Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.
Department of Psychiatry, University of Cambridge, Cambridge, UK.
Epidemiol Psychiatr Sci. 2021 Nov 25;30:e76. doi: 10.1017/S2045796021000603.
Depression is thought to be associated with lower subsequent educational attainment during school. But, without longitudinal studies which take account of prior attainment and other potential confounders, estimates of the impact of clinically recognised depression in childhood and early adolescence are unknown. We investigated whether a clinical diagnosis of depression is associated with lower subsequent educational attainment, and whether the association is modified by gender, ethnicity and socioeconomic status.
We conducted a secondary analysis of an existing administrative data linkage between national educational data and a large mental healthcare provider in London, UK (2007-2013). Depression diagnosis before age 15 (exposure) was measured from electronic health records, and subsequent educational attainment at age 15-16 (outcome) was measured from educational records. We fitted logistic regression models and adjusted for gender, ethnicity, socioeconomic status, relative age in school year, neurodevelopmental disorder diagnosis and prior attainment. We investigated effect modifiers using interaction terms.
In total, n = 63 623 were included in analysis, of whom n = 242 had record of a depression diagnosis before age 15. Depression was associated with lower odds of subsequently achieving expected attainment levels in national exams, after adjustment for all covariates (odds ratio = 0.60, 95% confidence interval = 0.43 to 0.84, p = 0.003). There was no evidence that gender, ethnicity or socioeconomic status modified this association.
These findings support a relationship between depression and lower subsequent educational attainment. This highlights the need for tailored educational interventions to support children and adolescents with depression, particularly in the lead up to key educational milestones.
据认为，抑郁与在校期间后续教育程度较低有关。但是，由于缺乏考虑先前学业成绩和其他潜在混杂因素的纵向研究，因此尚不清楚儿童和青少年期临床确诊的抑郁对教育程度的影响。我们调查了临床诊断的抑郁症是否与后续教育程度较低相关，以及这种关联是否受到性别、种族和社会经济地位的影响。
我们对英国伦敦一家大型精神卫生保健机构与国家教育数据之间现有的行政数据链接进行了二次分析（2007-2013 年）。15 岁之前的抑郁诊断（暴露）通过电子健康记录测量，15-16 岁的后续教育程度（结局）通过教育记录测量。我们拟合了逻辑回归模型，并对性别、种族、社会经济地位、在校年龄的相对位置、神经发育障碍诊断和先前学业成绩进行了调整。我们使用交互项来调查效应修饰物。
共有 63623 人纳入分析，其中 242 人在 15 岁之前有抑郁诊断记录。在调整所有协变量后，抑郁与随后在国家考试中达到预期学业成绩水平的几率较低有关（比值比=0.60，95%置信区间=0.43 至 0.84，p=0.003）。没有证据表明性别、种族或社会经济地位改变了这种关联。
这些发现支持抑郁与较低的后续教育程度之间存在关联。这凸显了需要针对有抑郁的儿童和青少年制定有针对性的教育干预措施的必要性，特别是在关键教育里程碑之前。
