Adolescents' Depression Symptoms After Social Distancing and Restrictions: The EpiCoV French Longitudinal Population-Based Cohort.

PURPOSE: The recent worldwide health pandemic and related social distancing and restrictions negatively impacted adolescents' mental health, including depression, underscoring the need for comprehensive understanding beyond immediate impacts. We aimed to identify factors assessed during the first and second lockdowns that were associated with depression symptoms 2 years after restrictions easing. METHODS: This study included 1,946 adolescents, aged 15-18 years, involved in the French Epidémiologie et Conditions de Vie population-based cohort. Depression symptoms were assessed twice, with the nine-item Patient Health Questionnaire, at the beginning of restrictions easing and 1 year later. Logistic regressions were used to estimate associations among sociodemographic, socioeconomics, health, substance use, lockdown conditions, and pandemic-related factors, self-reported during the first and second lockdowns in France, and depression symptoms. Elastic-Net regression was used to study the joint effect of characteristics assessed during both lockdowns. RESULTS: A total of 472 (25.25%) adolescents reported depression symptoms in the restrictions easing period, 369 (78.18%) were girls and 103 (21.82%) were boys. Factors associated with a higher risk of reporting depression symptoms included being a girl, a smoker, frequently consuming alcohol, having spent lockdowns in a place without outdoor space, poor perceived health, and pre-existing mental disorders. DISCUSSION: Factors associated with depression symptoms after restrictions easing were well known and mostly not related to social distancing and restrictions, suggesting that already vulnerable youth were more likely to be impacted by the stressful pandemic context. Special caution is needed for these adolescents to limit pandemic's impact on long-lasting mental health. These results also underscore the importance of early identification of at-risk adolescents and the development of interventions to enhance their resilience and support in case of future crises.

Acute reperfusion therapies and prognosis in nonagenarian stroke patients.

INTRODUCTION: Thrombolysis and endovascular thrombectomy (EVT) are standard treatments after stroke. We previously reported that these therapies benefit stroke patients over 80 years old. Now, we aim to study reperfusion therapies specifically in nonagenarians, hypothesizing a poorer prognosis in this group. METHODS: Nonagenarian stroke patients were identified from our prospective monocentric cohort, which included consecutive patients >80 years old treated with thrombolysis and/or EVT from 2015-2019. Baseline characteristics, treatments and outcomes, as well as complications and mortality were analyzed. RESULTS: 96 nonagenarians were treated with thrombolysis (69.8%) and/or EVT (81.1%). 51% had a pre-stroke modified Rankin Score (mRS) ≤2. Cardioembolism was the most common etiology (67.7%). Age was associated with a higher mRS after stroke with a turning point at 90 years old : (90-99 years old: odds ratio (OR)=0.33, 95% confidence interval (95%CI):0.13-0.83, P=0.02) versus (85-89 years old: OR=0.72, 95%CI:0.34-1.50, P=0.38), and (80-84-year-old patients as the reference). In nonagenarians, previous coronary artery disease (OR=8.02, 95%CI:1.66-38.68, P=0.01), initial NIHSS (OR=1.11, 95%CI:1.03-1.19, P=0.01), pre stroke independence (OR=0.25, 95%CI:0.08-0.71, P=0.01) and 'drip-and-ship' status (OR=3.35, 95%CI:1.22-9.16, P=0.02) were associated with 3-month mortality. Nonagenarians had more baseline co-morbidities (P=0.003) and lower levels of pre-stroke independence (P=0.002) than octogenarians (n=261). Despite no difference in the use of acute treatments, timelines and rates of successful reperfusion, a good functional status at 3 months was less common in nonagenarians than octogenarians (14.3% versus 34.0%, P<0.001) with a higher mortality (60.2% versus 16.4%, P<0.001). 9.5% of nonagenarians experienced a symptomatic intracranial hemorrhage. CONCLUSIONS: Age is a crucial factor affecting prognosis after stroke with a turning point at 90 years old. However, age alone should not be a limiting factor for treatment decision. Despite higher mortality and poorer functional prognosis overall, some nonagenarians may benefit from reperfusion therapies.

Sexual Health of Young Adults Living with Perinatally Acquired HIV in Paris, France: A Qualitative Study.

