Cross-sectional survey finds high symptom burden among French physiotherapy students

Clinically significant symptoms of depression, anxiety and insomnia were common among French physiotherapy students in a nationwide cross-sectional online survey, with the clearest associations emerging from students’ immediate experience of training rather than institutional location or status. Among 1,717 students recruited from 48 of France’s 63 physiotherapy training institutions, 46.8% met the study’s threshold for depressive symptoms, 35.1% met the threshold for anxiety symptoms and 18.1% met the threshold for insomnia symptoms. Researchers surveyed students aged 18 or older enrolled in years two through five of physiotherapy education between 18 November 2025 and 19 January 2026.

The study used voluntary, non-probability sampling, so participants were self-selected rather than recruited through a representative random sample of all eligible students. Mental health symptoms were assessed with the Patient Health Questionnaire-9, Generalized Anxiety Disorder-7 and Insomnia Severity Index. Prespecified thresholds of 10, 10 and 15, respectively, identified clinically significant depressive, anxiety and insomnia symptoms.

Although the descriptive sample contained 1,717 students, 1,711 were included in the regression analyses. The most consistent educational association involved the balance between personal life and training. Students reporting an unfavourable balance had 3.67 times the adjusted odds of depressive symptoms, 2.89 times the adjusted odds of anxiety symptoms and 2.70 times the adjusted odds of insomnia symptoms.

The 95% confidence intervals were 2.86–4.71 for depression, 2.38–3.51 for anxiety and 1.95–3.72 for insomnia. These estimates describe associations after adjustment in separate multivariable logistic regression models; because the data were cross-sectional, they do not show that an unfavourable balance caused the symptoms or that improving it would necessarily reduce them. Support from teachers, supervisors and peers was also associated with all three outcomes.

Students reporting unfavourable support in these relationships had higher odds of depressive, anxiety and insomnia symptoms, while high or very high perceived workload was independently associated with anxiety symptoms. In exploratory contextual analyses, neither institutional status nor geographical setting was independently associated with any of the three outcomes. That result does not demonstrate that institutional and geographic differences never exist; rather, those variables were not independently associated with the measured symptoms in the contextual models used in the study.

The researchers fitted separate multivariable logistic regression models for the three outcomes and used cluster-robust standard errors at the training-institution level to account for students being nested within institutions. Sensitivity analyses using continuous symptom scores and alternative approaches to clustering largely supported the main findings. The results support closer examination of potentially modifiable learning conditions, particularly work–life balance, supervision, peer support and workload, and the study’s authors call for prospective evaluation of interventions.

However, the voluntary, cross-sectional design and reliance on self-reported symptoms limit what can be inferred. The findings cannot establish prevalence throughout the French physiotherapy student population, track changes over time, determine the direction of causation or demonstrate that any programme-level response will improve mental health.

Subject of Research: Educational and contextual correlates of mental health symptoms among French physiotherapy students

Article Title: Mental health and learning conditions among French physiotherapy students: a nationwide cross-sectional study of individual, educational and contextual factors

Article References: Petit, M., Delafontaine, A., & Sarhan, F.-R. (2026). Mental health and learning conditions among French physiotherapy students: a nationwide cross-sectional study of individual, educational and contextual factors. BMC Medical Education. https://doi.org/10.1186/s12909-026-10413-5

Image Credits: AI Generated

DOI: 10.1186/s12909-026-10413-5

Keywords: physiotherapy students, mental health, depressive symptoms, anxiety symptoms, insomnia, student workload, work–life balance, educational support, France, cross-sectional study, Mental, health