PurposeTo systematically review articles reporting on depression, anxiety, and burnout among U.S. and Canadian medical students.MethodMedline and PubMed were searched to identify peer-reviewed English-language studies published between January 1980 and May 2005 reporting on depression, anxie

http://www.medical-mastermind-community.com/uploads/63-Systematic_Review_of_Depression_Anxiety_and.9.pdf

Systematic review of depression, anxiety, and other indicators of psychological distress among U.S. and Canadian medical students.

Abstract The 2001 Harvard School of Public Health College Alcohol Study surveyed students at 119 4-year colleges that participated in the 1993, 1997, and 1999 studies. Responses in the 4 survey years were compared to determine trends in heavy alcohol use, alcohol-related problems, and encounters with college and community prevention efforts. In 2001, approximately 2 in 5 (44.4%) college students reported binge drinking, a rate almost identical to rates in the previous 3 surveys. Very little change in overall binge drinking occurred at the individual college level. The percentages of abstainers and frequent binge drinkers increased, a polarization of drinking behavior first noted in 1997. A sharp rise in frequent binge drinking was noted among students attending all-women's colleges. Other significant changes included increases in immoderate drinking and harm among drinkers. More students lived in substance-free housing and encountered college educational efforts and sanctions resulting from their alcohol use.

Trends in College Binge Drinking during a Period of Increased Prevention Efforts. Findings from 4 Harvard School of Public Health College Alcohol Study Surveys: 1933-2001.

The 2001 Harvard School of Public Health College Alcohol Study surveyed students at 119 4-year colleges that participated in the 1993, 1997, and 1999 studies. Responses in the 4 survey years were compared to determine trends in heavy alcohol use, alcohol-related problems, and encounters with college and community prevention efforts. In 2001, approximately 2 in 5 (44.4%) college students reported binge drinking, a rate almost identical to rates in the previous 3 surveys. Very little change in overall binge drinking occurred at the individual college level. The percentages of abstainers and frequent binge drinkers increased, a polarization of drinking behavior first noted in 1997. A sharp rise in frequent binge drinking was noted among students attending all-women's colleges. Other significant changes included increases in immoderate drinking and harm among drinkers. More students lived in substance-free housing and encountered college educational efforts and sanctions resulting from their alcohol use.

https://www-static.bouldercolorado.gov/docs/journal-american-college-health-study-1-201307101733.pdf

Trends in College Binge Drinking During a Period of Increased Prevention Efforts: Findings from 4 Harvard School of Public Health College Alcohol Study Surveys: 1993–2001

In 1999, the Harvard School of Public Health College Alcohol Study resurveyed colleges that participated in the 1993 and 1997 surveys. Responses to mail questionnaires from more than 14 000 students at 119 nationally representative 4-year colleges in 39 states were compared with responses received in 1997 and 1993. Two of 5 students (44%) were binge drinkers in 1999, the same rate as in 1993. However, both abstention and frequent binge-drinking rates increased significantly. In 1999, 19% were abstainers, and 23% were frequent binge drinkers. As before, binge drinkers, and particularly frequent binge drinkers, were more likely than other students to experience alcohol-related problems. At colleges with high binge-drinking rates, students who did not binge drink continued to be at higher risk of encountering the secondhand effects of others’heavy drinking. The continuing high level of binge drinking is discussed in the context of the heightened attention and increased actions at colleges. Although it may take more time for interventions to take effect, the actions college health providers have undertaken thus far may not be a sufficient response.