We aimed to explore the sexual health of young adults with perinatally acquired human immunodeficiency virus (PHIV). Eighteen to 25 years old PHIV participants were recruited in two tertiary care units in Paris. Sexually transmitted HIV was an exclusion criterion. Individual interviews were conducted. Transcripts were analyzed using a semio-pragmatic phenomenological method. Twenty-five participants were interviewed from March 2022 to September 2022. Some of them renounced being in any romantic relationship. Those who disclosed their HIV status to their romantic partner reported that dating was more complex and those who did not disclose reported that keeping HIV a secret was a significant mental burden. Young men tended to disclose their HIV status to their romantic partner whereas young women did not consider doing so before marriage. Many participants had to educate themselves about sexuality, through school or websites. Identified interlocutors for sexuality varied across participants. All participants were aware of U = U (Undetectable = Untransmittable) slogan. Despite that, participants remained worried about transmitting HIV to their sexual partners. That hindered their sexual satisfaction. In addition, they neglected the risk of unwanted pregnancies or sexually transmitted diseases (STDs). In our study, knowing the U = U slogan did not provide reassurance to PHIV participants regarding the risk of onward HIV transmission. Further, they showed very little concern for protecting themselves from their partner's STD.

Variance due to the examination conditions and factors associated with success in objective structured clinical examinations (OSCEs): first experiences at Paris-Saclay medical school.

BACKGROUND: We aimed to measure the variance due to examination conditions during the first sessions of objective structured clinical examinations (OSCEs) performed at a French medical school and identify factors associated with student success. METHODS: We conducted a retrospective, observational study using data from the first three OSCEs sessions performed at Paris-Saclay medical school in 2021 and 2022. For all sessions (each organized in 5 parallel circuits), we tested a circuit effect using a linear mixed-effects model adjusted for sex and the average academic level of students (according to written tests). Then, we studied the factors associated with student success at one station using a multivariate linear mixed-effects model, including the characteristics of students, assessors, and standardized patients. RESULTS: The study included three OSCEs sessions, with 122, 175, and 197 students and a mean (± SD) session score of 13.7(± 1.5)/20, 12.7(± 1.7)/20 and 12.7(± 1.9)/20, respectively. The percentage of variance due to the circuit was 6.5%, 18.2% (statistically significant), and 3.8%, respectively. For all sessions, the student's average level and station scenario were significantly associated with the score obtained in a station. Still, specific characteristics of assessors or standardized patients were only associated with the student's score in April 2021 (first session). CONCLUSION: The percentage of the variance of students' performance due to the examination conditions was significant in one out of three of the first OSCE sessions performed at Paris-Saclay medical school. This result seems more related to individual behaviors rather than specific characteristics of assessors or standardized patients, highlighting the need to continue training teaching teams. NATIONAL CLINICAL TRIAL NUMBER: Not applicable.

Temporal changes in the risk of six-month post-covid symptoms: a national population-based cohort study.

It is unclear how the risk of post-covid symptoms evolved during the pandemic, especially before the spread of Severe Acute Respiratory Syndrome Coronavirus 2 variants and the availability of vaccines. We used modified Poisson regressions to compare the risk of six-month post-covid symptoms and their associated risk factors according to the period of first acute covid: during the French first (March-May 2020) or second (September-November 2020) wave. Non-response weights and multiple imputation were used to handle missing data. Among participants aged 15 or more in a national population-based cohort, the risk of post-covid symptoms was 14.6% (95% CI: 13.9%, 15.3%) in March-May 2020, versus 7.0% (95% CI: 6.3%, 7.7%) in September-November 2020 (adjusted RR: 1.36, 95% CI: 1.20, 1.55). For both periods, the risk was higher in the presence of baseline physical condition(s), and it increased with the number of acute symptoms. During the first wave, the risk was also higher for women, in the presence of baseline mental condition(s), and it varied with educational level. In France in 2020, the risk of six-month post-covid symptoms was higher during the first than the second wave. This difference was observed before the spread of variants and the availability of vaccines.

Entre santé et science : littératie en santé et perception de la recherche médicale.

OBJECTIVE: Biomedical innovation plays an important role in health care pathways and public debates. Nevertheless, existing measures of health literacy take little account of medical research. In this article, we explore the relationship between health literacy and attitudes toward medical research, from clinical trials to more general attitudes toward science. METHODS: We analyze the results of two self-administered questionnaires conducted on samples of the French adult population in 2020 and 2021 (N=2003 and N=2022). A series of twelve questions assessed health literacy (HLS19-Q12-EN) and ten questions addressed attitudes to clinical trials, medical research, and science in general. The analyses characterize the population’s perception of medical research issues and its association with health literacy. RESULTS: There is a significant association between health literacy and perception of research. A low level of literacy is associated with lower knowledge of clinical trials and a more negative attitude toward them, less confidence in science and its contributions to society. CONCLUSIONS: Given the continuity between care and research, health literacy is likely to be a relevant measure for characterizing disparity in attitudes toward clinical trials and improving access to innovation.

