Rate, relative risk, and method of suicide by students at 4-year colleges and universities in the United States, 2004-2005 through 2008-2009.

A total of 622 suicides were reported among students attending 645 distinct campuses from 2004-2005 through 2008-2009. Adjusting for gender in the population at risk of 14.9 million student-years and for the source of these data, the student suicide rate of 7.0 was significantly and substantially lower than for a matched national sample. Suicide rates by firearm were significantly and substantially lower for both female and male students. Hanging was significantly and substantially lower for male students, less prominently so for female students. It is principally the ninefold decrease in the availability of firearms on campuses (vs. homes) and secondarily other features of the campus environment that are the bases for lower student suicide rates.

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College student suicide in the United States: 1990-1991 through 2003-2004.

Suggestions that there is a growing epidemic of suicide among college students in the United States are false. The National Survey of Counseling Center Directors reports 1,404 student suicides over a 14-year period and an adjusted suicide rate of 6.5, half the rate of the general US population (12.6 for all races) during this period when matched for gender and age. Counseling centers appear effective in treating suicidal students, for although the suicide rate for students who were currently or previously clients at campus counseling centers is 3 times the rate of other students, student clients have 18 times the risk of suicide compared to students in general. Identifying and referring students at elevated risk for suicide could further reduce the crude and relative rate of student suicide. However, even programs that do this only moderately well may require substantial increases in counseling staffing.

Four eras of study of college student suicide in the United States: 1920-2004.

Studies of college student suicide can be grouped into the following 4 eras: 1920-1960, 1960-1980, 1980-1990, and 1990-2004. The suicide rate for students has declined monotonically across these 4 eras, from 13.4 to 8.0 to 7.5 and, most recently, to 6.5. The decreasing proportion of men in the student populations studied largely accounts for this decline. Since 1960, the suicide rate for students has consistently been about half the rate of the general US population, matched for age and gender. This highly favorable relative suicide rate is the result of firearms having been effectively banned from campuses. Additional population-oriented approaches warrant implementation to further reduce student-suicide rates. Approaches focused on high-risk groups also hold promise. These findings are based upon and may be most valid for the 70% of all students who attend 4-year colleges and universities full time.

Are college students more disturbed today? Stability in the acuity and qualitative character of psychopathology of college counseling center clients: 1992-1993 through 2001-2002.

Are clients at college counseling centers more disturbed today than they were 5, 10, or 20 years ago? Since the mid-1980s, counseling center personnel have consistently perceived student clients as more distressed or reported acutely distressed clients as more prevalent than they did 1, 3, or 5 years ago. Only 3 studies employing a systematic, data-based methodology have addressed this question. Two researchers used different actuarial measures of the acuity or character of client pathology and concluded that current student clients are not more disturbed than were earlier ones. One researcher used clinical judgments rendered at the end of therapy and concluded that current students were more distressed. Using the Personality Assessment Inventory, the author found the actuarially determined quantitative and qualitative indices of pathology unchanged for 3,400 counseling center clients seen during 10 consecutive years. Over the same period, the use of medications increased fivefold. An actuarial measure of client distress appears crucial to both accurate diagnosis and treatment and to the adequate preparation of future counseling center professionals.

Spontaneous ligamentum flavum hematoma in the lumbar spine.

Lumbar or sacral nerve root compression is most commonly caused by intervertebral disc degeneration and/or herniation. Less frequently, other extradural causes may be implicated, such as infection, neoplasm, epidural hematoma, or ligamentum flavum pathology. We present the case of a patient with spontaneous ligamentum flavum hematoma compressing the L4 nerve root, without antecedent trauma. Although exceedingly rare, the diagnosis of ligamentum flavum pathology in general, and that of ligamentum flavum hematoma in particular, should be considered on those rare occasions when the etiology of lumbar or sacral nerve root compressions appears enigmatic on radiological studies. Usually surgical treatment produces excellent clinical outcome.

Insertion of a folded laryngeal mask airway around a palatal torus.

The laryngeal mask airway (LMA) is an airway management device that is used to establish and maintain a patent airway for the patient. A palatal torus is a common benign bony exostosis, usually located in the midline of the palate, beneath the palatal mucosa. It should be recognized by the CRNA during the preoperative anesthetic assessment. A palatal torus can hinder insertion of the LMA when using the standard LMA insertion technique. Therefore, modification must be made to the operator's insertion technique with a folded LMA around a palatal torus.