Written by Joyce Smith, BS. This study suggests that in childhood or adolescence mental disorders are associated with lower educational achievements and merit additional educational support for these individuals.
Children and adolescents with mental health problems often struggle to succeed in school. Compared to their mentally healthy peers, these individuals have more missed school days, three times the rates of suspension and expulsion 1, a greater likelihood of dropping out of high school 2, and lower attendance in final examinations and lower test scores 3. Previous research has linked these educational challenges with inattention, anxiety, depression, and psychotic experiences, all of which can interfere with in-class learning, completion of homework, and performance evaluations 4. Genetic associations can also have a negative correlation with educational attainment 5. They include autism spectrum disorder (ASD), obsessive-compulsive disorder (OCD), attention-deficit/hyperactivity disorder (ADHD), bipolar disorder, major depressive disorder (MDD), anorexia, anxiety disorders, and schizophrenia 5.
Dalsgaard and colleagues 6 sought to determine the educational results of the final compulsory exams in Denmark schools among Danish-born individuals with or without a mental disorders. They analyzed data (January 1, 1988 to July 1, 1999) from two Danish cohorts of students of who were alive at 17 years of age. Twenty-nine mental disorders were found in the 629,622 adolescent students. Those with psychiatric conditions such as schizophrenia, substance use disorder, and attachment disorders were about 40% less likely to complete final exams in the compulsory schooling setting relative to peers without such diagnoses. Of the total study population, 523,312 individuals (83%) took the final examination. Eighty-three percent of the total student cohort took their exams before the age of 17, and 6% of that cohort were diagnosed with mental disorders before then. The mean age of taking exams was 16.
Overall, a higher proportion of female students took exams than males for both those with mental disorders (63% female vs 45% male) and those without (91% female vs 86% male). Further comparisons revealed that when comparing boys and girls with identical conditions of attention-deficit/hyperactivity disorder (ADHD), anxiety, mood, or developmental disorders, girls were more likely to take exams. However, girls with ADHD and anxiety and developmental disorders had lower grades than their male peers with the same disorders. The research team suggests that female students with these disorders may be perceived as being less impaired and/or more obedient, and their parents and/or teachers may be viewed as more likely to recommend them taking the exam; although, in reality, these female students might be as impaired as or even more impaired than their male peers with the same disorders. Children with intellectual disabilities, alcohol use disorder, and learning disorders scored the lowest grades (scoring one point lower than their peers without mental disorders). Yet, when comparing students with mental disorders to those without mental disorders, significantly higher grades were achieved by boys (0.31 points) and girls (0.38 points) with anorexia nervosa, as well as boys with obsessive-compulsive disorder (0.07 points). The Dalsgaard team acknowledges that their findings for ASD do not support the positive genetic correlations between ASD and educational attainment and IQ across different samples as genetic studies have shown. However, they believe their findings support previous findings of high levels of perfectionism in both anorexia nervosa and OCD, which correlates with higher academic achievement in college students. They also note that their findings regarding schizophrenia are consistent with previous findings of lower educational achievement in these students and of negative genetic correlations with educational achievement and intelligence.
A study limitation was the exclusion of adolescents diagnosed with mental disorders in private practice settings who may be more socioeconomically advantaged and less likely to be severely impaired than those diagnosed in hospitals. These findings suggest a need to provide educational support to our younger generation who have mental problems.
Source: Dalsgaard, Søren, John McGrath, Søren Dinesen Østergaard, Naomi R. Wray, Carsten Bøcker Pedersen, Preben Bo Mortensen, and Liselotte Petersen. “Association of Mental Disorder in Childhood and Adolescence with Subsequent Educational Achievement.” JAMA psychiatry (2020).
© 2020 American Medical Association. All rights reserved.
Posted May 5, 2020.
Joyce Smith, BS, is a degreed laboratory technologist. She received her bachelor of arts with a major in Chemistry and a minor in Biology from the University of Saskatchewan and her internship through the University of Saskatchewan College of Medicine and the Royal University Hospital in Saskatoon, Saskatchewan. She currently resides in Bloomingdale, IL.
References:
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- Breslau J, Lane M, Sampson N, Kessler RC. Mental disorders and subsequent educational attainment in a US national sample. J Psychiatr Res. 2008;42(9):708-716.
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- Corder K, Atkin AJ, Bamber DJ, et al. Revising on the run or studying on the sofa: prospective associations between physical activity, sedentary behaviour, and exam results in British adolescents. The international journal of behavioral nutrition and physical activity. 2015;12:106.
- Anttila V, Bulik-Sullivan B, Finucane HK, et al. Analysis of shared heritability in common disorders of the brain. Science. 2018;360(6395).
- Dalsgaard S, McGrath J, Østergaard SD, et al. Association of Mental Disorder in Childhood and Adolescence With Subsequent Educational Achievement. JAMA Psychiatry. 2020.
