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Long-term effects of mental disorders on educational attainment in the National Comorbidity Survey ten-year follow-up
Open accessAbstract
PurposeThe study sought to examine the association of mental disorders with educational attainment in a community sample.MethodsData were from 5001 respondents aged 15–54 in the 1990–1992 National Comorbidity Survey (NCS), re-interviewed in the 2001–2003 NCS follow-up (NCS-2). Discrete-time survival analysis was used to examine the association of disorders present at baseline (NCS) or having first onset after the baseline (assessed in NCS-2) with educational outcomes among 3954 eligible respondents. Mental disorders were categorized into internalizing fear disorders (simple phobia, social phobia, panic disorder with/without agoraphobia and agoraphobia without panic disorder), internalizing anxiety-misery disorders (major depressive disorder, generalized anxiety disorder and post-traumatic stress disorder), externalizing disorders (alcohol and drug use disorders, conduct disorder) and bipolar disorder. Analyses were conducted separately in students and non-students at baseline.ResultsAmong students, baseline bipolar and externalizing disorders, as well as fear, anxiety-misery and externalizing disorders with onset after baseline were associated with lower odds of high school graduation; baseline anxiety-misery disorders with lower odds of going to college; and baseline externalizing disorders and bipolar disorder with onset after baseline with lower odds of college graduation. Among non-students, baseline fear disorders were associated with lower odds of high school graduation and bipolar disorder with lower odds of going to college. Assuming that the regression coefficients represent causal effects, mental disorders accounted for 5.8–11.0 % of high school and 3.2–11.4 % of college non-completion.ConclusionsExpanding access to mental health services for youth might have a net positive societal value by helping to prevent some of these adverse educational outcomes.
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Written from the paper’s full text.
TL;DR
Using prospective National Comorbidity Survey panel data, this study finds modest associations between mental disorders and lower subsequent educational attainment, with effects generally stronger among students than non-students. Assuming causal effects, mental disorders accounted for 5.8–11.0% of high school non-completion and 3.2–11.4% of college non-completion.
Key findings
- Across 48 regression models, 9 coefficients were statistically significant, all showing decreased odds of educational transitions; significant odds ratios ranged from .17 to .61.
- Among students, baseline bipolar and externalizing disorders, and post-baseline fear, anxiety-misery, and externalizing disorders were associated with lower odds of high school graduation; baseline anxiety-misery disorders with lower odds of going to college; and baseline externalizing disorders and post-baseline bipolar disorder with lower odds of college graduation.
- Among non-students, baseline fear disorders were associated with lower odds of high school graduation and baseline bipolar disorder with lower odds of going to college.
- Population attributable risk proportions were 5.8–11.0% for high school non-completion and 3.2–11.4% for college non-completion; the largest were 11.4% for college graduation among students and 11.0% for high school graduation among non-students.
Methods
- Data came from 5,001 respondents aged 15–54 in the 1990–1992 National Comorbidity Survey re-interviewed in the 2001–2003 NCS follow-up; analyses used 3,954 eligible respondents and weighted data.
- Mental disorders were grouped into internalizing fear, internalizing anxiety-misery, externalizing, and bipolar disorder categories, assessed at baseline and for first onset after baseline; outcomes were high school graduation, going to college, and college graduation, analyzed separately among students and non-students at baseline.
- Discrete-time survival analysis with sociodemographic controls and childhood adversities was used, with Taylor series methods in SUDAAN and simulation-based population attributable risk proportions.
Limitations
- The paper states that individual disorder samples were too small, requiring disorder grouping and producing large confidence intervals for some odds ratios; results need replication in larger samples.
- The paper states that disorders assessed were incomplete—excluding psychotic disorders, ADHD, personality disorders, and subthreshold disorders—so the estimated effect is likely an underestimate, and residual confounding limits causal inference.
- The paper also notes no assessment of student performance or GPA and that education was measured as completed years of schooling rather than level achieved; the text makes evident that causal interpretation depends on the assumption that survival regression coefficients represent causal effects.
