Department of Child Psychiatry and INVEST Research Flagship Center, University of Turku and Turku University Hospital, Turku, Finland.
Department of Adolescent Psychiatry, University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland.
Acta Psychiatr Scand. 2022 Nov;146(5):420-429. doi: 10.1111/acps.13481. Epub 2022 Aug 7.
It is unclear whether there are differences between specific school subject performance and later psychiatric disorders. We examined whether mean grade point average (MGPA) and specific school subjects associated with diagnoses of nonaffective psychoses, bipolar disorder and depression.
In this register-based study, we studied the Finnish population born in 1987 who had available MGPA and six specific school grades (age = 15.4-16.4 years; n = 50,508). Grades were analyzed with smoothing splines. Covariates included sex, urbanicity, parental education level and parental diagnosed psychiatric disorders. Outcomes were incident nonaffective psychosis, bipolar disorder and depression diagnosed in specialized services until year 2015 (age = 28.0-28.9 years).
During the follow-up, 727 individuals were diagnosed with nonaffective psychoses, 489 with bipolar disorder and 3492 with depression. MGPA was inversely associated with all outcomes. In multivariate models including specific school subjects and covariates, the school subject with largest risk ratios (RR) was Physical Education (RR and Bonferroni-corrected confidence interval [CI] at -1.5 SD: nonaffective psychoses 1.63, 1.36-1.95; bipolar disorder 1.64, 1.30-2.05; depression 1.72, 1.53-1.93). Higher grades in Art were associated with nonaffective psychoses and depression (RR and Bonferroni-corrected CI at +1.5 SD: nonaffective psychoses 1.48, 1.11-1.96; depression 1.22, 1.07-1.38).
There was a robust association between poorer scores on Physical Education and risk for psychosis, bipolar disorder and depression. Higher grades in Art were also associated with risk for later disorders. Subject specific school performance may be more informative about mental disorder risk than overall school performance.
目前尚不清楚特定学科成绩与后期精神障碍之间是否存在差异。我们研究了平均绩点（MGPA）和与非情感性精神病、双相情感障碍和抑郁诊断相关的特定学校科目的关系。
在这项基于登记的研究中，我们研究了芬兰 1987 年出生的人群，这些人有可用的 MGPA 和六门特定学校成绩（年龄= 15.4-16.4 岁；n=50508）。使用平滑样条分析成绩。协变量包括性别、城市化程度、父母教育水平和父母诊断的精神障碍。结果是在专门服务中诊断出的非情感性精神病、双相情感障碍和抑郁，直到 2015 年（年龄= 28.0-28.9 岁）。
在随访期间，727 人被诊断为非情感性精神病，489 人被诊断为双相情感障碍，3492 人被诊断为抑郁症。MGPA 与所有结果呈负相关。在包括特定学校科目和协变量的多变量模型中，风险比（RR）最大的学校科目是体育（RR 和 Bonferroni 校正置信区间[CI]在-1.5 SD 处：非情感性精神病 1.63，1.36-1.95；双相情感障碍 1.64，1.30-2.05；抑郁症 1.72，1.53-1.93）。艺术成绩较高与非情感性精神病和抑郁症相关（RR 和 Bonferroni 校正 CI 在+1.5 SD 处：非情感性精神病 1.48，1.11-1.96；抑郁症 1.22，1.07-1.38）。
体育成绩较差与精神病、双相情感障碍和抑郁的风险之间存在显著关联。艺术成绩较高也与后期障碍的风险相关。特定学科的学校成绩可能比整体学校成绩更能反映精神障碍的风险。
