1. Conceptual Framework – Health Promotion Model
Student: Sara Randazzo, MS
Research Advisor: Dr. Elizabeth Hartman
The Correlation Between the Misuse of ADHD Medication and Depression Among College Students: An Integrative Literature Review
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Depaul Nursing, poster session, poster, 48 by 36, DePaul Nursing School Thesis Presentation
Background:
Attention deficit hyperactivity disorder (ADHD) is, “a condition characterized by inattentiveness, hyperactivity and impulsivity” (ADHD Foundation, 2017). Diagnosis of ADHD has been rapidly increasing in recent years and literature reveals that children are being over-diagnosed (Heins, Bruggers, van Dijk, & Korevaar, 2016). As these children move onto college, many of them begin selling their medication to other students. Prescribing medication to these individuals has allowed ADHD medication misuse to be integrated into college life.
Various medications exist that are used to treat ADHD and the most commonly used ones are stimulant-based medications, like Adderall (amphetamine or dextroamphetamine) and Ritalin (methylphenidate) (Benson, Flory, Humphreys, & Lee, 2015). The use of these drugs has increased dramatically, perhaps based on multiple factors: Inclusion of milder ADHD diagnoses, vast marketing of ADHD medication by the pharmaceutical industry, and illegal diversion of controlled ADHD medication to consumers seeking stimulants as neuroenhancements (Graf, Miller, & Nagel, 2014). ADHD medication can have a positive impact on those who use it for the treatment of their correct ADHD diagnosis. However, when the medication is misused, it can have opposite effects on the individual. These effects can include: decreased appetite, insomnia, depression, severe headaches, and many more. When used for a prolonged period of time, the individual may become addicted to the medication. Without it, they may experience adverse effects including: compulsive drug seeking, aggression, mood swings, psychosis, abnormal libido, and suicidal thoughts (Begdache, 2016).
Purpose: to synthesize the available data regarding the adverse effects of ADHD medication on college students. Depression has been reported as an adverse effect among students who use the medication without having a true diagnosis of ADHD, but it has not been widely studied.
Results & Discussion:
Each research study addressed the correlation between the misuse of prescription stimulants and depressive symptoms among college students. The data found in these studies showed there was a significant correlation between the misuse of prescription stimulant medication and depressive symptoms. The studies did not show whether the depressive symptoms pushed college students to seek out prescription stimulant medication, or whether the medication subsequently caused depressive symptoms.
Conceptual Framework – Health Promotion Model
Nursing Implications:
Nursing practice should focus on having a questioning attitude when unsure about the necessity of a prescription for stimulant medication. A thorough exam should be given to ensure that the prescription is needed. Also, educating college-age students on the adverse effects of prescription stimulants should be stressed. Offering educational resources at college health clinics is a great way to reach out to students and help raise awareness to this growing epidemic. These tactics can help prevent the use of these medications and also discourage further students from current use.
Problem Statement:
The use of ADHD medications has a prevalence rate of over 20% at U.S. college schools and continues to rise. Prolonged use of ADHD medication can have addictive effects and result in adverse effects which include drug seeking behaviors and even suicidal etiology with documentation of depression and suicide attempts (Begdache, 2016).
Methods:
DePaul University’s online library was used for the integrative literature review. Sources were taken from the following databases: Academic Search Complete, EBSCOhost, MEDLINE, PubMed, Wordcat.org. The integrated literature review search involved limitations including only peer-reviewed articles and a publication date range from 2010 to The keywords used to refine the search within the aforementioned databases were “ADHD medication” and “depression” and “college”. This returned 243 articles from libraries worldwide. Primary sources were used.
Conclusion:
This literature review helped identify and relate new research that had been published between on the correlation between the misuse of ADHD-specific stimulant medication among college students and depressive symptoms. The data showed there was a significant correlation, but the directionality of the correlation could not be identified. A longitudinal study design should be utilized in the future to ascertain the exact correlation between the variables. Finding this link will promote the development and distribution of accurate educational resources on college campuses.
Research Questions:
1. Is depression among college students related to the misuse of ADHD medication?
2. What can nurses do to decrease the incidence of prescription drug misuse among college students?
References
Begdache, L. (2016). The hefty price of 'study drug' misuse on college campuses. In The Conversation. Retrieved April 9, 2017, from Benson, K., Flory, K., Humphreys, K. L., & Lee, S. S. (2015). Misuse of stimulant medication among college students: A comprehensive review and meta-analysis. Clinical Child and Family Psychology Review, 18, doi: /s z; Graf, W. D., Miller, G., & Nagel, S. K. (2014). Addressing the problem of ADHD medication as neuroenhancements. Expert Review of Neurotherapeutics, 14(5), Retrieved from Heins, M. J., Bruggers, I., van Dijk, L., & Korevaar, J. C. (2016). ADHD medication prescription: Effects of child, sibling, parent, and general practice characteristics. Journal of Child Healthcare, 20(4), doi: / ; (n.d.). In The ADHD Foundation. Retrieved from Picture 1: Aubrey, A. (n.d.). Misuse of ADHD medications by young adults drives rise in ER visits. In National Public Radio. Retrieved February 16, 2016, from Picture 2: Let's get high: Feeling drugs and their consequences (n.d.). In Addiction Recovery and Interventional Services. Retrieved December 23, 2012, from Picture 3: Common medications and treatments for children (n.d.). In healthychildren.org. Retrieved January 10, 2017, from