Fergusson David M, McLeod Geraldine F H, Horwood L John
Christchurch Health and Development Study, Department of Psychological Medicine, University of Otago, Christchurch, PO Box 4345, Christchurch, 8140, New Zealand,
Soc Psychiatry Psychiatr Epidemiol. 2015 Mar;50(3):469-78. doi: 10.1007/s00127-014-0971-4. Epub 2014 Oct 15.
To examine the associations between leaving school without qualifications and subsequent mental health to age 30, using data gathered over the course of a 30-year longitudinal study.
Data were gathered over the course of a 30-year study (Christchurch Health and Development Study) of a birth cohort of 1265 children, born in Christchurch in 1977. This cohort has been studied on 22 occasions from birth to age 30. As part of this study, information was gathered on: (a) school leaving qualifications, (b) mental health problems from 18 to 30; and (c) prospectively assessed childhood and adolescent factors including: child and family background; family violence and child abuse; and adolescent mental health problems.
Leaving school without qualifications was associated with increased risks of subsequent: major depression (OR = 1.37 at 95 % CI 1.05-1.78, p = 0.019); anxiety disorder (OR = 1.99 at 95 % CI 1.55-2.57, p < 0.001); suicidal ideation/attempt (OR = 1.60 at 95 % CI 1.15-2.36, p = 0.005); alcohol abuse/dependence (OR = 1.54 at 95 % CI 1.20-1.98, p < 0.001); and illicit substance abuse/dependence (OR = 2.97 at 95 % CI 2.16-4.07, p < 0.001). Adjustment for the covariate factors above (family social background; family violence; child abuse and adolescent mental health problems) reduced these associations substantially and to the point of statistical non-significance.
The findings of this study suggest that there was no direct causal association between leaving school without qualifications and subsequent mental health problems. Associations were explained by the linkages between leaving school without qualifications and: child and family social background; and mental health around the point of school leaving.
利用一项为期30年的纵向研究过程中收集的数据，研究未取得学历而离校与30岁之前的心理健康之间的关联。
数据来自对1977年出生在克赖斯特彻奇的1265名儿童的出生队列进行的为期30年的研究（克赖斯特彻奇健康与发展研究）。该队列从出生到30岁共接受了22次研究。作为本研究的一部分，收集了以下信息：（a）离校学历；（b）18岁至30岁期间的心理健康问题；（c）对童年和青少年因素进行前瞻性评估，包括：儿童和家庭背景；家庭暴力和虐待儿童；以及青少年心理健康问题。
未取得学历而离校与随后出现以下情况的风险增加相关：重度抑郁症（比值比=1.37，95%置信区间1.05 - 1.78，p = 0.019）；焦虑症（比值比=1.99，95%置信区间1.55 - 2.57，p < 0.001）；自杀意念/企图（比值比=1.60，95%置信区间1.15 - 2.36，p = 0.005）；酒精滥用/依赖（比值比=1.54，95%置信区间1.20 - 1.98，p < 0.001）；以及非法药物滥用/依赖（比值比=2.97，95%置信区间2.16 - 4.07，p < 0.001）。对上述协变量因素（家庭社会背景；家庭暴力；虐待儿童和青少年心理健康问题）进行调整后，这些关联大幅降低，直至无统计学意义。
本研究结果表明，未取得学历而离校与随后的心理健康问题之间不存在直接因果关联。这些关联可通过未取得学历而离校与以下方面的联系来解释：儿童和家庭社会背景；以及离校前后的心理健康状况。
