Young adults hit by mental health issues

Nearly half of college-age adults struggle with a mental health disorder, from alcohol dependency to depression and anxiety. But only a quarter seek treatment, according to a study published today.

"This study gives a picture of the magnitude of the problem and the extent to which these disorders go untreated," said Dr. Mark Olfson, a professor of clinical psychiatry at Columbia University Medical Center and lead author of the study. "It really lays out the challenge of providing services to meet the need, particularly of alcohol use disorders."

The study found similar rates of psychiatric illnesses among college students and those not enrolled in college, suggesting that the stressful transition from adolescence to adulthood can trigger the onset of a mental health problem regardless of setting. Olfson said he hopes the data will provoke discussion about how to get more young people into treatment.

Researchers analyzed results of the 2001-2002 National Epidemiologic Survey on Alcohol and Related Conditions, a sweeping national survey of 43,093 adults of all ages conducted by the U.S. Census Bureau and the National Institute on Alcohol Abuse and Alcoholism.Olfson's study, which appears in this week's Archives of General Psychiatry, focuses on the responses from about 5,000 people between the ages of 19 and 25. It compared findings in two groups, those enrolled in college - 2,188 - and those who were not - 2,904.

Among college students, alcohol abuse and dependency were the most common at 20 percent, followed by personality disorders such as obsessive-compulsive and paranoid disorders at 18 percent. Non-college students were most likely to report personality disorders and nicotine dependence.

The rates of mood disorders, such as depression and bipolar disorder, were 11 percent for college students and 12 percent for non-students. The same rates were found for anxiety disorders in each group.

The study did not measure the prevalence of such disorders among adults of other ages.

Jim Spivack, a psychologist and director of the counseling center at Towson University, said the problem of alcohol abuse among students has long been recognized. But today, he said, nearly half of the students who seek help from the center display signs of anxiety and mood disorders.

"Counseling center directors have reported consistently over the last five to 10 years the increase in the complexity and severity of issues college students are bringing to college campuses," he said.

Many factors may be contributing to the rise. While young adulthood has long been recognized as a tumultuous time, greater awareness of mood and anxiety disorders and the availability of drugs to treat them have resulted in young people being diagnosed earlier, Spivack said.

Some young people are under a lot of stress, with more students working while going to school and under greater pressure to declare a major and career field as soon as possible, he said.

In addition, the onset of some disorders appears in the early adult years, just as young people are leaving the structured world of childhood and navigating their new freedoms and responsibilities.

"Years ago we thought that childhood and late adolescence are happy times and people didn't tend to be depressed," Olfson said. "In fact, it is in late adolescence and early adulthood some of these problems have their onset."

A limitation of the analysis is that it did not include eating disorders, said Dr. Harry Brandt, director for the Center for Eating Disorders at Sheppard Pratt and head of the psychiatry department at St. Joseph Medical Center.

At least half of the patients he sees at the eating disorder center are young adults, he said. "I was very surprised that among all the diagnoses, they did not look at eating disorders, since those are among the most deadly and serious disorders of that age range," he said.

In general, Brandt said, young people resist treatment because of denial and the societal stigma of mental illness.

Spivack said that Towson is trying to raise awareness of mental health problems and services. For instance, this semester, for the first time, resident assistants took part in a mandatory suicide-prevention training session.

"I think that we probably see about 10 percent of the student body in any given year," Spivack said. "We certainly are not catching all of them."

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