Development and evaluation of a food literacy questionnaire for schoolchildren in France.

Food literacy is gaining importance in nutrition education programs for children. To date, food literacy assessment tools have been developed in many countries, however, none exist in France. The objectives of this study were to develop a questionnaire and to evaluate its measurement properties among French schoolchildren aged 8-11 years. The questionnaire was developed in three phases: i) item selection (literature review and adaptation or creation of items) and content validity (submission to an expert panel), ii) questionnaire development including a pre-test in a small sample of children (n = 41) and item reduction and dimensionality based on the responses of children who completed the questionnaire in 31 schools between December 2022 and March 2023, and iii) questionnaire evaluation in terms of reliability, validity and acceptability. In total, 1187 responses were included in the analysis. The mean age of the children was 9.6 ± 0.7 years (girls: 51.2%, boys: 48.8%). The development process resulted in a 25-item questionnaire with good acceptability and satisfactory estimated reliability (McDonald omega coefficient = 0.73). Factor evaluation revealed a three-dimensional structure encompassing food and nutrition knowledge, participation in food preparation activities and food habits. To our knowledge, this study was the first to assess food literacy for schoolchildren in France. Our questionnaire can contribute to assess the factors that make food literacy vary, especially regarding socioeconomic variables to target priority populations for nutrition education actions and to describe changes in food literacy scores from a longitudinal perspective.

Smoking and mental disability : A mixed observational study using a diverse sample of medical-social establishments and services / Tabagisme et handicap psychique : étude observationnelle mixte dans un échantillon diversifié d'établissements et de services médico-sociaux.

INTRODUCTION: A multi-center observational study was carried out in ten ESMS, using a mixed methodology (site visits, questionnaire survey, semi-directive group interviews with professionals and individual interviews with users). PURPOSE OF THE RESEARCH: The aim of this article is to describe the management and prevention of smoking in ESMS for people with mental health disorders, and to characterize and identify the smoking behaviors and representations of ESMS users and the professionals working there. RESULTS: The study made it possible to distinguish between ESMS in terms of the organization of smoking areas and tobacco prevention initiatives. It also revealed that 37 percent of respondents among the professionals said they smoked tobacco, with some of them explaining that they smoked with users and sometimes gave them cigarettes. With regard to prevention, there was a consensus among professionals that they should help users who wanted to stop smoking. Professionals were divided, however, on the need for more active prevention, citing the users' freedom and the fact that ESMS are places where people live. Among the users, 47 percent said they were smokers. Of the users who smoked, 55 percent said they wanted to stop. Interviews with the users revealed that twelve of them wanted to quit, with some asking for help and more assistance from professionals. CONCLUSIONS: This report suggests that intervention research could be developed in ESMS for people with mental health disorders, who could benefit from the smoking prevention actions identified in the facilities and services investigated.

Introduction: Une étude observationnelle multicentrique a été réalisée dans dix ESMS et mobilisait une méthodologie mixte (visite des structures, enquête par questionnaires, entretiens semi-directifs collectifs avec des professionnels et individuels avec des usagers). But de l'étude: Cet article vise à décrire la gestion et la prévention du tabagisme dans des établissements et services médico-sociaux (ESMS) accueillant des personnes avec un trouble psychique, et à caractériser et identifier les comportements tabagiques et les représentations de leurs usagers et professionnels. Résultats: L'étude a permis de distinguer les ESMS au regard de l'organisation des espaces du tabagisme et des actions de prévention du tabac. Elle a permis également de constater que 37 % des professionnels qui ont répondu déclaraient fumer du tabac, une partie d'entre eux expliquant fumer avec les usagers et leur donner parfois des cigarettes. Concernant la prévention, un consensus se dégageait chez les professionnels sur le fait d'aider les usagers qui souhaitaient arrêter. Les professionnels étaient cependant divisés à l'égard d'une prévention plus active, invoquant la liberté de l'usager et le fait que les ESMS sont des lieux de vie. 47 % des usagers se disaient fumeurs. 55 % des usagers fumeurs déclaraient vouloir arrêter. Les entretiens avec les usagers ont permis de constater que douze d'entre eux souhaitaient arrêter, une partie réclamant de l'aide et d'être davantage aidés par les professionnels. Conclusions: Cet état des lieux invite à développer des recherches interventionnelles dans les ESMS accueillant des personnes avec un trouble psychique qui pourraient tirer profit des actions de prévention du tabac repérées dans des structures enquêtées.