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23 Own result · 20 Not checked yet · 20 Own method · 15 Own interpretation · 1 No basis given
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“bipolar disorder with lower odds of going to college”
- Also stated in: § Associations of mental disorders with educational attainment · plain
“T1 lifetime bipolar disorder was associated with lower odds of going to college”
§ Long-Term Effects of Mental disorders on Educational Attainment In the National Comorbidity Survey Ten-Year Follow-up > Abstract > Results
plaincorrelational- Asserted: passes — The authors put it forward as true.
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- Also stated in: § Associations of mental disorders with educational attainment · plain
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The associations of T1 lifetime disorders with educational outcomes were for the most part not affected by controlling for childhood adversities.”
§ Long-Term Effects of Mental disorders on Educational Attainment In the National Comorbidity Survey Ten-Year Follow-up > RESULTS > Associations of mental disorders with educational attainment
plain- Asserted: passes — The authors put it forward as true.
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In the paper
“Furthermore, childhood adversities were not associated with educational outcomes at a statistically significant level in any of the models (data not shown).”
§ Long-Term Effects of Mental disorders on Educational Attainment In the National Comorbidity Survey Ten-Year Follow-up > RESULTS > Associations of mental disorders with educational attainment
plain- Asserted: passes — The authors put it forward as true.
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A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Similarly, in the model adjusting for all disorder groups, the association of lifetime anxiety-misery disorders with high school graduation was significantly larger than one (AOR=1.97, 95% CI=1.14–3.38)”
§ Long-Term Effects of Mental disorders on Educational Attainment In the National Comorbidity Survey Ten-Year Follow-up > RESULTS > Associations of mental disorders with educational attainment
plaincorrelational- Asserted: passes — The authors put it forward as true.
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A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Among non-students, baseline fear disorders were associated with lower odds of high school graduation”
- Also stated in: § Associations of mental disorders with educational attainment · plain
“while T1 lifetime fear disorders were associated with lower odds of graduating from high school”
§ Long-Term Effects of Mental disorders on Educational Attainment In the National Comorbidity Survey Ten-Year Follow-up > Abstract > Results
plaincorrelational- Asserted: passes — The authors put it forward as true.
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- Also stated in: § Associations of mental disorders with educational attainment · plain
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“fear, anxiety-misery and externalizing disorders with onset after baseline were associated with lower odds of high school graduation”
§ Long-Term Effects of Mental disorders on Educational Attainment In the National Comorbidity Survey Ten-Year Follow-up > Abstract > Results
plaincorrelational- Asserted: passes — The authors put it forward as true.
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A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“among T1 lifetime disorders, bipolar disorder and externalizing disorders were associated with lower odds of graduating from high school in students”
§ Long-Term Effects of Mental disorders on Educational Attainment In the National Comorbidity Survey Ten-Year Follow-up > RESULTS > Associations of mental disorders with educational attainment
plaincorrelational- Asserted: passes — The authors put it forward as true.
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A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The number of fear disorders in this model was associated with lower odds of going to college even after adjusting for the binary variable indicating any fear disorders (AOR=.65, 95% CI=.48–.88).”
§ Long-Term Effects of Mental disorders on Educational Attainment In the National Comorbidity Survey Ten-Year Follow-up > RESULTS > Associations of mental disorders with educational attainment
plaincorrelational- Asserted: passes — The authors put it forward as true.
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A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“only bipolar disorder with first onset after T1 was associated with the lower odds of graduating from college among students”
§ Long-Term Effects of Mental disorders on Educational Attainment In the National Comorbidity Survey Ten-Year Follow-up > RESULTS > Associations of mental disorders with educational attainment
plaincorrelational- Asserted: passes — The authors put it forward as true.
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A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“T1 lifetime externalizing disorders with lower odds of graduating from college”
§ Long-Term Effects of Mental disorders on Educational Attainment In the National Comorbidity Survey Ten-Year Follow-up > RESULTS > Associations of mental disorders with educational attainment
plaincorrelational- Asserted: passes — The authors put it forward as true.