/pdf/college-binge-drinking-in-the-1990s-a-continuing-problem-2rzwvc2qti.pdf

College Binge Drinking in the 1990s: A Continuing Problem

OBJECTIVE: This report estimates the numbers of 18-24 year old United States college students who annually experience alcohol-related deaths, injuries and other health problems. METHOD: We examined traffic and unintentional injury deaths in 1998 reported by the National Highway Traffic Safety Administration and the Centers for Disease Control (CDC). We also examined results of national coroner studies, Department of Education college enrollment data, the National Household Survey on Drug Abuse (NHSDA), the CDC National College Health Risk Behavior Survey and the Harvard School of Public Health College Alcohol Survey (CAS). All survey participants were ages 18-24: 6,930 college and 12,394 noncollege respondents in the NHSDA survey; 3,077 college students in the CDC survey; and 12,217 full-time 4-year college students in the CAS. Based on the number and proportion of 18-24 year olds enrolled in college, data on alcohol involvement in injury deaths among 18-24 year olds and survey responses, we calculated the numbers of 18-24 year old alcohol-related injury deaths and other health problems. RESULTS: We estimate that over 1,400 students aged 18-24 and enrolled in 2- and 4-year colleges died in 1998 from alcohol-related unintentional injuries, including motor vehicle crashes. According to surveys conducted in 1999, in the preceding year, over 2 million of the 8 million college students in the United States drove under the influence of alcohol and over 3 million rode with a drinking driver. Over 500,000 full-time 4-year college students were unintentionally injured under the influence of alcohol and over 600,000 were hit or assaulted by another student who had been drinking. CONCLUSIONS: There is an urgent need for expanding prevention and treatment programs, to reduce alcohol-related harm among U.S. college students and other young adults. Language: en

/pdf/magnitude-of-alcohol-related-mortality-and-morbidity-among-u-2bgxvwjhzw.pdf

Magnitude of alcohol-related mortality and morbidity among U.S. college students ages 18-24.

In 1997, the Harvard School of Public Health College Alcohol Study resurveyed colleges that participated in a 1993 study. The findings revealed little change in binge drinking: a slight decrease in percentage of binge drinkers and slight increases in percentages of abstainers and frequent binge drinkers. Two of 5 students were binge drinkers (42.7%); 1 in 5 (19.0%) was an abstainer, and 1 in 5 was a frequent binge drinker (20.7%). As was true in 1993, 4 of 5 residents of fraternities or sororities were binge drinkers (81.1%). Asian students showed a greater increase and White students a greater decrease in binge drinking from 1993 to 1997, compared with all other students. Among students who drank alcohol, increases in frequency of drinking; drunkenness; drinking to get drunk; and alcohol-related problems, including drinking and driving, were reported. Binge drinkers in both 1993 and 1997 were at increased risk of alcohol-related problems, and nonbingers at colleges with high binge drinking rates had increased risks of encountering secondhand effects of binge drinking.

/pdf/changes-in-binge-drinking-and-related-problems-among-1ixnjy32qd.pdf

Changes in Binge Drinking and Related Problems Among American College Students Between 1993 and 1997 Results of the Harvard School of Public Health College Alcohol Study

Context.—Adolescent smoking prevalence is tracked annually and has increased
since 1991. In contrast, little is known about trends in smoking among college
students, a group that has previously been more resistant to tobacco use than
other young adults.Objective.—To examine changes in cigarette smoking among college students between
1993 and 1997 and among different types of students and colleges.Design.—Self-administered survey (Harvard School of Public Health College Alcohol
Study).Setting.—One hundred sixteen nationally representative 4-year colleges.Subjects.—A total of 15,103 randomly selected students in 1993 (70% response rate)
and 14,251 students in 1997 (60% response rate).Main Outcome Measures.—Self-reports of cigarette smoking in the past 30 days and in the past
year, age at smoking first cigarette, and number of attempts to quit.Results.—Over 4 years, the prevalence of current (30-day) cigarette smoking rose
by 27.8%, from 22.3% to 28.5% (P<.001). The increase
was observed in 99 of 116 colleges and was statistically significant (P<.05) in 27 (23%) of them. Current smoking increased
across all student subgroups (defined by sex, race/ethnicity, and year in
school) and in all types of colleges. Smoking is rising faster in public schools
(from 22.0% to 29.3%) than in private schools (from 22.9% to 26.8%). Eleven
percent of college smokers had their first cigarette and 28% began to smoke
regularly at or after age 19 years, by which time most were already in college.
Half of current smokers tried to quit in the previous year; 18% had made 5
or more attempts to quit.Conclusions.—Cigarette use is increasing on campuses nationwide in all subgroups
and types of colleges. Substantial numbers of college students are both starting
to smoke regularly and trying to stop. National efforts to reduce smoking
should be extended to college students.