Trajectories of school refusal: sequence analysis using retrospective parent reports.

School refusal (SR) is a form of school attendance problem (SAP) that requires specific mental health care. Despite improvements in the definition of SAPs, the course of SR is not well characterized. To explore three-year patterns of SR course in children, as reported by their parents, we deployed an anonymous web-based survey. We defined SR onset as the absence of ≥ 2 school weeks during one academic year, combined with emotional distress. We defined standard SR trajectories using sequence analysis of parents' recollection of three consecutive years of school attendance. We obtained 1970 responses, 1328 (67%) completed by a parent and meeting the definition of SR. Of these, 729 (55%) responses included three years of school attendance recollection. We identified five prototypical trajectories of SR: two profiles for children: beaded absences (n = 272), and rapid recovery (n = 132); and three for adolescents: prolonged recovery (n = 93), gradual decline (n = 89), and rapid decline (n = 143). We found five distinct trajectories of retrospective recall of SR course. Through pattern recognition, this typology could help with timely identification of SR and implementation of evidence-based interventions to optimize outcomes. Prospective replication of these findings and their field application is warranted.

Equating and linking Patient-Reported Outcomes Measurement Information System 29-item questionnaire and 36-item Short-Form Health Survey domains using Rasch modeling.

OBJECTIVES: To develop a simple, practical methodology to equate or link equivalent domains of the 36-item Short-Form Health Survey (SF-36) and the Patient-Reported Outcomes Measurement Information System 29-item questionnaire (PROMIS-29) using the Rasch framework. STUDY DESIGN AND SETTING: In April 2016, the PROMIS-29 and SF-36 were completed by 1501 individuals selected to be representative of the French population. For each domain common to the two questionnaires, a Partial Credit Model was fitted to the items related to that dimension in the two questionnaires. These items were then calibrated on the same metric, which enabled the scores from one questionnaire to be associated with the scores from the other. RESULTS: Six of the seven PROMIS-29 scales and five of the six SF-36 subscales (physical, pain, social, vitality, depression and anxiety domains) were equated or linked. Correspondence tables between scores, with a 95% confidence interval, were established for each domain. A freely available Stata macro program was developed to automatize the equating or linking process. CONCLUSION: These results should facilitate comparisons across studies using the SF-36 and the PROMIS-29 in France. The equating or linking process developed is simple to implement and can be used in other countries and for other instruments.

Depressive symptomatology from a network perspective: Differences in the experience of symptoms involved in the self-recognition of depression and the diagnosis process by social position.

BACKGROUND: While social disparities in depression are well-documented, the symptom experience across social positions remains less studied. AIMS: This study examines the connections between depressive symptoms and self-recognizing a depressive episode, on the one hand, and clinical diagnosis, on the other hand, by three social position indicators. METHODS: We analyzed baseline data from a population-based cohort of adults living in France, grouping participants by three indicators: education, financial difficulties, and occupation, and stratifying by sex. Utilizing a psychometric network approach, we estimated 24 networks. Nodes corresponded to the 20 CES-D items and 1 external variable, either 'Limitations due to depression' or 'Clinical depression'. Comparisons between socially disadvantaged and advantaged groups across the three social indicators were made in terms of network structures, global strength, and edge weights involving symptoms and both external nodes. RESULTS: The study included data from 201,952 participants. Individuals in lower social positions exhibited higher rates of depressive-related variables. Four depressive symptoms emerged as crucial, being linked both to 'Clinical depression' and 'Limitations' across all social positions. Socially disadvantaged groups had denser networks. Some of the tests comparing network structures according to social position were significant, suggesting differences in the symptom activation chains. Connections between each external node and 'Felt depressed' and 'Could not get going' were non-invariant in educational and financial-based networks. CONCLUSIONS: Findings highlight four depressive symptoms, likely to play a key role in the experience of depression across all social positions. Other insights from specific symptoms could be used for improving depression care among disadvantaged populations.