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- The quote only partly states this claim. 1
- It may state two separate claims as one. 13
- Probably not a substantial claim. 27
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“However, the adjusted odds ratios for the association of bipolar disorder with high school graduation among T1 students was significantly larger than one (AOR=6.75, 95% CI=1.09–41.83).”
§ Long-Term Effects of Mental disorders on Educational Attainment In the National Comorbidity Survey Ten-Year Follow-up > RESULTS > Associations of mental disorders with educational attainment
plaincorrelational- Asserted: passes — The authors put it forward as true.
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The quote only partly states this claim.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Assuming that the regression coefficients represent causal effects, mental disorders accounted for 5.8–11.0% of high school and 3.2–11.4% of college non-completion.”
§ Long-Term Effects of Mental disorders on Educational Attainment In the National Comorbidity Survey Ten-Year Follow-up > Abstract > Results
hedgedconditional- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
- The authors state this as an assumption: The survival regression coefficients accurately represent causal effects of mental disorders.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The largest PARPs were for graduating from college (11.4%) among T1 students and for graduating from high school among T1 non-students (11.0%).”
§ Long-Term Effects of Mental disorders on Educational Attainment In the National Comorbidity Survey Ten-Year Follow-up > RESULTS > Population attributable risk proportions
plaincorrelational- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Social phobia was the most common disorder in this category.”
§ Long-Term Effects of Mental disorders on Educational Attainment In the National Comorbidity Survey Ten-Year Follow-up > DISCUSSION
plain- Asserted: passes — The authors put it forward as true.
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A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Seven of the 9 statistically significant associations in Table 2 were in the student group even though the non-student subsamples were larger in size.”
§ Long-Term Effects of Mental disorders on Educational Attainment In the National Comorbidity Survey Ten-Year Follow-up > DISCUSSION
plaincorrelational- Asserted: passes — The authors put it forward as true.
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A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“which was the most common disorder in the category of internalizing anxiety-misery disorders in the present study.”
§ Long-Term Effects of Mental disorders on Educational Attainment In the National Comorbidity Survey Ten-Year Follow-up > DISCUSSION
plain- Asserted: passes — The authors put it forward as true.
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The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“with alcohol disorders being the most common disorders in this category”
§ Long-Term Effects of Mental disorders on Educational Attainment In the National Comorbidity Survey Ten-Year Follow-up > DISCUSSION
plain- Asserted: passes — The authors put it forward as true.
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What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“A total of 5,463 cases were successfully resolved (166 deceased, 5,001 re-interviewed), for a conditional response rate of 87.6%.”
§ Long-Term Effects of Mental disorders on Educational Attainment In the National Comorbidity Survey Ten-Year Follow-up > METHODS > Sample
plainn = 5,463- Asserted: passes — The authors put it forward as true.
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In the paper
“The Part II sample was weighted to adjust for differential probabilities of selection and for discrepancies between the sample and the Census population on a wide range of socio-demographic and geographic variables.”
§ Long-Term Effects of Mental disorders on Educational Attainment In the National Comorbidity Survey Ten-Year Follow-up > METHODS > Sample
plainn = 5,877- Asserted: passes — The authors put it forward as true.
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None of the sources cited for this claim have been checked yet.
In the paper
“Blinded clinical reappraisal interviews administered to a probability sub-sample of respondents using the Structured Clinical Interview for DSM-III-R [30] in the NCS and the Structured Clinical Interview for DSM-IV (SCID) [31] in the NCS-2 documented generally good concordance between diagnoses based on the CIDI and independent diagnoses based on blinded clinical reappraisal interviews [32,33].”
