Context Although young adulthood is often characterized by rapid intellectual and social development, college-age individuals are also commonly exposed to circumstances that place them at risk for psychiatric disorders. Objective To assess 12-month prevalence of psychiatric disorders, sociodemographic correlates, and rates of treatment among individuals attending college and their non-college attending peers in the United States. Design, Setting, Participants Face-to-face interviews were conducted in the 2001-2002 National Epidemiologic Survey on Alcohol and Related Conditions ([NESARC] n=43,093). Analyses were done for the subsample of college-age individuals, defined as those aged 19-25 that were both attending (n=2,188) and not attending college (n=2,904) in the previous year. Main Outcome Measure Sociodemographic correlates and prevalence of 12-month DSM-IV psychiatric disorders, substance use, and treatment seeking among college-attending individuals and their non-college attending peers. Results Almost half of college-age individuals had a psychiatric disorder in the past year. The overall rate of psychiatric disorders was not different between college-attending individuals and their non-college attending peers. The unadjusted risk of alcohol use disorders was significantly greater for college students than their non-college attending peers (OR: 1.25, 95%, CI:1.04-1.50), though not after adjusting for background socio-demographic characteristics (AOR: 1.19, 95%: 0.98-1.44). College students were significantly less likely (unadjusted and adjusted) to have a diagnosis of drug use disorder or nicotine dependence or have used tobacco than their non-college-attending peers. Bipolar disorder was less common in individuals attending college. College students were significantly less likely to receive past year treatment for alcohol/drug use disorders than their non-college-attending peers. Conclusions Psychiatric disorders, particularly alcohol use disorders, are common in the college-age population. Although treatment rates varied across disorders, overall, less than 25% of individuals with a mental disorder sought treatment in the year prior to the survey. These findings underscore the importance of treatment and prevention interventions among college-age individuals.

CONTEXT Although antipsychotic treatment has recently increased, little is known about how this development has differentially affected the office-based care of adults and young people in the United States. OBJECTIVE To compare national trends and patterns in antipsychotic treatment of adults and youths in office-based medical practice. DESIGN Trends between 1993 and 2009 in visits with antipsychotics for children (0-13 years), adolescents (14-20 years), and adults (≥21 years) are described on a per population basis and as a proportion of total medical office visits. Background and clinical characteristics of recent (2005-2009) antipsychotic visits are also compared by patient age. SETTING Outpatient visits to physicians in office-based practice. PARTICIPANTS Visits from the 1993-2009 National Ambulatory Medical Care Surveys (N = 484 889). MAIN OUTCOME MEASURES Visits with a prescription of antipsychotic medications. RESULTS Between 1993-1998 and 2005-2009, visits with a prescription of antipsychotic medications per 100 persons increased from 0.24 to 1.83 for children, 0.78 to 3.76 for adolescents, and 3.25 to 6.18 for adults. The proportion of total visits that included a prescription of antipsychotics increased during this period from 0.16% to 1.07% for youths and from 0.88% to 1.73% for adults. From 2005 to 2009, disruptive behavior disorders were the most common diagnoses in child and adolescent antipsychotic visits, accounting for 63.0% and 33.7%, respectively, while depression (21.2%) and bipolar disorder (20.2%) were the 2 most common diagnoses in adult antipsychotic visits. Psychiatrists provided a larger proportion of the antipsychotic visits for children (67.7%) and adolescents (71.6%) than to adults (50.3%) (P < .001). From 2005 to 2009, antipsychotics were included in 28.8% of adult visits and 31.1% of youth visits to psychiatrists. CONCLUSIONS On a population basis, adults make considerably more medical visits with a prescription of antipsychotics than do adolescents or children. Yet antipsychotic treatment has increased especially rapidly among young people, and recently antipsychotics have been prescribed in approximately the same proportion of youth and adult visits to psychiatrists.

Objective To determine whether cannabis use is associated with a change in the risk of incident nonmedical prescription opioid use and opioid use disorder at 3 year follow-up. Methods We used logistic regression models to assess prospective associations between cannabis use at Wave 1 (2001–2002) and nonmedical opioid use and prescription opioid use disorder at Wave 2 (2004–2005) of the National Epidemiologic Survey on Alcohol and Related Conditions. Corresponding analyses were performed among adults with moderate or more severe pain and with nonmedical opioid use at Wave 1. Cannabis and prescription opioid use were measured with a structured interview (AUDADIS-IV). Other covariates included age, sex, race/ethnicity, anxiety or mood disorders, family history of drug, alcohol, and behavioral problems, and in opioid use disorder analyses, nonmedical opioid use. Results In logistic regression models, Wave 1 cannabis use was associated with increased incident non-medical prescription opioid use (OR=5.78, 95%CI=4.23–7.90) and opioid use disorder (OR=7.76, 95%CI=4.95–12.16) at Wave 2. These associations remained significant following adjustment for background characteristics (non-medical opioid use: AOR=2.26, 95%CI=1.86–3.69; opioid use disorder: AOR=2.18, 95%CI=1.14–4.14). Among adults with pain at Wave 1, cannabis use was also associated with increased incident non-medical opioid use (AOR=2.99, 95%CI=1.63–5.47) and approached significance with incident prescription opioid use disorder (AOR=2.14, 95%CI=0.95–4.83). Among adults with nonmedical opioid use at Wave 1, cannabis use was also associated with an increase in non-medical opioid use (AOR=3.13, 95%CI=1.19–8.23). Conclusions Cannabis use appears to increase rather than decrease the risk of developing nonmedical prescription opioid use and opioid use disorder.

A recent overall increase in suicide attempts among adults in the United States has disproportionately affected younger adults with less formal education and those with antisocial personality disorder, anxiety disorders, depressive disorders, and a history of violence.