Frequency of Depressive Symptoms and Suicidal Ideation Among University Students Before and After the COVID-19 Pandemic

Background: The COVID-19 pandemic and lockdown have had negative effects on students mental health. However, little information is available regarding the frequencies of depressive symptoms and suicidal ideation during the post-pandemic period. We aimed to compare prevalence rates of depressive symptoms and suicidal ideation among university students, before versus after the COVID-19 pandemic. Methods: In this comparative study, 4464 students were recruited during the pre-COVID-19 pandemic period (2013-2020) and 1768 students, during the post-COVID-19 pandemic period (2022-2023). Standardized frequencies of depressive symptoms and suicidal ideation were compared between the two time periods. Adjusted logistic regression models were used to assess the association between the pandemic period (with the pre-COVID-19 period as reference) and depressive symptoms and suicidal ideation. Results: Compared to participants from the pre-pandemic sample, participants from the post-pandemic sample had higher standardized rates of depressive symptoms (40.6% vs 25.6%) and suicidal ideation (29.3% vs 21.1%). With adjustment for age, gender, university campus, scholarship, and past history of depression and suicide attempt, students in the post-pandemic period experienced more depressive symptoms (aOR, 1.89; 95% CI, 1.67-2.13) and suicidal ideation (aOR, 1.46; 95% CI, 1.28-1.67) compared to students in the pre-COVID-19 era. Limitations: The main limitations were self-selection bias and information bias due to potential over-reporting linked to media coverage, as well as measures of past history of depression and suicide attempt across the lifespan. Conclusions: These findings reveal an alarming deterioration of students mental health in the post-pandemic period compared to the pre-pandemic era. Pending replications in others countries, these results suggest that it is crucial to continue monitoring students mental health, strengthening communication on this topic, and reinforcing university mental healthcare systems. ### Competing Interest Statement The authors have declared no competing interest. ### Funding Statement The i-Share study was funded by the Nouvelle-Aquitaine Regional Council (grant 4370420), the Bordeaux Initiatives excellence (IdEx) program of the University of Bordeaux (ANR-10-IDEX-03-02), the Nouvelle-Aquitaine Regional Health Agency (Agence Regionale de Sante Nouvelle-Aquitaine, grant 6066R-8), Public Health France (Sante Publique France, grant 19DPPP023-0), and The National Institute against cancer INCa (grant INCa_11502). Prisme was supported by the Augmented university for Campus and world Transition (ACT) project of the University of Bordeaux, with the support of the Agence Nationale de la Recherche under the Programme d'Investissements avenir with the reference ANR-20-IDES-0001, and by Inserm. The funding bodies were not involved in the study design, or in the data collection, analysis, or interpretation. ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes The details of the IRB/oversight body that provided approval or exemption for the research described are given below: The Regional South-East VI ethics committee (Comite de Protection des Personnes Sud Est VI) approved the Prisme study (under the National Number 2022-A00666-37). I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable. Yes All data produced in the present study are available upon reasonable request to the authors