Psychiatric disorders common among college-age individuals; few seek treatment

Psychiatric disorders appear to be common among 18- to 24-year-olds, with overall rates similar among those attending or not attending college, according to a report in the December issue of Archives of General Psychiatry, one of the JAMA/Archives journals. Almost half of college-aged individuals meet criteria for substance abuse, personality disorders or another mental health condition during a one-year period, but only one-fourth of those seek treatment. Recent tragic events at U.S. universities have called attention to the mental health needs of young adults, according to background information in the article. "For many, young adulthood is characterized by the pursuit of greater educational opportunities and employment prospects, development of personal relationships and, for some, parenthood," the authors write. "While all of these circumstances offer opportunities for growth, they may also result in stress that precipitates the onset or recurrence of psychiatric disorders."

Approximately one-half of Americans age 18 to 24 are enrolled in college at least part-time. To compare their mental health to that of individuals the same age not enrolled in college, Carlos Blanco, M.D., Ph.D., of the New York State Psychiatric Institute and Columbia University, New York, and colleagues analyzed data from the National Epidemiologic Survey on Alcohol and Related Conditions. In this national survey, individuals age 19 to 25 who were attending (2,188) or not attending (2,904) college during the previous year were interviewed and assessed for psychiatric disorders between 2001 and 2002.

A total of 45.8 percent of college students and 47.7 percent of young adults not in college met the criteria for at least one psychiatric disorder. The most common disorders in college students were alcohol use disorders (20.4 percent) and personality disorders (17.7 percent), whereas those not in college most frequently met criteria for personality disorders (21.6 percent) and nicotine dependence (20.7 percent). College students were less likely to have a diagnosis of drug use disorder, nicotine dependence or bipolar disorder and were less likely to have used tobacco. However, their risk of alcohol use disorders was significantly greater.

Treatment rates were low for all psychiatric disorders. College students were significantly less likely to receive treatment for alcohol or drug use disorders than those not in college. "In view of the high prevalence and low rate of treatment of alcohol use disorders in college students, greater efforts to implement screening and intervention programs on college and university campuses are warranted," the authors write. "The centralized delivery of campus student health services might offer an advantageous structure for carrying out such screening and interventions."

Overall, the authors note, the rate of psychiatric disorders is high among young adults, who are at a vulnerable stage of development. "The vast majority of disorders in this population can be effectively treated with evidence-based psychosocial and pharmacological approaches," they conclude. "Early treatment could reduce the persistence of these disorders and their associated functional impairment, loss of productivity and increased health care costs. As these young people represent our nation's future, urgent action is needed to increase detection and treatment of psychiatric disorders among college students and their non–college-attending peers."

(Arch Gen Psychiatry. 2008;65[12]:1429-1437. Available pre-embargo to the media at www.jamamedia.org.)

Source: JAMA and Archives Journals