§ Long-Term Effects of Mental disorders on Educational Attainment In the National Comorbidity Survey Ten-Year Follow-up > METHODS > Assessments
What the sources say
- Not checked yetcites [32] Kessler RC, Wittchen HU, Abelson JM, Mcgonagle K, Schwarz N, Kendler KS, Knäuper B, Zhao S (1998) Methodological studies of the Composite International Diagnostic Interview (CIDI) in the US national comorbidity survey (NCS). Int J Methods Psychiatr Res 7(1):33–55 source
- Not checked yetcites [33] Haro JM, Arbabzadeh-Bouchez S, Brugha TS, de Girolamo G, Guyer ME, Jin R, Lepine JP, Mazzi F, Reneses B, Vilagut G, Sampson NA, Kessler RC (2006) Concordance of the Composite International Diagnostic Interview Version 3.0 (CIDI 3.0) with standardized clinical assessments in the WHO World Mental Health surveys. Int J Methods Psychiatr Res 15(4):167–180 source
plaincorrelational- Asserted: passes — The authors put it forward as true.
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In the paper
“The response rate was 82.4%.”
§ Long-Term Effects of Mental disorders on Educational Attainment In the National Comorbidity Survey Ten-Year Follow-up > METHODS > Sample
plainn = 8,098- Asserted: passes — The authors put it forward as true.
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In the paper
“The percentage of baseline respondents interviewed in both surveys was 72.2% (0.876 × 0.824).”
§ Long-Term Effects of Mental disorders on Educational Attainment In the National Comorbidity Survey Ten-Year Follow-up > METHODS > Sample
plainn = 5,463- Asserted: passes — The authors put it forward as true.
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In the paper
“Relative to other baseline NCS respondents, those who were successfully followed up and re-interviewed in NCS-2 were significantly more likely to be female, well-educated, and residents of rural areas.”
§ Long-Term Effects of Mental disorders on Educational Attainment In the National Comorbidity Survey Ten-Year Follow-up > METHODS > Sample
plaincorrelationaln = 5,463- Asserted: passes — The authors put it forward as true.
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In the paper
“Analyses are based on these weighted data.”
§ Long-Term Effects of Mental disorders on Educational Attainment In the National Comorbidity Survey Ten-Year Follow-up > METHODS > Sample
plainn = 5,463- Asserted: passes — The authors put it forward as true.
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In the paper
“Much of the past research on the impact of mental disorders on educational attainment has focused on depression [38,22,7,8,21]”
§ Long-Term Effects of Mental disorders on Educational Attainment In the National Comorbidity Survey Ten-Year Follow-up > DISCUSSION
What the sources say
- Not checked yetcites [38] Eisenberg D, Chung H (2012) Adequacy of depression treatment among college students in the United States. Gen Hosp Psychiatry 34(3):213–220 source
- Not checked yetcites [22] Fergusson DM, Woodward LJ (2002) Mental health, educational, and social role outcomes of adolescents with depression. Arch Gen Psychiatry 59(3):225 source
- Not checked yetcites [7] Fletcher JM (2008) Adolescent depression: diagnosis, treatment, and educational attainment. Health Econ 17(11):1215–1235 source
- Not checked yetcites [8] Fletcher JM (2010) Adolescent depression and educational attainment: results using sibling fixed effects. Health Econ 19(7):855–871 source
- Not checked yetcites [21] Jonsson U, Goodman A, von Knorring A-L, von Knorring L, Koupil I (2012) School performance and hospital admission due to unipolar depression: a three-generational study of social causation and social selection. Soc Psychiatry Psychiatr Epidemiol 47(10):1695–1706 source
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In the paper
“Years of schooling is not a perfect measure of educational attainment as some individual may have been held back in the same level for 1 year or longer.”
§ Long-Term Effects of Mental disorders on Educational Attainment In the National Comorbidity Survey Ten-Year Follow-up > DISCUSSION
plain- Asserted: passes — The authors put it forward as true.
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In the paper
“Second, the mental disorders assessed in the NCS were incomplete and did not include psychotic disorders, attention-deficit/hyperactivity disorder, or personality disorders”
§ Long-Term Effects of Mental disorders on Educational Attainment In the National Comorbidity Survey Ten-Year Follow-up > DISCUSSION
plain- Asserted: passes — The authors put it forward as true.
