Young People and Personality Disorders

It is strange what the press picks up on. In the latest issue of Archives of General Psychiatry is the following article: "Mental Health of College Students and Their Non-College-Attending Peers: Results From the National Epidemiologic Study on Alcohol and Related Conditions," by Carlos Blanco; Mayumi Okuda; Crystal Wright; Deborah S. Hasin; Bridget F. Grant; Shang-Min Liu; Mark Olfson. The abstract of the article concludes: "Psychiatric disorders, particularly alcohol use disorders, are common in the college-aged population. Although treatment rates varied across disorders, overall fewer 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-aged individuals." There's nothing very surprising here. I probably would not have looked at it, but for the headline from the Associated Press on Yahoo News: "1 in 5 young adults has personality disorder." 20%? Good grief!

US News and World Report has a more measured summary. "Among college students, the most common disorders were alcohol use (20.4 percent) and personality disorders (17.7 percent). The most common disorders among young adults not in college were personality disorders (21.6 percent) and nicotine dependence (20.7 percent)." Still, the incidence of personality disorders is very high here, and without having looked at the article itself, and not being familiar with the literature, I can't say if they are using an over-expansive definition. However, this points to the suspicion that the DSM-IV criteria of personality must be too broad, or being applies in too broad a way.

Of course, the media are right in picking out the most surprising feature of the article, which isn't even mentioned in the abstract. And the overall message, that nearly half of college-aged students experience psychiatric disorders, while only one quarter get treatment, is still alarming even if it isn't surprising.