travaux soulignent la fragilité de la population étudiante et la nécessité d’y porter une plus grande attention. Plus spécifiquement, nos résultats montrent l’intérêt de renforcer des programmes portant sur le soutien à la parentalité et la lutte contre le harcèlement scolaire pour réduire le risque suicidaire à long terme du jeune adulte et ils ouvrent la voie à de nouvelles stratégies d’interventions, en lien avec le renforcement de l’estime de soi à l’université. Les conduites suicidaires sont fréquentes chez les étudiants et les recherches doivent être poursuivies afin de développer et évaluer des outils de dépistage pouvant être utilisés en routine, par exemple à l’entrée à l’université, pour identifier les étudiants les plus vulnérables