Courtney Zulauf

Bio: Courtney Zulauf is an academic researcher from Harvard University. The author has contributed to research in topics: Conduct disorder & Attention deficit hyperactivity disorder. The author has an hindex of 10, co-authored 18 publications receiving 601 citations. Previous affiliations of Courtney Zulauf include University of Illinois at Chicago.

College Students: Mental Health Problems and Treatment Considerations

Abstract: Attending college can be a stressful time for many students. In addition to coping with academic pressure, some students have to deal with the stressful tasks of separation and individuation from their family of origin while some may have to attend to numerous work and family responsibilities. In this context, many college students experience the first onset of mental health and substance use problems or an exacerbation of their symptoms. Given the uniqueness of college students, there is a need to outline critical issues to consider when working with this population. In this commentary, first, the prevalence of psychiatric and substance use problems in college students and the significance of assessing age of onset of current psychopathology are described. Then, the concerning persistent nature of mental health problems among college students and its implications are summarized. Finally, important aspects of treatment to consider when treating college students with mental health problems are outlined, such as the importance of including parents in the treatment, communicating with other providers, and employing of technology to increase adherence. It is concluded that, by becoming familiar with the unique problems characteristic of the developmental stage and environment college students are in, practitioners will be able to better serve them.

The complicated relationship between attention deficit/hyperactivity disorder and substance use disorders.

Abstract: Adolescents and young adults with substance use disorders (SUD) and attention deficit/hyperactivity disorder (ADHD) are increasingly presenting in clinical practice. The overlap and role of treatment for these co-occurring disorders remains unclear. A review of the literature was conducted to highlight and update recent evidence on the overlap of ADHD and SUD, the role of ADHD medication on later SUD, and the treatment of ADHD and SUD in adolescents and young adults. Recent work continues to highlight the high risk for comorbid ADHD in patients with SUD; and conversely, the high risk for SUD developing in ADHD across the lifespan, particularly in the context of comorbid conduct disorder. Although the data remains discordant, it appears that ADHD pharmacotherapy does not increase the risk for SUD. Medication treatment alone does not appear to be particularly effective in treating SUD in currently active substance abusing individuals with ADHD. Structured therapies may be effective in treating adolescents and young adults with ADHD and SUD. Further controlled trials evaluating the sequence and effect of structured psychotherapies and/or ADHD pharmacotherapy on SUD relapse in these groups are warranted.

Prescription medication misuse among opioid dependent patients seeking inpatient detoxification.

Abstract: Background and Objectives Opioid related morbidity and mortality is heightened in context to the concomitant use of psychotropic medications. The aim of this project was to examine the extent to which opioid dependent patients seeking detoxification are using and misusing specific psychotropic agents. Methods As part of a quality assurance/improvement project, we systematically assessed prospectively consecutive admissions to a public detoxification program using a self-report questionnaire to query for specific psychotropic medication use. Patients were asked about having a current prescription, appropriate use, and/or medical misuse (higher doses, using without prescription) of amphetamine salts, clonazepam, clonidine, gabapentin, and pregabalin. Results We had data on 196 admissions including 162 patients with opioid dependency. Patients receiving detoxification from opioids compared to alcohol had statistically significant higher rates of medication misuse (30% vs. 0%, respectively; χ2 = 12.8, p < .0003). Of opioid dependent patients receiving prescription medication, 28% reported using higher amounts of each medication than prescribed. Of opioid patients, 10% self-reported misusing clonidine, 22% gabapentin, 7% pregabalin, 25% clonazepam, 11% amphetamine salts, and 36% any of these medications. Discussion and Conclusions Despite the “nonaddictive nature” of some medications (eg, gabapentin, clonidine), high rates of medication misuse in opioid dependent patients admitted for detoxification was found and appeared similar to rates of misuse among controlled substances such as clonazepam and amphetamine salts. These data suggest that opioid dependent patients should be queried for the appropriate use of prescribed medications and that practitioners need to monitor for medication misuse in opioid dependent patients. (Am J Addict 2014;XX:1–5)

Prescription medication misuse among opioid dependent patients seeking inpatient detoxification: Prescription Misuse Among Opioid Dependent Patients

