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Shinn AK, Cawkwell PB, Bolton K, Healy BC, Karmacharya R, Yip AG, Öngür D, Pinder-Amaker S. Return to College After a First Episode of Psychosis. SCHIZOPHRENIA BULLETIN OPEN 2020; 1:sgaa041. [PMID: 32984820 PMCID: PMC7503481 DOI: 10.1093/schizbullopen/sgaa041] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Abstract
A first episode of psychosis (FEP) can derail a patient’s educational goals, including attainment of a college education, and this can have lasting ramifications for socioeconomic and health outcomes. Despite this, few studies have examined return to college, which is an important index of real-world educational success after a FEP. In this study, we conducted a longitudinal medical record review of patients in a transdiagnostic outpatient FEP program and performed survival analysis, setting return to college as the endpoint, among the subset of patients whose college education was interrupted. We found that 82% (93/114) of college-enrolled FEP individuals experienced disruptions to their education after FEP, but that return to college also occurred in a substantial proportion (49/88, 56%) among those on leave who had follow-up data. In this sample, the median time to college return was 18 months. When separated by baseline diagnostic category, FEP patients with affective psychotic disorders (FEAP, n = 45) showed faster time to college return than those with primary psychotic disorders (FEPP, n = 43) (median 12 vs 24 mo; P = .024, unadjusted). When adjusted for having no more than 1 psychiatric hospitalization at intake and absence of cannabis use in the 6 months prior to intake (which were also significant predictors), differences by diagnostic category were more significant (hazard ratio 2.66, 95% CI 1.43–4.94, P = .002). Participation in education is an important outcome for stakeholders, and students with FEP can be successful in accomplishing this goal.
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Affiliation(s)
- Ann K Shinn
- Psychotic Disorders Division, McLean Hospital, Belmont, MA
- Department of Psychiatry, Harvard Medical School, Boston, MA
| | | | - Kirsten Bolton
- Psychotic Disorders Division, McLean Hospital, Belmont, MA
| | - Brian C Healy
- Ann Romney Center for Neurologic Diseases, Brigham & Women’s Hospital, Boston, MA
- Department of Neurology, Harvard Medical School, Boston, MA
| | - Rakesh Karmacharya
- Psychotic Disorders Division, McLean Hospital, Belmont, MA
- Department of Psychiatry, Harvard Medical School, Boston, MA
| | - Agustin G Yip
- Psychotic Disorders Division, McLean Hospital, Belmont, MA
- Department of Psychiatry, Harvard Medical School, Boston, MA
| | - Dost Öngür
- Psychotic Disorders Division, McLean Hospital, Belmont, MA
- Department of Psychiatry, Harvard Medical School, Boston, MA
| | - Stephanie Pinder-Amaker
- Department of Psychiatry, Harvard Medical School, Boston, MA
- College Mental Health Program, McLean Hospital, Belmont, MA
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Oswalt SB, Lederer AM, Chestnut-Steich K, Day C, Halbritter A, Ortiz D. Trends in college students' mental health diagnoses and utilization of services, 2009-2015. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2020; 68:41-51. [PMID: 30355071 DOI: 10.1080/07448481.2018.1515748] [Citation(s) in RCA: 151] [Impact Index Per Article: 37.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/03/2018] [Revised: 06/22/2018] [Accepted: 08/18/2018] [Indexed: 05/21/2023]
Abstract
Objective: To examine changes in diagnoses/treatment for 12 mental health (MH) conditions, previous use of campus MH services, and willingness to seek MH services in the future. Participants: ACHA-NCHA II participants from 2009 to 2015 (n = 454,029). Methods: Hierarchical binary logistic regression with step 1 controlling for demographics and step 2 considering time. Results: Time was significant except for bipolar disorder, bulimia, and schizophrenia with increases for all conditions except substance abuse. Anxiety (OR = 1.68), panic attacks (OR = 1.61), and ADHD (OR = 1.40) had the highest odd ratios. Use of MH services at current institution (OR = 1.30) and willingness to utilize services in the future (OR = 1.37) also increased over time. Conclusions: Based on a national sample, self-reported diagnoses/treatment of several MH conditions are increasing among college students. This examination of a variety of MH issues can aid college health professionals to engage institutional stakeholders regarding the resources needed to support college students' MH.
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Affiliation(s)
- Sara B Oswalt
- Department of Kinesiology, Health and Nutrition, University of Texas at San Antonio, San Antonio, TX, USA
- American College Health Association Health Promotion Section Research Committee, Silver Spring, MD, USA
| | - Alyssa M Lederer
- American College Health Association Health Promotion Section Research Committee, Silver Spring, MD, USA
- Department of Global Community Health and Behavioral Sciences, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA
| | - Kimberly Chestnut-Steich
- American College Health Association Health Promotion Section Research Committee, Silver Spring, MD, USA
- Student Affairs, West Chester University of Pennsylvania, West Chester, PA, USA
| | - Carol Day
- American College Health Association Health Promotion Section Research Committee, Silver Spring, MD, USA
- Health Education Services, Georgetown University, Washington, DC, USA
| | - Ashlee Halbritter
- American College Health Association Health Promotion Section Research Committee, Silver Spring, MD, USA
- Campus Health, University of Pennsylvania, Philadelphia, PA, USA
| | - Dugeidy Ortiz
- American College Health Association Health Promotion Section Research Committee, Silver Spring, MD, USA
- Wellness and Education Program, Lehman College, New York, NY, USA
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