Parental mental health and reporting of their child's behaviour: measurement invariance of the French version of the parental strengths and difficulties questionnaire.

Symptomatic effects of mental disorders in parents could bias their reporting on their child's mental health. This study aimed to investigate the measurement invariance of the French version of the parental Strengths and Difficulties Questionnaire (SDQ) across parental mental health in a sample (N = 20,765) of parents of children aged 3 to 17 years in France. Confirmatory factor analysis (CFA) and Exploratory Structural Equation Modelling (ESEM) were used to evaluate the fit of three known alternative SDQ factor structures (five, three, or second-order factor structures). Invariance was tested across parental mental health (present anxiety and depressive symptoms, psychiatric history) and across socio-demographic characteristics (child's age, child's gender, parent's gender, parent's educational level). CFA models showed a poor fit, while all ESEM models achieved acceptable or good fit, with the five-factor model presenting the best fit. Invariance was observed for all characteristics tested, indicating that the SDQ can be used to study the links between parental mental health and their child's mental health without bias. However, ESEM showed that the hyperactivity/inattention and conduct problems dimensions were not well differentiated in the French version of the SDQ.

How do men and women differ in their depressive symptomatology? A gendered network analysis of depressive symptoms in a French population-based cohort.

BACKGROUND: The experience of depressive manifestations and the presentation of symptoms in clinical settings may differ in men and women. Despite the extensive literature, it remains unclear how depressive manifestations interact at symptom levels in men and women. First, we aimed to describe and compare depressive networks by sex. Second, we examined symptom connections to Clinical depression and Functional Limitations as a proxy of self-recognition of a depressive episode. METHODS: We estimated networks from the 20 CES-D items in men and women from a large population-based French cohort. We computed centrality measures and ran comparisons. Then, we re-estimated two networks in men and women separately, adding, on the one hand, Clinical Depression and, on the other hand, Limitations due to a depressive episode. RESULTS: Over 200,000 participants were included in this study. Women were twice as likely to have a previous diagnosis of depression. Sex-ratio was less pronounced (1,7:1) for Limitations due to depression. Centrality measures revealed similar symptom patterns. However, network structures differed between men and women. We found some symptom connections to Clinical depression and Limitations to be non-invariant according to sex. LIMITATIONS: Cross-sectional data does not capture the direction of the connections between symptoms and an eventual diagnosis. We lacked data about the diagnosis's context and could not account for other factors influencing depressive symptomatology. CONCLUSIONS: Network structures differed, suggesting gender-specific mechanisms in activating symptoms and depressive states. Addressing central symptoms evoking depressed moods with tailored interventions may serve to tackle depressive states in men and women.

External validation of an artificial intelligence solution for the detection of elbow fractures and joint effusions in children.

PURPOSE: The purpose of this study was to conduct an external validation of an artificial intelligence (AI) solution for the detection of elbow fractures and joint effusions using radiographs from a real-life cohort of children. MATERIALS AND METHODS: This single-center retrospective study was conducted on 758 radiographic sets (1637 images) obtained from consecutive emergency room visits of 712 children (mean age, 7.27 ± 3.97 [standard deviation] years; age range, 7 months and 10 days to 15 years and 10 months), referred for a trauma of the elbow. For each set, fracture and/or effusion detection by eleven senior radiologists (reference standard) and AI solution was recorded. Diagnostic performance of the AI solution was measured via four different approaches: fracture detection (presence/absence of fracture as binary variable), fracture enumeration, fracture localization and lesion detection (fracture and/or a joint effusion used as constructed binary variable). RESULTS: The sensitivity of the AI solution for each of the four approaches was >89%. Greatest sensitivity of the AI solution was obtained for lesion detection (95.0%; 95% confidence interval: 92.1-96.9). The specificity of the AI solution ranged between 63% (for lesion detection) and 77% (for fracture detection). For all four approaches, the negative predictive values were >92% and the positive predictive values ranged between 54% (for fracture enumeration and localization) and 73% (for lesion detection). Specificity was lower for plastered children for all approaches (P < 0.001). CONCLUSION: The AI solution demonstrates high performances for detecting elbow's fracture and/or joint effusion in children. However, in our context of use, 8% of the radiographic sets ruled-out by the algorithm concerned children with a genuine traumatic elbow lesion.

