Dalforno Ryan W, Wengert Hadassah I, Kim Loan Pham, Jacobsen Kathryn H
Pepperdine University, 24255 Pacific Coast Highway, Malibu, CA 90263, USA.
Department of Health Studies, University of Richmond, 231 Richmond Way, Richmond, VA 23173, USA.
Dialogues Health. 2022 Sep 16;1:100046. doi: 10.1016/j.dialog.2022.100046. eCollection 2022 Dec.
Anxiety disorders are common among adolescents. In high-income countries, anxiety is a known contributor to truancy and school refusal, but this association has been understudied in low- and middle-income countries (LMICs).
We used complex samples analysis to examine the association between self-reported worry-induced insomnia (an indicator of anxiety) and unauthorized school absenteeism among 268,142 adolescents from 69 LMICs that participated in the Global School-based Student Health Survey (GSHS).
The median proportion of students who reported experiencing symptoms of anxiety most or all of the time during the previous year was 11.4% (range: 3.6%-28.2%); in 44 of the 69 countries, girls had a significantly higher prevalence of anxiety than boys. The percentage of students reporting school absence without permission during the past month was 30.2% (range: 14.7%-56.0%); in 40 countries, boys were significantly more likely than girls to report that they had missed school without permission. In 53 countries, adolescents who reported frequent anxiety were significantly more likely to miss school than adolescents reporting infrequent anxiety; in most of those countries, the association was significant for both girls and boys.
School-based interventions that help children and adolescents learn how to manage stress and refer students with symptoms of psychiatric disorders to healthcare services that can provide formal diagnosis and clinical treatment may be useful for improving both mental health and school attendance, thus contributing to achievement of Sustainable Development Goals related to both health (SDG 3.4) and education (SDG 4.1).
焦虑症在青少年中很常见。在高收入国家，焦虑是导致逃学和拒学的一个已知因素，但在低收入和中等收入国家（LMICs），这种关联尚未得到充分研究。
我们使用复杂样本分析，在参与全球学校学生健康调查（GSHS）的69个低收入和中等收入国家的268,142名青少年中，研究自我报告的因担忧导致的失眠（焦虑的一个指标）与未经批准的学校缺勤之间的关联。
报告在前一年大部分或全部时间都有焦虑症状的学生的中位数比例为11.4%（范围：3.6%-28.2%）；在69个国家中的44个国家，女孩的焦虑患病率显著高于男孩。报告在过去一个月未经批准缺课的学生比例为30.2%（范围：14.7%-56.0%）；在40个国家，男孩比女孩更有可能报告他们未经批准缺课。在53个国家，报告频繁焦虑的青少年比报告不频繁焦虑的青少年更有可能缺课；在大多数这些国家，这种关联对女孩和男孩都很显著。
以学校为基础的干预措施，帮助儿童和青少年学习如何管理压力，并将有精神疾病症状的学生转介到能够提供正式诊断和临床治疗的医疗服务机构，可能有助于改善心理健康和学校出勤率，从而有助于实现与健康（可持续发展目标3.4）和教育（可持续发展目标4.1）相关的可持续发展目标。
