Attention deficit hyperactivity disorder (ADHD) has been increasingly recognized as a valid adult diagnosis. Yet the impairments related to ADHD in college students have received little scholarly attention. Psychological and academic impairments in college students not previously diagnosed with ADHD were assessed in a retrospective chart review, using specifically defined diagnostic criteria, and compared with a control group. Students with ADHD had a significantly lower mean grade point average, were more likely to be on academic probation, and reported significantly more academic problems. Measures of psychological impairment in the ADHD group were not significantly different from those in the control group. College students diagnosed with ADHD had a specific pattern of academic impairment. The problems of these students, compared with other groups of children and adults with ADHD, appeared to be more related to a type of learning disorder than to the conceptualization of ADHD in the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV).
Identification of attention deficit hyperactivity disorder (ADHD) in adults presents a number of problems because there is no one specific diagnostic test for the condition. Given this challenge, clinicians often struggle between restrictive and exclusionary diagnostic methods or overinclusive acceptance that ADHD is a prevalent and disabling problem. A modified version of the Attention Deficit Hyperactivity Rating Scale was administered to 468 students at a large midwestern university. Analysis of the results suggested that the degree of ADHD symptoms in college students is modest and indicated that cutoff scores of 4 for current symptoms of inattention and hyperactivity-impulsivity would be sufficient to identify a college student as distinct from the norm. Although it would be premature to accept the calculated thresholds completely, clinicians should be aware of these differences when evaluating college students for ADHD.
Depression and suicide are of increasing concern on college campuses. This article presents data from the College Health Intervention Projects on the frequency of depression and suicide ideation among 1,622 college students who accessed primary care services in 4 university clinics in the Midwest, Northwest, and Canada. Students completed the Beck Depression Inventory and other measures related to exercise patterns, alcohol use, sensation seeking, and violence. The frequency of depression was similar for men (25%) and women (26%). Thought of suicide was higher for men (13%) than women (10%). Tobacco use, emotional abuse, and unwanted sexual encounters were all associated with screening positive for depression. "Days of exercise per week" was inversely associated with screening positive for depression. Because the majority of students access campus-based student health centers, medical providers can serve a key role in early identification and intervention. With every 4th student reporting symptoms of depression and every 10th student having suicidal thoughts, such interventions are needed.Keywords university students; full and reduced-form logistic regression; randomized controlled trials; depression; suicidal ideation; university health clinics Correspondence concerning this article should be addressed to Michael Fleming, Feinberg School of Medicine, Northwestern University, Abbott Hall, 710 N. Lake Shore Dr., Chicago, IL 60611. Electronic mail may be sent to m-fleming@northwestern.edu. Brian Harahan is now at the University of Minnesota. Michael Fleming is now at Northwestern University. NIH Public Access Author ManuscriptAm J Orthopsychiatry. Author manuscript; available in PMC 2012 January 1. Depression and other mental health disorders are a significant public health problem on college campuses. Many students experience their first psychiatric episode while at college, and 12 to 18% of students have a diagnosable mental illness (Mowbray, Megivern & Mandiberg, 2006). Epidemiological studies suggest that the 15 to 21 age category (typical college years) has the highest past-year prevalence rate of mental illness at 39%. Eisenberg (2007) reported that the general prevalence of depression and anxiety is 16% among undergraduate students and 13% among graduate students. Based on findings from the American College Health Association (ACHA) National College Health Assessment (NCHA), the rates of students reporting having been diagnosed with depression has increased from 10% in 2000 to 18% in 2008 (2000, 2008). A number of factors contribute to the initial presentation of depression during college. The transition itself from home to college places additional life stressors on young adults as they explore their identity, strive to master new skills, are away from established social support systems, and have increased time demands (Dyson & Renk, 2006).The consequences of depression are significant. Depression has long been associated with academic impairment (Heiligenstein, Guenther, Hsu, & Herman, 1996). Depr...
Impairment from depression and its impact on productivity are of profound societal importance. We report the results of an evaluation of depression and academic impairment in university students, using standardized measures. Sixty-three students completed the Beck Depression Inventory and the work role section from the Social Adjustment Scale-Self Report. Academic impairment, manifested as missed time from class, decreased academic productivity, and significant interpersonal problems at school, was seen in 92% of the students. More severe depression was related to a higher level of impairment. At all levels of depression, affective impairment-inadequacy, distress, and disinterest in school-was more prevalent than was academic impairment. The risk of academic impairment became likely at only moderate-to-severe levels of depression. Discussing the implications of depression with students and aggressively pursuing both medication and nonmedication therapies are essential in preventing the high morbidity associated with untreated depression.
Introduction: While most college students and other young adults who smoke fall into the light and intermittent smoking (LITS) category, they remain at risk for tobacco dependence and other adverse health effects from their smoking. This study examines smoking patterns, tobacco dependence, and other health variables among students at five universities to better understand how to identify and address tobacco use and related risks in a college health clinic setting. Methods:A health screening survey was completed by 2,091 college and graduate student volunteers seeking routine care at their university health centers or participating in a health class. Independent health variables were analyzed descriptively and in regression analyses with three levels of smoking (none, nondaily, and daily) and tobacco dependence to determine predictors and associated risks.Results: Nearly a quarter of students reported any current smoking, 41% of whom reported smoking less than 1 cigarette/ day (cpd). Of the daily smokers, 80% smoked less than 10 cpd but 45% met criteria for tobacco dependence. Any smoking was associated with high-risk alcohol use, risky driving, relational abuse, depression, less exercise, and utilization of emergency and mental health services. In regression analyses, students who experienced depression had more than double the odds of being dependent smokers (odds ratio [OR] = 2.32), as did those who reported abuse (OR = 2.07) or sought mental health counseling (OR = 2.09).
Pemoline, a dopamine agonist, is effective in children with attention deficit hyperactivity disorder (ADHD), but its efficacy in adults is unknown. The authors studied the efficacy and safety of pemoline, using retrospective chart review of treated students with ADHD over a 2-year period. Forty students met diagnostic and treatment criteria; pemoline was associated with much improved or very much improved Clinical Global Impression symptoms scores in 70% of the students during a treatment period of 14 or more days. Severity of illness scores dropped from 4.11 to 3.01 between baseline and subsequent evaluation. Nine evaluable patients had adverse events, most commonly headaches, insomnia, and decreased appetite. Five additional students, who failed to meet the treatment-duration criterion, terminated because of severe initial insomnia. The authors concluded that pemoline is effective and safe in students with ADHD and has a lower abuse potential than methylphenidate and dextroamphetamine, the other two widely used, structurally dissimilar compounds, but controlled studies may be necessary before any final conclusions are reached.
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