High screen time and internalizing and externalizing behaviours among children aged 3 to 14 years during the COVID-19 pandemic in France.

Children's screen time increased as a result of the COVID-19 pandemic. In the summer of 2021, we explored the association between high screen time over a period of one year since May 2020 and behavioural problems among children and adolescents. The data were derived from the French EpiCov cohort study, collected in spring 2020, autumn 2020, and spring 2021. Participants (N = 1089) responded to online or telephone interviews about one of their children aged 3 to 14 years. Screen time was categorized as high if the daily mean screen time exceeded recommendations at each collection time. The Strengths and Difficulties Questionnaire (SDQ) was completed by parents to identify internalizing (emotional or peer problems) and externalizing (conduct problems or hyperactivity/inattention) behaviours in their children. Among the 1,089 children, 561 (51.5%) were girls, the average age was 8.6 years (SD 3.7). Internalizing behaviours: High screen time was not associated with internalizing behaviours (OR [95% CI] 1.20 [0.90-1.59]) or emotional symptoms (1.00 [0.71-1.41]) while it was associated with peer problems (1.42 [1.04-1.95]). Externalizing behaviours: High screen time was associated with externalizing problems (1.63 [1.01-2.63]) and conduct problems (1.91 [1.15-3.22]) only among older children aged 11 to 14 years. No association with hyperactivity/inattention was found. In a French cohort, exploration of persistent high screen time in the first year of the pandemic and behaviour difficulties in Summer 2021 resulted in mixed findings according to behaviour's type and children's age. These mixed findings warrant further investigation into screen type and leisure/school screen use to enhance future pandemic responses appropriate for children.

Diagnostic performance of real-time quantitative PCR in tear samples in various subtypes of herpes simplex keratitis.

Diagnosis of herpes simplex keratitis (HSK) is mostly based on clinical findings, yet biological confirmation supports management of challenging cases. This study evaluated the place of real-time quantitative PCR (RT-qPCR) on tear samplings in the management of HSK. Clinical records of patients who underwent tear sampling tested by RT-qPCR for herpes simplex virus type 1 for an acute episode of corneal inflammation or defect between January 2013 and December 2021 were retrospectively reviewed, and results were compared to clinical diagnosis (i.e., HSK or not) based on biomicroscopic findings and medical history. Of 465 tested tear samples from 364 patients, a clinical diagnosis of active (ongoing) HSK was recorded in 240 cases, among which 76 were RT-qPCR positive (global sensitivity of 31.6%, specificity of 99.5%). Sensitivity of RT-qPCR was higher in epithelial (97.4%) and stromal keratitis with ulceration (48.7%), compared to other types of HSK (23.5% in keratouveitis, 13.6% in endotheliitis, 11.1% in postherpetic neurotrophic keratopathy, and 8.1% in stromal keratitis without ulceration). The highest viral loads were detected from epithelial and stromal keratitis with ulceration, while in HSK with no epithelial involvement, the viral load detected was 196-fold lower, on average. The proportion of clinically characterized HSK patients with negative tear samples was higher in patients receiving antiviral treatment (P < 0.0001). RT-qPCR, performed on tear samples, can help in confirming diagnosis in case of presumed HSK, including clinical forms with no obvious epithelial involvement. The sensitivity of tear sampling is much higher whenever epithelial keratitis is present.

Country and sex measurement invariance of the Cannabis abuse screening test (CAST) in European Youth.

BACKGROUND: Monitoring the prevalence of problematic cannabis use is an important public health issue. International surveys need invariant measurement tools to allow reliable comparisons across countries and between sexes. The Cannabis abuse screening test (CAST) has been developed for this purpose. This study is the first assessing its country and sex invariance in a sample of European pupils. METHODS: The data come from the self-administered questionnaires completed in 2019 by pupils aged 15-16 in the European school survey project (Espad). The analytical sample was restricted to the 17 countries where at least 300 pupils reported a previous-year cannabis use (n = 8740); multigroup confirmatory factor analyses were used to assess the configural, metric and scalar invariance of the CAST toward country and sex in the 2019 Espad release. RESULTS: Configural, metric and scalar invariance toward country hold for the 17 countries: Austria, Bulgaria, Croatia, Czech Republic, Denmark, Estonia, Finland, France, Georgia, Greece, Italia, Latvia, Poland, Portugal, Slovakia, Slovenia and Spain. Scalar invariance toward sex was met in the 17 countries as a whole and in 11 of the 12 countries where the test could be run. Scalar invariance toward country was met with 6 additional countries comprising at least 250 respondents: Ireland, Lithuania, Malta, Montenegro, the Netherlands and Norway. CONCLUSION: The CAST is a suitable test for comparing the measurement of problematic cannabis use amongst adolescents in Europe.

