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...
Objective: The aim of this study was to test the effi cacy of brief physician advice in reducing alcohol use and related harm in college students. Method: The College Health Intervention Projects (CHIPs) is a randomized, controlled clinical trial with 12-month followup conducted in fi ve college health clinics in Wisconsin; Washington state; and Vancouver, Canada. Of the 12,900 students screened for highrisk drinking, 484 men and 502 women met inclusion criteria and were randomized into a control (n = 493) or intervention (n = 493) group. Ninety-six percent of students participated in the follow-up procedures. The intervention consisted of two 15-minute counseling visits and two follow-up phone calls, and used motivational interviewing, contracting, diary cards, and take-home exercises. Results: No signifi cant differences were found between groups at baseline on alcohol use, age, socioeconomic or smoking status, rates of depression, or measures of alcohol-related harm. At 12 months, the experimental subjects reduced their 28-day drinking totals by 27.2%, and the control group reduced their totals by 21%. A mixed effects repeated measures model found a statistical difference in favor of the brief-intervention group (β = 4.7, SE = 2.0, p = .018) in 28-day drinking totals. The total Rutgers Alcohol Problem Index score was also signifi cantly different during the 12-month follow-up period (β = 0.8, SE = 0.4, p = .033). There was no difference on the other outcome measures of interest, such as frequency of excessive heavy drinking, health care utilization, injuries, drunk driving, depression, or tobacco use. Conclusions: The study supports resource allocation and implementation of alcohol screening and brief physician advice in primary care-based college health clinics. (J. Stud. Alcohol Drugs, 71, 23-31, 2010)
Purpose-To explore gender differences in prevalence, types, perpetrators and correlates of recent violence experiences among university students at campus clinics at 5 universities in the Midwest and Pacific Northwest U.S. and Canada.Methods-Systematic survey of students presenting for routine primary care visits (N=2,091), pencil-&-paper screen for recent emotional and physical violence exposure (past 6 months), demographics, plus sensation seeking, at-risk alcohol use, and depression. Chi-square tests compared prevalence by gender; correlates for types of violence were analyzed separately for men and women using chi-square with adjusted standardized residuals comparing no violence, intimate partner violence (IPV) and other violence (Other).Results-Similar rates of men (17%) and women (16%) reported any violence in the past 6 months; women were more likely to report emotional and men to report physical violence. Of those reporting emotional violence, 45.5% women and 50% men indicated it was IPV, and 23.7% women and 20.9% men reported physical IPV. Correlates differed by gender; demographics were not linked to IPV. Atrisk drinking was associated with both IPV and Other violence for women, but only Other violence for men. Depression was the only correlate significantly linked to IPV for men.Conclusions-Recent violence exposure among university students affects nearly 1 in 5 attending campus clinics. Screening for violence exposure should include both men and women, especially students who indicate heavy drinking patterns or depressive symptoms. Campus health promotion interventions should address healthy dating relationships. Further research on IPV among college men is needed.Contact author: Dr. Elizabeth Saewyc, University of British Columbia, T201-2211 Wesbrook Mall, Vancouver, BC V6T 2B5 Canada, Office: 1-604-822-7505, Fax: 1-604-822-7466, Email: saewyc@interchange.ubc.ca. Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. The theoretical frameworks to help explain violence exposure among young adults vary widely depending on the scientific discipline and type of violence exposure, but all seem to incorporate some interplay between individual characteristics and situational or contextual factors [7,8,[12][13][14]. The majority of models tend to be focused on violence perpetration [7,8,11,[17][18][19][20][21], not victimization, yet, given the health issues associated with victimization, it is important to identify those at higher risk of victimization, especially among those who are more likely to be reached for screening and intervention through campus health ser...
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