https://jamanetwork.com/journals/jama/articlepdf/188176/JOC80656.pdf

Increased Levels of Cigarette Use Among College Students: A Cause for National Concern

Aims. To examine rates and patterns of marijuana and other illicit drug use among different types of students and colleges in 1999, and changes in use since 1993. Design. Self-administered mail survey (Harvard School of Public Health College Alcohol Study). Setting. One hundred and nineteen nationally representative US 4-year colleges. Participants. A representative sample of 15 403 randomly selected students in 1993, 14 724 students in 1997 and 14 138 students in 1999. Measurements. Self-reports of marijuana and other illicit drug use in the past 30 days and in the past year, cigarette use, drinking behavior, and age of initiation of smoking, drinking and using marijuana. Findings. The prevalence of past 30-day marijuana use rose from 12.9% to 15.7% between 1993 and 1999, an increase of 22%. Almost all of this change occurred by 1997. An increase was observed at 66% of the 119 colleges. The prevalence of 30-day and annual marijuana use increased in nearly all student demographic subgroups except for Hispanic students, and at all types of colleges except for colleges with low binge drinking rates. Rates of illicit drug use in the past 30 days increased slightly for other illicit drugs in the 4-year interval except for LSD. Nine out of 10 students (91%) who used marijuana in the past 30 days used other illicit drugs, smoked cigarettes and/or engaged in binge drinking. Of students who used any other illicit drug in the past 30 days, 87% used another substance or binge drank. Twenty nine per cent of past 30-day marijuana users first used marijuana and 34% began to use marijuana regularly at or after the age of 18, when most were in college. Conclusions. Use of marijuana and other illicit drugs has increased on campuses across the United States in most student subgroups and all types of colleges. This may reflect earlier increases in middle schools and secondary schools among this cohort. However, nearly one-third of students initiated marijuana use in college and one of three began to use it regularly. Intervention efforts should be directed at college students, as well as secondary school students.

Increased use of marijuana and other illicit drugs at US colleges in the 1990s: results of three national surveys

OBJECTIVE: This study examines student alcohol use and associated problems, including drinking and driving, at U.S. colleges that ban alcohol for all students on campus. METHOD: A nationally representative sample of students (N = 11,303, 61% women) attending U.S. colleges completed questionnaires regarding alcohol use and related behaviors in the spring of 1999. The responses of 2,252 students at 19 ban schools were compared with those of 9,051 students at 76 nonban schools. RESULTS: Students at ban colleges were 30% less likely to be heavy episodic drinkers and more likely to abstain from alcohol. The lower rates of heavy episodic drinking apply to students whether or not they were heavy episodic drinkers in high school. However, among drinkers, students at ban schools engaged in as much extreme drinking as drinkers at schools that do not ban alcohol and experienced the same rate of alcohol-related problems. At schools that ban alcohol, fewer students experienced secondhand effects of the drinking of others than did students at nonban schools. Students at ban schools were not more likely to drink and drive than were students at nonban schools. CONCLUSIONS: A campus ban on alcohol may support abstention from alcohol use and reduce heavy episodic drinking and the associated secondhand effects in college. Since this is a correlational study, we cannot determine whether the lower rates of heavy episodic drinking are due to the ban or to other factors (e.g., self-selection of students to these schools). Ban schools do not enroll fewer high school heavy episodic drinkers.

Jeana Gledhill-Hoyt

Papers

Changes in Binge Drinking and Related Problems Among American College Students Between 1993 and 1997 Results of the Harvard School of Public Health College Alcohol Study

Increased Levels of Cigarette Use Among College Students: A Cause for National Concern

Increased use of marijuana and other illicit drugs at US colleges in the 1990s: results of three national surveys

Alcohol use and problems at colleges banning alcohol: results of a national survey.