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International audience; 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.

OBJECTIVES: Assisted death has been discussed for years in medicine. Ten countries have adopted legislation that authorises some form of euthanasia or assisted suicide, and the incidence and practices vary from country to country. Consideration of psychological pain linked to psychiatric disorders as a sufficient legal condition for enabling assisted death has added a new layer of complexity to the debate. Thus, Switzerland, Netherlands, Belgium and Luxembourg legalised assisted suicide or euthanasia for psychiatric reasons. In these cases, it is not a question of choosing death conditions but the occurrence of death. This manuscript is a narrative review of the literature about characteristics of patients with psychiatric disorders who requested assisted death in these countries. METHODS: Scientific manuscripts, reports and legal documents were reviewed. RESULTS: The incidence of assisted death for psychiatric reasons was low but has increased over the years. They represented 1.1 % of assisted deaths in Belgium (n=23) and 1.3 % in Netherlands (n=83) in 2017, and 4.5 % in Switzerland in 2014 when also considering dementia. The most frequent diagnoses were depressive and personality disorders. Patients were more often women than men, unlike suicide and middle aged. CONCLUSIONS: Authors who support these practices emphasise the right to die with dignity and the inequality of ruling out patients with psychiatric reasons, whereas they meet the legal requirements, and psychological pain is as severe as somatic pain. Some major issues are highlighted: the close relationship between mood symptoms and death wish, thinking biases and cognitive disturbances that limit the ability to decide, access and consent to medical care, the difficulty of assessing psychological pain, and the definitions of incurability or treatment refractoriness in psychiatry. To date, medical knowledge and assessment tools are not sufficient to define possible indications and offer the best support possible to these patients.; OBJECTIFS: L’aide médicale à mourir est discutée depuis des dizaines d’années en médecine. Dix pays sont favorables à l’euthanasie et/ou au suicide assisté. La fréquence et les pratiques sont assez différentes d’un pays à l’autre. L’intégration des souffrances psychiques liées aux pathologies psychiatriques comme condition légale suffisante à leur accès dans quatre pays a rendu cette question d’autant plus complexe. Pour ces troubles, il ne s’agit plus de choisir les modalités du décès mais bien la survenue de ce décès. Ce travail est une revue de la littérature narrative s’intéressant au profil des patients souffrant d’un trouble psychiatrique qui entreprennent une telle démarche. METHODES: Ont été abordés des articles scientifiques, des rapports et des textes de loi. RESULTATS: Les diagnostics les plus fréquemment retrouvés étaient les troubles dépressifs et les troubles de la personnalité. Il s’agissait le plus souvent de femmes, à la différence du suicide, et de personnes d’âge moyen. CONCLUSIONS: Les questions de l’intrication de symptômes thymiques, de biais de raisonnement et de perturbations cognitives entravant le jugement, de l’accès et du consentement aux soins, de l’évaluation de la souffrance psychique et de la définition de l’incurabilité des troubles psychiatriques font particulièrement débat. À ce jour, les connaissances médicales et les outils d’évaluation ne semblent pas assez satisfaisants pour définir les indications éventuelles et accompagner au mieux des demandes d’assistance médicale à la fin de vie pour motifs psychiatriques.

Supplemental material, supplemental_material for Pathways From ADHD Symptoms to Suicidal Ideation During College Years: A Longitudinal Study on the i-Share Cohort by Julie Arsandaux, Massimiliano Orri, Marie Tournier, Antoine Gbessemehlan, Sylvana Coté, Réda Salamon, Christophe Tzourio and Cédric Galéra in Journal of Attention Disorders