Tempelaar Wanda M, Otjes Christiaan P, Bun Clothilde J, Plevier Carolien M, van Gastel Willemijn A, MacCabe James H, Kahn René S, Boks Marco P M
Rudolf Magnus Institute of Neuroscience, Department of Psychiatry, University Medical Center Utrecht, Utrecht, The Netherlands.
BMC Psychiatry. 2014 Sep 14;14:244. doi: 10.1186/s12888-014-0244-5.
Accumulating evidence suggests that several adult mental disorders, particularly psychoses, are preceded by impairments in cognitive function, reflected in scholastic underachievement. This study investigates the association between scholastic underachievement and general mental health problems in adolescence, using delay in school progression as a marker of poor scholastic performance.
Cross-sectional secondary school survey comprising 10,803 adolescents. Participants completed the Strengths and Difficulties Questionnaire (SDQ) to assess mental health problems. The association of delayed school progression with the SDQ was investigated using logistic regression with SDQ as outcome and delayed school progression as primary exposure of interest while adjusting for socio-demographic characteristics, adverse life events, school-related factors, risk taking behaviour, healthy lifestyle and physical health.
Unadjusted analysis showed an association between delayed school progression and total mental health problems (OR 1.83, 95% CI 1.27-2.63) in adolescents. After adjusting for other risk factors (socio-demographic factors and life events) in a logistic regression model the association between delayed school progression en mental health problems was attenuated (OR 1.33, 95% CI 0.86-2.05).
Delayed school progression is associated with general mental health problems in adolescence, but this relationship is heavily confounded by other factors. A causal relationship between impaired cognitive function such as poor scholastic performance and general mental health at adolescence is less likely and delayed school progression may merely be considered an indicator of risk for mental health problems.
越来越多的证据表明，几种成人精神障碍，尤其是精神病，在认知功能受损之前就已出现，这在学业成绩不佳中有所体现。本研究以学业进展延迟作为学业成绩差的标志，调查青少年学业成绩不佳与一般心理健康问题之间的关联。
对10,803名青少年进行横断面中学调查。参与者完成优势与困难问卷（SDQ）以评估心理健康问题。以SDQ为结果、学业进展延迟作为主要关注暴露因素，采用逻辑回归分析学业进展延迟与SDQ之间的关联，同时对社会人口学特征、不良生活事件、学校相关因素、冒险行为、健康生活方式和身体健康进行校正。
未校正分析显示，青少年学业进展延迟与总体心理健康问题之间存在关联（比值比1.83，95%置信区间1.27 - 2.63）。在逻辑回归模型中对其他风险因素（社会人口学因素和生活事件）进行校正后，学业进展延迟与心理健康问题之间的关联减弱（比值比1.33，95%置信区间0.86 - 2.05）。
学业进展延迟与青少年的一般心理健康问题有关，但这种关系受到其他因素的严重混淆。诸如学业成绩差等认知功能受损与青少年一般心理健康之间的因果关系不太可能成立，学业进展延迟可能仅被视为心理健康问题风险的一个指标。
