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I need psychiatric help. Not the usual kind (well, maybe), but someone in the psychiatric field to help me understand what this new report in the Archives of General Psychiatry is really telling us. I know the headlines, that almost half of adults 18 to 24 have a psychiatric disorder. Alcohol was higher in college students. Nicotine and drug addiction was higher in non-college students, along with bipolar disorder.
How were these disorders diagnosed? What was the criteria for diagnosis? What are we to do about it?
Is this just another “scare of the day”? Are smoking and drinking now “psychiatric disorders”?
Last question first.
According to the Diagnostic and Statistical Manual for Mental Disorders (or DSM, which is psychiatry’s bible for diagnosis), yes, nicotine and excessive alcohol use are disorders. I know these are serious problems with dangerous consequences, but I’m just letting you know the study includes them.
The headlines I’m seeing emphasize that one in five young adults has a personality disorder.
How were these diagnosed?
As far as I can tell, the data came from a 2004 interview-type survey that found that 14.79 percent of U.S. adults had at least one personality disorder. Higher rates were found in Native Americans, blacks, young adults, low socioeconomic status, divorced, separated, widowed, never-married.
The top 3 were:
obsessive-compulsive: 7.88 percent
paranoid: 4.41 percent
antisocial: 3.63 percent
The diagnosis criteria was based on DSM criteria. I don’t know the details, but I don’t think psychiatrists/psychologists make a confident diagnosis with one short interview.
What are we to do?
If you or your peers think your personality is causing problems for you, get help. Even if you’re just a little concerned there’s no harm to be evaluated. But a lot of us seem to manage fine. One of my medical school professors thought many good doctors are borderline obsessive-compulsive. Dr. Rob at “Musings of a Distractible Mind” embraces his ADHD.
Check out criteria for personality disorders at the Mayo online. I bet you find yourself in a couple.
Is this another “scare of the day”?
Yes and No (I hedge a lot). The headline needs context. Some people look for a label as an excuse for their, or their children’s, behavior instead of trying to change bad habits and embrace the positives. On the other hand, some have a true disorder that leads to harmful tendencies. Treatment could avert serious consequences So it is important to raise awareness.
What to you think? Is this over-hyped news or not? Do you think awareness can lead to effective treatment, or are we all victims of our personality? (Many criminals have antisocial personalities.) Have you found ways to embrace you “abnormal” personality traits for the positive?
by James Hubbard, M.D., M.P.H.