Abstract: BACKGROUND AND OBJECTIVES Opioid related morbidity and mortality is heightened in context to the concomitant use of psychotropic medications. The aim of this project was to examine the extent to which opioid dependent patients seeking detoxification are using and misusing specific psychotropic agents. METHODS As part of a quality assurance/improvement project, we systematically assessed prospectively consecutive admissions to a public detoxification program using a self-report questionnaire to query for specific psychotropic medication use. Patients were asked about having a current prescription, appropriate use, and/or medical misuse (higher doses, using without prescription) of amphetamine salts, clonazepam, clonidine, gabapentin, and pregabalin. RESULTS We had data on 196 admissions including 162 patients with opioid dependency. Patients receiving detoxification from opioids compared to alcohol had statistically significant higher rates of medication misuse (30% vs. 0%, respectively; χ2 = 12.8, p < .0003). Of opioid dependent patients receiving prescription medication, 28% reported using higher amounts of each medication than prescribed. Of opioid patients, 10% self-reported misusing clonidine, 22% gabapentin, 7% pregabalin, 25% clonazepam, 11% amphetamine salts, and 36% any of these medications. DISCUSSION AND CONCLUSIONS Despite the "nonaddictive nature" of some medications (eg, gabapentin, clonidine), high rates of medication misuse in opioid dependent patients admitted for detoxification was found and appeared similar to rates of misuse among controlled substances such as clonazepam and amphetamine salts. These data suggest that opioid dependent patients should be queried for the appropriate use of prescribed medications and that practitioners need to monitor for medication misuse in opioid dependent patients. (Am J Addict 2014;XX:1-5).

WHO World Mental Health Surveys International College Student Project: Prevalence and distribution of mental disorders.

Abstract: Increasingly, colleges across the world are contending with rising rates of mental disorders, and in many cases, the demand for services on campus far exceeds the available resources. The present study reports initial results from the first stage of the WHO World Mental Health International College Student project, in which a series of surveys in 19 colleges across 8 countries (Australia, Belgium, Germany, Mexico, Northern Ireland, South Africa, Spain, United States) were carried out with the aim of estimating prevalence and basic sociodemographic correlates of common mental disorders among first-year college students. Web-based self-report questionnaires administered to incoming first-year students (45.5% pooled response rate) screened for six common lifetime and 12-month DSM-IV mental disorders: major depression, mania/hypomania, generalized anxiety disorder, panic disorder, alcohol use disorder, and substance use disorder. We focus on the 13,984 respondents who were full-time students: 35% of whom screened positive for at least one of the common lifetime disorders assessed and 31% screened positive for at least one 12-month disorder. Syndromes typically had onsets in early to middle adolescence and persisted into the year of the survey. Although relatively modest, the strongest correlates of screening positive were older age, female sex, unmarried-deceased parents, no religious affiliation, nonheterosexual identification and behavior, low secondary school ranking, and extrinsic motivation for college enrollment. The weakness of these associations means that the syndromes considered are widely distributed with respect to these variables in the student population. Although the extent to which cost-effective treatment would reduce these risks is unclear, the high level of need for mental health services implied by these results represents a major challenge to institutions of higher education and governments. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Challenges and Opportunities for Higher Education amid the COVID-19 Pandemic: The Philippine Context

Abstract: Covid-19 affected higher educational institutions not just in Wuhan, China where the virus originated but all other higher educational institutions in 188 countries as of April 06, 2020. Educational countermeasures are taken to continue educating the students despite the COVID-19 predicaments. Based on the author’s experiences, research, observations in the academe, COVID-19 guidelines, and the need for alternative solutions, this article introduces how higher education is affected and how it can respond to future challenges. This article recommends to educational institutions to produce studies to proliferate and document the impact of the pandemic to the educational system. There is also a greater need for educational institutions to strengthen the practices in the curriculum and make it more responsive to the learning needs of the students even beyond the conventional classrooms.

Abuse and Misuse of Pregabalin and Gabapentin.

Abstract: Background Gabapentinoid (pregabalin and gabapentin) abuse is increasingly being reported.