School performance and hospital admissions due to self-inflicted injury: a Swedish national cohort study
School performance and hospital admissions due to self-inflicted injury: a Swedish national cohort study
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DOI：
10.1093/ije/dyp236
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发表时间：
2009-10-01
影响因子：
7.7
通讯作者：
Hjern, Anders
中科院分区：
文献类型：
--
作者：
Jablonska, Beata;Lindberg, Lene;Hjern, Anders
背景近几十年来，在许多西方国家，青少年的自我伤害有所增加。教育是影响青少年幼年后生活状况的最有影响力的社会决定因素。方法对1973年至1977年出生的447929名儿童在全国范围内进行前瞻性跟踪调查，从他们第九年和最后一年的义务教育结束到2001年。采用多因素Cox比例风险分析方法对9年级学生因自残入院的预测因素进行检验。结果自残入院风险呈阶梯式递增趋势，平均分呈下降趋势。平均成绩最低者与最高者的危险比为6.2(95%可信区间5.5-7.0)。女性和男性的风险是相似的。在多变量比例风险回归分析中，对潜在的社会经济混杂因素进行了调整，仅略微减弱了这种强烈的梯度。结论学校表现是预测未来精神疾病的一个强有力的因素，表现为自我伤害。
Background Self-inflicted injury in youth has increased in many Western countries during recent decades. Education is the most influential societal determinant of living conditions in young people after early childhood. This study tested the hypothesis that school performance predicts self-inflicted injury.Methods A national cohort of 447929 children born during 1973-77 was followed prospectively in the National Patient Discharge Register from the end of their ninth and last year of compulsory school until 2001. Multivariate Cox analyses of proportional hazards were used to test hypotheses regarding grades in ninth grade as predictors of hospital admission due to self-inflicted injury.Results The risk of hospital admission because of self-inflicted injury increased steeply in a step-wise manner with decreasing grade point average. Hazard ratios were 6.2 (95% confidence interval 5.5-7.0) in those with the lowest level of grade point average compared with the highest. The risks were similar for women and men. Adjustment for potential socio-economic confounders in a multivariate proportional hazards regression analysis attenuated this strong gradient only marginally.Conclusion School performance is a strong factor for predicting future mental ill-health as expressed by self-inflicted injury.