Prevention Book

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College Student Medical Care

Aka: College Student Medical Care
  1. Epidemiology
    1. U.S. college students: 20 Million (12 million under age 24 years)
    2. Uninsured college students: 9%
  2. Associated Conditions
    1. Attention Deficit Disorder (ADHD)
      1. IncidenceADHD: 2-8% among college students
      2. Screen with Adult ASRS
        1. http://webdoc.nyumc.org/nyumc/files/psych/attachments/psych_adhd_checklist.pdf
      3. Consider allowing additional time for classroom tests (however minimal evidence of benefit)
      4. Stimulant misuse or diversion in up to 35% of college students receiving these prescriptions
    2. Alcohol Abuse
      1. Screen with AUDIT-C (Alcohol Use Disorders Identification Test - Consumption Items)
      2. Increased risk of binge drinking (especially among Fraternities and similar groups)
      3. Increased risk in women who self-treat distress with Alcohol
        1. Associated with increased Sexual Assault risk
    3. Tobacco Abuse
    4. Chemical abuse
      1. Cocaine Abuse
      2. Flunitrazepam (Rohypnol)
      3. Gamma-hydroxybutyrate (GHB)
      4. Ketamine
      5. Marijuana
      6. Methamphetamine
      7. Methylenedioxy-Methamphetamine (MDMA or Ecstasy)
    5. Eating Disorder
      1. Incidence: 1% of college students
      2. Anorexia Nervosa
      3. Bulimia Nervosa
      4. Binge Eating Disorder
    6. Major Depression
      1. Incidence: 30% with depressed mood episode interfering with function in prior year
      2. Suicidal Ideation in 7%, plan in 2%, attempt in 0.5%
        1. War veteran students have Suicidal Ideation in 46%, plan in 20%, attempt in 4%
      3. Resources: Suicide prevention
        1. http://www.sprc.org/collegesanduniversities
    7. Anxiety Disorder
      1. Incidence: 48% with episode of overwhelming anxiety episode in prior year
    8. Post-Traumatic Stress Disorder
      1. Commonly associated with Sexual Assault, returning war veterans
      2. Screen with Primary Care PTSD Screen (PC-PTSD)
    9. Sleep Disorder
      1. Incidence: 20% with poor sleep that interferes with academic performance
  3. Prevention: Immunizations
    1. Influenza Vaccine annually
    2. Meningococcal Vaccine (after 16 year birthday)
    3. PertussisVaccine (e.g. Adacel)
  4. References
    1. Unwin (2013) Am Fam Physician 88(9): 596-604 [PubMed]

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