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1 in 5 young adults has personality disorder

By LINDSEY TANNER, AP Medical Writer Lindsey Tanner, Ap Medical Writer 2 hrs 14

mins ago

CHICAGO Almost one in five young American adults has a personality disorder

that interferes with everyday life, and even more abuse alcohol or drugs,

researchers reported Monday in the most extensive study of its kind.

The disorders include problems such as obsessive or compulsive tendencies and

anti-social behavior that can sometimes lead to violence. The study also found

that fewer than 25 percent of college-aged Americans with mental problems get

treatment.

One expert said personality disorders may be overdiagnosed. But others said the

results were not surprising since previous, less rigorous evidence has

suggested mental problems are common on college campuses and elsewhere.

Experts praised the study's scope face-to-face interviews about numerous

disorders with more than 5,000 young people ages 19 to 25 and said it

spotlights a problem college administrators need to address.

Study co-author Dr. Mark Olfson of Columbia University and New York State

Psychiatric Institute called the widespread lack of treatment particularly

worrisome. He said it should alert not only "students and parents, but also

deans and people who run college mental health services about the need to

extend access to treatment."

Counting substance abuse, the study found that nearly half of young people

surveyed have some sort of psychiatric condition, including students and

non-students.

Personality disorders were the second most common problem behind drug or

alcohol abuse as a single category. The disorders include obsessive,

anti-social and paranoid behaviors that are not mere quirks but actually

interfere with ordinary functioning.

The study authors noted that recent tragedies such as fatal shootings at

Northern Illinois University and Virginia Tech have raised awareness about the

prevalence of mental illness on college campuses.

They also suggest that this age group might be particularly vulnerable.

"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 said. These

circumstances, they said, can result in stress that triggers the start or

recurrence of psychiatric problems.

The study was released Monday in Archives of General Psychiatry. It was based

on interviews with 5,092 young adults in 2001 and 2002.

Olfson said it took time to analzye the data, including weighting the results

to extrapolate national numbers. But the authors said the results would

probably hold true today.

The study was funded with grants from the National Institutes of Health, the

American Foundation for Suicide Prevention and the New York Psychiatric

Institute.

Dr. Sharon Hirsch, a University of Chicago psychiatrist not involved in the

study, praised it for raising awareness about the problem and the high numbers

of affected people who don't get help.

Imagine if more than 75 percent of diabetic college students didn't get

treatment, Hirsch said. "Just think about what would be happening on our

college campuses."

The results highlight the need for mental health services to be housed with

other medical services on college campuses, to erase the stigma and make it

more likely that people will seek help, she said.

In the study, trained interviewers, but not psychiatrists, questioned

participants about symptoms. They used an assessment tool similar to criteria

doctors use to diagnose mental illness.

Dr. Jerald Kay, a psychiatry professor at Wright State University and chairman

of the American Psychiatric Association's college mental health committee, said

the assessment tool is considered valid and more rigorous than self-reports of

mental illness. He was not involved in the study.

Personality disorders showed up in similar numbers among both students and

non-students, including the most common one, obsessive compulsive personality

disorder. About 8 percent of young adults in both groups had this illness,

which can include an extreme preoccupation with details, rules, orderliness and

perfectionism.

Kay said the prevalence of personality disorders was higher than he would

expect and questioned whether the condition might be overdiagnosed.

All good students have a touch of "obsessional" personality that helps them

work hard to achieve. But that's different from an obsessional disorder that

makes people inflexible and controlling and interferes with their lives, he

explained.

Obsessive compulsive personality disorder differs from the better known OCD, or

obsessive-compulsive disorder, which features repetitive actions such as

hand-washing to avoid germs.

OCD is thought to affect about 2 percent of the general population. The study

didn't examine OCD separately but grouped it with all anxiety disorders, seen

in about 12 percent of college-aged people in the survey.

The overall rate of other disorders was also pretty similar among college

students and non-students.

Substance abuse, including drug addiction, alcoholism and other drinking that

interferes with school or work, affected nearly one-third of those in both

groups.

Slightly more college students than non-students were problem drinkers 20

percent versus 17 percent. And slightly more non-students had drug problems

nearly 7 percent versus 5 percent.

In both groups, about 8 percent had phobias and 7 percent had depression.

Bipolar disorder was slightly more common in non-students, affecting almost 5

percent versus about 3 percent of students.