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In the paper
“This study had several strengths including a relatively large sample size, longitudinal design with excellent follow-up, and the use of structured interview instruments at two time points.”
§ Long-Term Effects of Mental disorders on Educational Attainment In the National Comorbidity Survey Ten-Year Follow-up > DISCUSSION
plain- Asserted: passes — The authors put it forward as true.
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In the paper
“Even where these resources are available, many students do not access them because of stigma, low mental health literacy or because of not knowing about available resources [53].”
§ Long-Term Effects of Mental disorders on Educational Attainment In the National Comorbidity Survey Ten-Year Follow-up > DISCUSSION
What the sources say
- Not checked yetcites [53] Eisenberg D, Golberstein E, Gollust SE (2007) Help-seeking and access to mental health care in a university student population. Med Care 45(7):594–601 source
plaindirect- Asserted: passes — The authors put it forward as true.
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What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“This study had several strengths including a relatively large sample size, longitudinal design with excellent follow-up, and the use of structured interview instruments at two time points.”
§ Long-Term Effects of Mental disorders on Educational Attainment In the National Comorbidity Survey Ten-Year Follow-up > DISCUSSION
plain- Asserted: passes — The authors put it forward as true.
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A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“the finding with regard to other disorders perhaps highlights the greater ability of older students to cope with the effects of mental illness.”
§ Long-Term Effects of Mental disorders on Educational Attainment In the National Comorbidity Survey Ten-Year Follow-up > DISCUSSION
hedgedconditional- Asserted: passes — The authors put it forward as true.
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None of the sources cited for this claim have been checked yet.
In the paper
“poor educational performance is a major contributor to school drop-out as well as a risk factor for mental disorders [44,45].”
§ Long-Term Effects of Mental disorders on Educational Attainment In the National Comorbidity Survey Ten-Year Follow-up > DISCUSSION
What the sources say
- Not checked yetcites [44] Chassin L (1984) Adolescent substance use and abuse. Adv Child Behav Anal Ther 3:99–152
- Not checked yetcites [45] Rosenberg M, Schooler C, Schoenbach C (1989) Self-esteem and adolescent problems: modeling reciprocal effects. Am Sociol Rev 54:1004–1018 source
plaindirect- Asserted: passes — The authors put it forward as true.
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Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“This study had several strengths including a relatively large sample size, longitudinal design with excellent follow-up, and the use of structured interview instruments at two time points.”
§ Long-Term Effects of Mental disorders on Educational Attainment In the National Comorbidity Survey Ten-Year Follow-up > DISCUSSION
plain- Asserted: passes — The authors put it forward as true.
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What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“First, despite the large sample size of the study, the number of respondents with individual mental disorders was too small to provide reliable estimates, requiring us to combine individual disorders into groups.”
§ Long-Term Effects of Mental disorders on Educational Attainment In the National Comorbidity Survey Ten-Year Follow-up > DISCUSSION
plain- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“both of which could have been affected by mental disorders”
§ Long-Term Effects of Mental disorders on Educational Attainment In the National Comorbidity Survey Ten-Year Follow-up > DISCUSSION
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“in which PARP estimates ranged from 0 to 11.37 for non-completion of high school, −0.05 to 4.65 for non-entry into college, and 0 to 2.64 for non-completion of college [10]”
§ Long-Term Effects of Mental disorders on Educational Attainment In the National Comorbidity Survey Ten-Year Follow-up > DISCUSSION
What the sources say
- Not checked yetcites [10] Lee S, Tsang A, Breslau J, Aguilar-Gaxiola S, Angermeyer M, Borges G, Bromet E, Bruffaerts R, de Girolamo G, Fayyad J, Gureje O, Haro JM, Kawakami N, Levinson D, Oakley Browne MA, Ormel J, Posada-Villa J, Williams DR, Kessler RC (2009) Mental disorders and termination of education in high-income and low- and middle-income countries: epidemiological study. Br J Psychiatry 194(5):411–417 source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“Previously published cross-sectional analyses of the baseline NCS used retrospective age-of-onset reports to estimate associations of lifetime mental disorders with subsequent educational attainment, concluding that these disorders account for 14.2% of high school drop-out and 4.7% of college drop-out in the US [14].”
