School achievement as a predictor of depression and self-harm in adolescence: linked education and health record study
School achievement as a predictor of depression and self-harm in adolescence: linked education and health record study
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DOI：
10.1192/bjp.2017.69
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发表时间：
2018-04-01
影响因子：
10.5
通讯作者：
Brophy, Sinead
中科院分区：
文献类型：
--
作者：
Rahman, Muhammad A.;Todd, Charlotte;Brophy, Sinead
背景儿童和青少年的精神障碍对受教育程度有影响。目的研究受教育程度与青少年期抑郁或自我伤害的诊断之间的时间关系。方法全科医生，使用考克斯回归对1999年至2014年威尔士年轻人的医院和教育记录进行了关联和分析。其中33498人（5.1%）在12岁之后但在20岁之前患上抑郁症，15946人（2.4%）自残。在研究期间患上抑郁症的年轻人更有可能达到关键阶段1（7岁），而不是关键阶段2（11岁）（风险比（HR）= 0.79，95% CI 0.74-0.84）里程碑，这表明他们在小学期间的学业成绩下降。相反，那些自我伤害的实现，以及那些谁没有自我伤害在小学，但表现出严重的下降，他们的成绩在中学（HR = 0.72，95%CI 0.68-0.78）。自我伤害仅与中学期间的教育程度下降有关。将学习成绩下降的信息与其他已知的抑郁/自我伤害风险因素（例如压力性生活事件，父母心理健康问题）相结合，可能会改善风险分析方法。
BackgroundMental disorders in children and adolescents have an impact on educational attainment.AimsTo examine the temporal association between attainment in education and subsequent diagnosis of depression or self-harm in the teenage years.MethodGeneral practitioner, hospital and education records of young people in Wales between 1999 and 2014 were linked and analysed using Cox regression.ResultsLinked records were available for 652 903 young people and of these 33 498 (5.1%) developed depression and 15 946 (2.4%) self-harmed after the age of 12 but before the age of 20. Young people who developed depression over the study period were more likely to have achieved key stage 1 (age 7 years) but not key stage 2 (age 11) (hazard ratio (HR) = 0.79, 95% CI 0.74-0.84) milestones, indicating that they were declining in academic attainment during primary school. Conversely, those who self-harmed were achieving as well as those who did not self-harm in primary school, but showed a severe decline in their attainment during secondary school (HR = 0.72, 95% CI 0.68-0.78).ConclusionsLong-term declining educational attainment in primary and secondary school was associated with development of depression in the teenage years. Self-harm was associated with declining educational attainment during secondary school only. Incorporating information on academic decline with other known risk factors for depression/self-harm (for example stressful life events, parental mental health problems) may improve risk profiling methods.