The French General Population's Perception of New Information and Communication Technologies for Medical Consultations: National Survey.

BACKGROUND: The development of telehealth and telemedicine, in the form of increased teleconsultation and medical telemonitoring, accelerated during the COVID-19 health crisis in France to ensure continued access to care for the population. Since these new information and communication technologies (ICTs) are diverse and likely to transform how the health care system is organized, there is a need better to understand public attitudes toward them and their relationship with peoples' current experience of health care. OBJECTIVE: This study aimed to determine the French general population's perception of the usefulness of video recording/broadcasting (VRB) and mobile Health (mHealth) apps for medical consultations in France during the COVID-19 health crisis and the factors associated with this perception. METHODS: Data were collected for 2003 people in 2 waves of an online survey alongside the Health Literacy Survey 2019 (1003 in May 2020 and 1000 in January 2021) based on quota sampling. The survey collected sociodemographic characteristics, health literacy levels, trust in political representatives, and perceived health status. The perceived usefulness of VRB in medical consultations was measured by combining 2 responses concerning this technology for consultations. The perceived usefulness of mHealth apps was measured by combining 2 responses concerning their usefulness for booking doctor appointments and for communicating patient-reported outcomes to doctors. RESULTS: The majority (1239/2003, 62%) of respondents considered the use of mHealth apps useful, while only 27.6% (551/2003) declared VRB useful. The factors associated with the perceived usefulness of both technologies were younger age (≤ 55 years), trust in political representatives (VRB: adjusted odds ratio [aOR] 1.68, 95% CI 1.31-2.17; mHealth apps: aOR 1.88, 95% CI 1.42-2.48), and higher (sufficient and excellent) health literacy. The period of the beginning of the COVID-19 epidemic, living in an urban area, and being limited in daily activities were also associated with perceiving VRB positively. The perceived usefulness of mHealth apps increased with the level of education. It was also higher in people who had 3 or more consultations with a medical specialist. CONCLUSIONS: There are important differences in attitudes toward new ICTs. Perceived usefulness was lower for VRB than for mHealth apps. Moreover, it decreased after the initial months of the COVID-19 pandemic. There is also the possibility of new inequalities. Hence, despite the potential benefits of VRB and mHealth apps, people with low health literacy considered them to be of little use for their health care, possibly increasing their difficulties in accessing health care in the future. As such, health care providers and policy makers need to consider those perceptions to guarantee that new ICTs are accessible and beneficial to all.

Comparison of Depression and Anxiety Following Self-reported COVID-19-Like Symptoms vs SARS-CoV-2 Seropositivity in France.

Importance: The long-term consequences of COVID-19 on mental health are a critical issue given the number of people infected with SARS-CoV-2 worldwide since the beginning of the pandemic. Objective: To investigate the associations between self-reported COVID-19-like symptoms or SARS-CoV-2 seropositivity and subsequent depression or anxiety. Design, Setting, and Participants: This propensity score-matched cohort study began in May 2020, with follow-ups in November 2020 and July 2021. The study used data from a large, randomly selected, national population-based cohort from France, the EpiCoV (Epidémiologie et Conditions de Vie) study. Of 85 074 individuals 15 years or older who completed the questionnaires at the 3 collection times, 28 568 were excluded because they did not return a blood sample for serologic testing, 1994 because of missing data on outcomes or exposures, and 9252 to respect the temporal sequence (exposure must precede the outcome). Exposures: Propensity scores based on various socioeconomic, lifestyle, and health variables were computed to match participants who experienced COVID-19-like symptoms between February and November 2020 or showed SARS-CoV-2 seropositivity in November 2020. Main Outcomes and Measures: Logistic regression models were used to estimate associations between these occurrences and depression or anxiety assessed in July 2021 using the Patient Health Questionnaire 9-item and Generalized Anxiety Disorder 7-item scales, respectively. Results: Among the 45 260 included participants (mean [SD] age, 51.1 [18.9] years; 52.4% women; 8.0% with depression and 5.3% with anxiety in July 2021), COVID-19-like symptoms were associated with subsequent depression (adjusted odds ratio, 1.70; 95% CI, 1.45-1.99) and anxiety (adjusted OR, 1.57; 95% CI, 1.29-1.92), whereas SARS-CoV-2 seropositivity was not. Furthermore, COVID-19-like symptoms, but not anosmia or dysgeusia alone, were associated with subsequent depression and anxiety in both the seropositive and seronegative subgroups. Conclusions and Relevance: In this cohort study of more than 45 000 individuals drawn from the French general population, SARS-CoV-2 infection was not found as a risk factor of subsequent depression or anxiety. Moreover, self-reported COVID-19-like symptoms were associated with depression and anxiety assessed at least 8 months later in both seropositive and seronegative subgroups, suggesting that factors other than SARS-CoV-2 infection are implied in this association.