§ Long-Term Effects of Mental disorders on Educational Attainment In the National Comorbidity Survey Ten-Year Follow-up > INTRODUCTION
What the sources say
- Not checked yetcites [14] Kessler RC, Foster CL, Saunders WB, Stang PE (1995) Social consequences of psychiatric disorders, I: educational attainment. Am J Psychiatry 152(7):1026–1032 source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“The excellent follow-up rate was made possible by the use of exhaustive tracing procedures developed by SRC over the years in conjunction with their landmark long-term panel surveys (e.g., Panel Study of Income Dynamics, the Health and Retirement Study).”
§ Long-Term Effects of Mental disorders on Educational Attainment In the National Comorbidity Survey Ten-Year Follow-up > DISCUSSION
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“Treatment of mental health conditions in children and adolescents has increased in the years since early 2000s when the NCS-2 was conducted [56].”
§ Long-Term Effects of Mental disorders on Educational Attainment In the National Comorbidity Survey Ten-Year Follow-up > DISCUSSION
What the sources say
- Not checked yetcites [56] Olfson M, Blanco C, Wang S, Laje G, Correll CU (2014) National trends in the mental health care of children, adolescents, and adults by office-based physicians. JAMA Psychiatry 71(1):81–90 source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
None of the sources cited for this claim have been checked yet.
In the paper
“Research on treatment and prevention programs for child and adolescent mental disorders has produced promising results regarding the impact on education [46–51].”
§ Long-Term Effects of Mental disorders on Educational Attainment In the National Comorbidity Survey Ten-Year Follow-up > DISCUSSION
What the sources say
- Not checked yetcites [46] Sinclair MF, Christenson SL, Elevo DL, Hurley CM (1998) Dropout prevention for youth with disabilities: efficacy of a sustained school engagement procedure. Except Child 65:7–21 source
- Not checked yetcites [47] Balfanz R, Herzog L, Mac Iver DJ (2007) Preventing student disengagement and keeping students on the graduation path in urban middle-grades schools: early identification and effective interventions. Educ Psychol 42(4):223–235 source
- Not checked yetcites [48] Hawken LS, Horner RH (2003) Evaluation of a targeted intervention within a schoolwide system of behavior support. J Behav Educ 12(3):225–240 source
- Not checked yetcites [49] Prevatt F, Kelly FD (2003) Dropping out of school: a review of intervention programs. J Sch Psychol 41(5):377–395 source
- Not checked yetcites [50] Wilson SJ, Tanner-Smith EE, Lipsey MW, Steinka-Fry K, Morrison J (2011) Dropout prevention and intervention programs: effects on school completion and dropout among school-aged children and youth. campbell systematic reviews. http://files.eric.ed.gov/fulltext/ED519121.pdf source
- Not checked yetcites [51] Chung H, Klein MC, Silverman D, Corson-Rikert J, Davidson E, Ellis P, Kasnakian C (2011) A pilot for improving depression care on college campuses: results of the College Breakthrough Series-Depression (CBS-D) Project. J Am Coll Health 59(7):628–639 source
plainconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
None of the sources cited for this claim have been checked yet.
In the paper
“As a result, there is a large unmet need for mental health care among both high school and college students [38,54,55].”
