Study: Personality disorders prevalent in young adults

Study: Personality disorders prevalent in
young adults
(February 2009 Issue)

By Catherine Robertson-Souter

An alarming number of college-aged Americans suffer from mental disorders and far too few of them seek treatment.

This news, published in the Archives of General Psychology in December, swept through the media in early December after researchers from Columbia University, New York State Psychiatric Institute announced the findings of a study looking at the rates of mental disorders among college students and their same-age peers in the working world.

The study analyzed more than 5,000 face-to-face interviews conducted in 2001 and '02 as part of the National Epidemiologic Survey on Alcohol and Related Conditions to identify the rates of psychiatric disorders and treatment in Americans ages 19 to 25.

The results show that nearly half of college-aged Americans (both students and those not currently in school) had "a psychiatric disorder in the past year." Furthermore, less than one fourth of this age group with mental disorders sought treatment in the year prior to the survey. The study is the largest of its kind and the first to show that overall disorders may be far higher than previously believed.

"We are not suggesting that there is an increase in disorders," says Carlos Blanco, M.D., Ph.D., associate professor of clinical psychiatry at Columbia University and lead author of the study. "This is the first national study of this age group so we do not know if there has been an increase or decrease from 10 years ago. What we are saying is that there are high rates and we need to be aware."

The study looked at a range of psychiatric disorders. The most prevalent, personality disorders, was found among 17.7 percent of college students and 21.6 percent of those not in school. While the overall rate of disorders was not vastly different between those in college and their peers, college students had much higher rates of alcohol use disorders compared to a higher nicotine dependence for those not in college.

"One thing that was not picked up on by most of the media but is important to note, was the high rate of alcohol use disorders," says Blanco. "This is something that is easily preventable. Policies need to be implemented to raise awareness among college students."

The psychiatric disorders so widely reported on may have caught more media attention because, on the other hand, no one is surprised that college students drink. It is part of popular culture, expected and accepted.

"This is something that is well recognized on campus that students drink. Things are not going to change overnight," says Blanco.

Heavy drinking among college students can lead to severe physical problems later in life, Blanco points out, as well as physical injuries, sexual assault and poor academic performance during the college years.

Some experts have questioned the reliability of the study. Most, if not all, late adolescents and young adults feel pressure to achieve, in school or outside of it, and may report higher rates of anxiety and depression than older or younger people. As Blanco points out, however, there is a difference between normal anxiety and an anxiety disorder.

"Just like we all have a temperature but if it is too high, it is called a fever, having anxiety is not the same as having a disorder," he explains. "And just because it is expected for this age group to have anxiety does not mean it should not be treated. Just like if you have been stabbed in the back, you might expect it to bleed but that does not mean that you would not go to the hospital to get it taken care of."

At the University of Massachusetts Dartmouth's Student Counseling Center, Director Christine Frizzell, Ed.D., has seen an increase in the number of students with mental disorders over the past 10 years. She sees it as a positive sign, though.

"We are seeing an increase in the number of students coming to college already diagnosed with some kind of mental illness, whether it is depression or personality disorder," she says. "This is good news. This means that they are being diagnosed earlier and that they are here whereas before they may not have made it to college."

"They do require more support on our side, of course," she adds. "The Campus Counseling Center is extremely busy - the pace has probably doubled since 10 years ago." Frizzell attributes part of the increase in business to the increase in diagnoses but also to the reduction of stigma on campus.

"There is less stigma these days, less of a sense that you have to be 'crazy' to be in treatment," she says. "This generation is more psychological-minded. They grew up on Dr. Laura and Dr. Phil and Jerry Springer. They tend to diagnose their friends and talk about things that other generations would never have talked about."

But what about the findings that only about one-fourth of this age group will seek treatment for their illness?

"Well, still, at the end of every semester I find people coming in to see us and I am amazed that they hadn't been in before then," she says.