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Cited by 171Child and Adolescent Psychosocial and Emotional DevelopmentMental Health Treatment and AccessSchizophrenia research and treatment

Association of mental disorder in childhood and adolescence with subsequent educational achievement

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Dalsgaard, Søren, McGrath, John, Østergaard, Søren Dinesen, Wray, Naomi R., Pedersen, Carsten Bøcker, Mortensen, Preben Bo, Petersen, Liselotte·2020·JAMA Psychiatry
DOI 10.1001/jamapsychiatry.2020.0217PMC PMC7097843
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Abstract

Importance: Onset of mental disorders during childhood or adolescence has been associated with underperformance in school and impairment in social and occupational life in adulthood, which has important implications for the affected individuals and society. Objective: To compare the educational achievements at the final examination of compulsory schooling in Denmark between individuals with and those without a mental disorder. Design, Setting, and Participants: This population-based cohort study was conducted in Denmark and obtained data from the Danish Civil Registration System and other nationwide registers. The 2 cohorts studied were (1) all children who were born in Denmark between January 1, 1988, and July 1, 1999, and were alive at age 17 years (n = 629 622) and (2) all children who took the final examination at the end of ninth grade in both Danish and mathematics subjects between January 1, 2002, and December 31, 2016 (n = 542 500). Data analysis was conducted from March 1, 2018, to March 1, 2019. Exposures: Clinical diagnosis by a psychiatrist of any mental disorder or 1 of 29 specific mental disorders before age 16 years. Main Outcomes and Measures: Taking the final examination at the end of ninth grade and mean examination grades standardized as z scores with differences measured in SDs (standardized mean grade difference). Results: Of the total study population (n = 629 622; 306 209 female and 323 413 male), 523 312 individuals (83%) took the final examination before 17 years of age and 38 001 (6%) had a mental disorder before that age. Among the 542 500 individuals (274 332 female and 268 168 male), the mean (SD) age was 16.1 (0.33) years for the females and 16.2 (0.34) years for the males. Among the 15 843 female and 22 158 male students with a mental disorder, a lower proportion took the final examination (0.52; 95% CI, 0.52-0.53) compared with individuals without a mental disorder (0.88; 95% CI, 0.88-0.88). Mental disorders affected the grades of male individuals (standardized mean grade difference, -0.30; 95% CI, -0.32 to -0.28) more than the grades of their female peers (standardized mean grade difference, -0.24; 95% CI, -0.25 to -0.22) when compared with same-sex individuals without mental disorders. Most specific mental disorders were associated with statistically significantly lower mean grades, with intellectual disability associated with the lowest grade in female and male students (standardized mean grade difference, -1.07 [95% CI, -1.23 to -0.91] and -1.03 [95% CI, -1.17 to -0.89]; P = .76 for sex differences in the mean grades). Female and male students with anorexia nervosa achieved statistically significantly higher grades on the final examination (standardized mean grade difference, 0.38 [95% CI, 0.32-0.44] and 0.31 [95% CI, 0.11-0.52]; P = .54 for sex differences in the mean grades) compared with their peers without this disorder. For those with anxiety, attachment, attention-deficit/hyperactivity, and other developmental disorders, female individuals attained relatively lower standardized mean grades compared with their male counterparts. Conclusions and Relevance: Results of this study suggest that, in Denmark, almost all mental disorders in childhood or adolescence may be associated with a lower likelihood of taking the final examination at the end of ninth grade; those with specific disorders tended to achieve lower mean grades on the examination; and female, compared with male, individuals with certain mental disorders appeared to have relatively more impairment. These findings appear to emphasize the need to provide educational support to young people with mental disorders.

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  • Poor mental health in adolescence increases the risk of poor educational attainment, non-participation in postsecondary education, unemployment, low income when working, and being a recipient of welfare payments.

    “Poor mental health in adolescence increases the risk of poor educational attainment, 24 and non-participation in postsecondary education, unemployment, low income when working, and being a recipient of welfare payments.”

    From The Lancet Psychiatry Commission on youth mental health (2024) · cites this paper as [24]

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Authors
Dalsgaard, S., McGrath, J., Østergaard, S. D., Wray, N. R., Pedersen, C. B., Mortensen, P. B., & Petersen, L.
Affiliations
  • Aarhus University (DK)
  • The University of Queensland (AU)
Corresponding author
Dalsgaard, Søren
ORCID
Venue
JAMA Psychiatry
Publisher
American Medical Association (AMA)
Published
2020-08-01
Volume
77
Issue
8
Pages
797
ISSN
2168-622X (ISSN-L)
DOI
10.1001/jamapsychiatry.2020.0217
PMC
PMC7097843
OpenAlex
W3013219780
Cited by
171
References
72
Citations by year
2026: 37 · 2025: 35 · 2024: 18 · 2023: 34 · 2022: 18 · 2021: 22 · 2020: 7
FWCI
8.11
Type
journal article
Language
en
Open access
Locations
  • JAMA Psychiatry (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
Funders
  • European Commission (667302)
  • Lundbeckfonden (R155-2014-1724, R248‐2017‐2003, R276-2017-4581)
  • Helsefonden
  • Novo Nordisk Fonden (NNF 16OC0022018)
  • National Institutes of Health
Topics
  • Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
  • Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
  • Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
Keywords
child psychopathology, adolescent mental disorders, academic performance, compulsory education, prevalence of mental disorders, gender differences, socioeconomic status, parental education, parental income, parental mental illness, Denmark, school dropout, mental health service utilization, psychiatric hospitalization, outpatient psychiatric care, psychiatric inpatient care
MeSH terms
Academic Success, Adolescent, Mental Disorders, Child, Denmark, Educational Status, Female, Humans, Male, Registries, Cohort Studies

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