§ Long-Term Effects of Mental disorders on Educational Attainment In the National Comorbidity Survey Ten-Year Follow-up > DISCUSSION
What the sources say
- Not checked yetcites [38] Eisenberg D, Chung H (2012) Adequacy of depression treatment among college students in the United States. Gen Hosp Psychiatry 34(3):213–220 source
- Not checked yetcites [54] Hunt J, Eisenberg D (2010) Mental health problems and help-seeking behavior among college students. J Adolesc Health 46(1):3–10 source
- Not checked yetcites [55] Said D, Kypri K, Bowman J (2013) Risk factors for mental disorder among university students in Australia: findings from a web-based cross-sectional survey. Soc Psychiatry Psychiatr Epidemiol 48(6):935–944 source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“However, many schools lack adequate resources to effectively identify youth at risk or means to implement evidence-based prevention and treatment programs [52].”
§ Long-Term Effects of Mental disorders on Educational Attainment In the National Comorbidity Survey Ten-Year Follow-up > DISCUSSION
What the sources say
- Not checked yetcites [52] Langley AK, Nadeem E, Kataoka SH, Stein BD, Jaycox LH (2010) Evidence-based mental health programs in schools: barriers and facilitators of successful implementation. Sch Mental Health 2(3):105–113 source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Even after aggregating disorders in groups, samples for some groups were rather small for the analyses, resulting in very large confidence intervals for the some of the odds ratios.”
§ Long-Term Effects of Mental disorders on Educational Attainment In the National Comorbidity Survey Ten-Year Follow-up > DISCUSSION
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“an outcome for which the WMH study found very large associations for substance disorders.”
§ Long-Term Effects of Mental disorders on Educational Attainment In the National Comorbidity Survey Ten-Year Follow-up > DISCUSSION
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“This discrepancy might reflect recall bias.”
§ Long-Term Effects of Mental disorders on Educational Attainment In the National Comorbidity Survey Ten-Year Follow-up > DISCUSSION
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
None of the sources cited for this claim have been checked yet.
In the paper
“Social and economic changes in the past decade, and especially the economic crisis of 2007 all likely impacted financial access to education [58,59].”
§ Long-Term Effects of Mental disorders on Educational Attainment In the National Comorbidity Survey Ten-Year Follow-up > DISCUSSION
What the sources say
- Not checked yetcites [58] Pan W, Ost B (2014) The impact of parental layoff on higher education investment. Econ Educ Rev 42:53–63 source
- Not checked yetcites [59] Greenglass E, Antonides G, Christandl F, Foster G, Katter JK, Kaufman BE, Lea SE (2014) The financial crisis and its effects: perspectives from economics and psychology. J Behav Exp Econ 50:10–12 source
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
In the paper
“Yet, a 2010 study by Heckman and Lafontaine found a steady decline in the high school graduation rates in the US since 1970s [57].”
§ Long-Term Effects of Mental disorders on Educational Attainment In the National Comorbidity Survey Ten-Year Follow-up > DISCUSSION
What the sources say
- Not checked yetcites [57] Heckman JJ, LaFontaine PA (2010) The American high school graduation rate: trends and levels. Rev Econ Stat 92(2):244–262 source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“Other social and institutional factors such as the quality of school programs and the ability of these programs to meet the student needs have also been shown to be associated with school completion [60]”
§ Long-Term Effects of Mental disorders on Educational Attainment In the National Comorbidity Survey Ten-Year Follow-up > DISCUSSION
What the sources say
- Not checked yetcites [60] Rumberger R, Lim SA (2008) Why students drop out of school: a review of 25 years of research. Santa Barbara, CA: California Dropout Research Project. http://cdrp.ucsb.edu/dropouts/pubs_reports.htm
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
The authors state this as an assumption.
The survival regression coefficients accurately represent causal effects of mental disorders.
“based on the assumption that the survival regression coefficients accurately represent causal effects of these disorders.”
“Assuming that the regression coefficients represent causal effects”
The paper relies on this without support.
The associations of mental disorders with return to schooling among individuals who experienced a disruption in education have not been examined previously.
“The associations of mental disorders with return to schooling among individuals who experienced a disruption in education have not been examined previously.”
The paper relies on this without support.