Depression, anxiety, and suicidal ideation in a population-based cohort of young adults before and during the first 12 months of the COVID-19 pandemic in Canada.

OBJECTIVES: Findings from a birth cohort study indicated that the mental health of young adults had not worsened during the first wave of the COVID-19 pandemic, compared to 2018. This study examined longitudinal changes in mental health between March 2018 and June 2021 in the context of protracted public health mitigation measures about 12 months after the onset of the pandemic. METHODS: Participants from the Quebec Longitudinal Study of Child Development (n = 2120 at inception; n = 1461 during the COVID-19 pandemic), a population-based cohort of individuals born in 1997/1998, reported on their depressive and anxiety symptoms as well as suicidal ideation prior to the pandemic in 2018 (age 20), and during the pandemic in the summer of 2020 (age 22) and spring of 2021 (age 23). RESULTS: Depressive (Cohen's d = 0.15 [95% CI: 0.09 to 0.20]) and anxiety (Cohen's d = 0.33 [95% CI: 0.27 to 0.39]) symptoms increased between 2018 and 2021 for both males and females, but suicidal ideation did not change. There was also a significant increase in moderate to severe depressive (31.7% to 36.3%) and anxiety (14.7% to 24.8%) symptoms from 2018 to 2021. Youth who were students, those who were experiencing financial stress, food insecurity, and loneliness, and those without pre-existing poor mental health experienced the largest increase in depressive and anxiety symptoms over time. CONCLUSION: These findings highlight the mental health burden experienced by young adults during the COVID-19 pandemic, highlighting the need for preventive services and continued longitudinal follow-ups of these youths.

RéSUMé: OBJECTIFS: Les résultats d'une étude de cohorte de naissance ont indiqué que la santé mentale des jeunes adultes ne s'était pas détériorée au cours de la première vague de la pandémie de la COVID-19, en comparaison à 2018. La présente étude examine maintenant les changements longitudinaux de la santé mentale entre mars 2018 et juin 2021, dans le contexte de mesures prolongées de santé publique, environ 12 mois après le début de la pandémie. MéTHODES: Les participants de l'Étude longitudinale du développement des enfants du Québec (n = 2120 à la création; n = 1461 pendant la pandémie de COVID-19), une cohorte basée sur la population de personnes nées en 1997­98, ont rapporté leurs symptômes de dépression et d'anxiété ainsi que leurs idéations suicidaires avant la pandémie en 2018 (20 ans), pendant la pandémie à l'été 2020 (22 ans) ainsi qu'au printemps 2021 (23 ans). RéSULTATS: Les symptômes de dépression (d de Cohen = 0,15 [95% IC: 0,09 à 0,20]) et d'anxiété (d de Cohen = 0,33 [95% IC: 0,27 à 0,39]) ont augmenté entre 2018 et 2021 chez les hommes et les femmes, mais les idéations suicidaires n'ont pas changé. Une augmentation significative des symptômes dépressifs modérés à sévères (31,7 % à 36,3 %) et des symptômes d'anxiété (14,7 % à 24,8 %) a également été observée entre 2018 et 2021. Les jeunes qui étaient étudiants, ceux qui rapportaient un stress financier, de l'insécurité alimentaire et de la solitude, ainsi que ceux qui avaient une bonne santé mentale en prépandémie, ont connu la plus forte augmentation des symptômes de dépression et d'anxiété au fil du temps. CONCLUSION: Ces résultats mettent en évidence l'impact de la pandémie de la COVID-19 sur la santé mentale des jeunes adultes, et soulignent la nécessité de mettre en place des services de prévention et de poursuivre le suivi longitudinal de ces jeunes.