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2008-12-02 09:28:13
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.