Psychotic disorders, attention-deficit/hyperactivity disorder, and personality disorders likely impact educational attainment.
“which likely impact educational attainment.”
The paper relies on this without support.
Social adversities besides those measured in NCS, childhood physical health conditions, and socio-economic status not captured by the breadwinner’s education may influence both the risk of mental disorders and educational outcomes.
“For example, social adversities besides the ones measured in NCS, childhood physical health conditions and socio-economic status not captured by the breadwinner’s education may all influence both the risk of mental disorders as well as educational outcomes.”
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
In the citing paper
“More broadly, mental disorders are associated with lower employment in adulthood (Mojtabai et al., 2015).”
From Severe role impairment associated with mental disorders: Results of the WHO World Mental Health Surveys International College Student Project (2018) · cites this paper as Mojtabai et al., 2015
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
Each contradiction between two passages listed here was confirmed by an independent check.
Rated minor: it would not touch a result — a value no result rests on, a p-value that stays on the same side of the significance level, or a conflict that is clerical, resolved elsewhere in the paper, or outside its own findings.
In the paper
§ Long-Term Effects of Mental disorders on Educational Attainment In the National Comorbidity Survey Ten-Year Follow-up > Abstract > Results
“Among students, baseline bipolar and externalizing disorders, and fear, anxiety-misery and externalizing disorders with onset after baseline were associated with lower odds of high school graduation;”
§ Long-Term Effects of Mental disorders on Educational Attainment In the National Comorbidity Survey Ten-Year Follow-up > RESULTS > Associations of mental disorders with educational attainment
“whereas, among disorders with first onsets after T1, fear and anxiety-misery disorders were the disorders associated with this outcome.”
Citations
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Metadata
- Authors
- Mojtabai, R., Stuart, E. A., Hwang, I., Eaton, W. W., Sampson, N., & Kessler, R. C.
- Affiliations
- Johns Hopkins University (US)
- Harvard University (US)
- Corresponding author
- Mojtabai, Ramin
- Venue
- Social Psychiatry and Psychiatric Epidemiology
- Published
- 2015-06-17
- Volume
- 50
- Issue
- 10
- Pages
- 1577-1591
- ISSN
- 0933-7954 (ISSN-L)
- 1433-9285
- PMC
- PMC4964966
- OpenAlex
- W639695655
- Semantic Scholar
- dec412e67e2b2dfebafe8d7a67815acfed54f6fc
- Cited by
- 215
- References
- 65
- Citations by year
- 2026: 15 · 2025: 25 · 2024: 27 · 2023: 21 · 2022: 21 · 2021: 32 · 2020: 13 · 2019: 14 · 2018: 21 · 2017: 17 · 2016: 5 · 2015: 1
- FWCI
- 24.00
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Social Psychiatry and Psychiatric Epidemiology (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health (5r13mh066849-04, 5r01mh069864-04, 5r01mh070884-05)
- Johns Hopkins Bloomberg School of Public Health
- National Institute of Mental Health (R13-MH-066849, R01‐MH070884, R01MH046376, R01MH096826, R01‐MH069864)
- National Institute on Drug Abuse (R01DA016558, R01DA012058)
- Fogarty International Center (R03TW006481)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Mental Health Treatment and Access
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
- Keywords
- mental illness, educational attainment, high school graduation, college completion, bipolar disorder, externalizing disorders, internalizing disorders, fear disorders, anxiety disorders, substance use disorders, conduct disorder, access to mental health care, youth, National Comorbidity Survey
- MeSH terms
- Adolescent, Adult, Mental Disorders, Educational Status, Female, Follow-Up Studies, Health Surveys, Humans, Male, Middle Aged, United States, Comorbidity, Young Adult
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
A language model drew the claims from the paper on 2026-10-10, under version 3 of the claim definition (model deepseek-v4.1-flash, prompt extract-v3).
A second model labelled each claim on 2026-10-10 (model jev-1.13-20260917, definition revision gold-guideline-v0.2).
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