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Associations between children’s diagnosed mental disorders and educational achievements in Sweden
Umeå University, Faculty of Social Sciences, Department of Social Work.ORCID iD: 0000-0001-6008-2296
Umeå University, Faculty of Social Sciences, Department of Sociology.
Umeå University, Faculty of Social Sciences, Department of Social Work.ORCID iD: 0000-0002-6867-6205
2022 (English)In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 50, no 8, p. 1140-1147Article in journal (Other academic) Published
Abstract [en]

Aims: To examine associations between multiple clinically diagnosed mental disorders among children in Sweden and educational achievements at the end of ninth grade.

Methods: Data from Swedish administrative registers were utilised. Diagnoses of specific mental disorders (unipolar depression, mood, anxiety, obsessive compulsive, eating, attention deficit hyperactivity disorder) were used as exposure variables. Educational achievements were assessed in terms of teacher-assigned school grades and eligibility for upper secondary education. The sample comprised 266,664 individuals (49% females) born in 2000 to 2002 who were alive and resident in Sweden in 2017. Exposed and unexposed individuals were compared in terms of outcome variables by fitting linear and logistic regression models.

Results: The results revealed negative associations between all the examined mental disorders and educational achievements, except for positive associations between eating disorders and grades among female students. Attention deficit hyperactivity disorder was the most strongly associated disorder in terms of non-successful completion of compulsory education, among both male and female students (odds ratio (OR): 3.58 (95% confidence interval (CI), 3.42 to 3.74) and 4.31 (95% CI, 4.07 to 4.57), respectively). This was followed by unipolar depression among males (OR: 2.92 (95% CI, 2.60 to 3.28)) and anxiety disorder among females (OR: 2.68 (95% CI, 2.49 to 2.88)). Obsessive compulsive disorder had the weakest negative association with educational achievements among both males (OR: 1.48 (95% CI, 1.01 to 2.17)) and females (OR: 1.38 (95% CI, 1.11 to 1.72)).

Conclusions: Specific diagnosed mental disorders have varying, largely disadvantageous, associations with educational achievements of students in Sweden that differ between males and females.

Place, publisher, year, edition, pages
Sage Publications, 2022. Vol. 50, no 8, p. 1140-1147
Keywords [en]
Mental disorders, educational achievement, register data, Sweden, sex differences
National Category
Social Work
Identifiers
URN: urn:nbn:se:umu:diva-192125DOI: 10.1177/14034948221089056ISI: 000783876500001PubMedID: 35416111Scopus ID: 2-s2.0-85129236583OAI: oai:DiVA.org:umu-192125DiVA, id: diva2:1634344
Part of project
How are school achievements influenced by poor childhood health? The importance of poor health, family living conditions, schools and neighborhoods for grades and the risk of dropouts., Swedish Research Council
Funder
Swedish Research CouncilRiksbankens Jubileumsfond
Note

Originally included in thesis in manuscript form. 

Available from: 2022-02-02 Created: 2022-02-02 Last updated: 2023-03-23Bibliographically approved
In thesis
1. Growing up with poor health and managing school: Studies on ill health and young people's educational achievements
Open this publication in new window or tab >>Growing up with poor health and managing school: Studies on ill health and young people's educational achievements
2022 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Aim and objectives: The overall aim of this thesis was to empirically investigate consequences of poor health for children’s educational outcomes in Sweden. A central tenet is that health problems impact not only the afflicted individual but also people in their social and emotional proximity, in particular immediate family members. More specific objectives were to study: 1. The relationship between multiple clinically diagnosed mental disorders and children’s educational achievements in Sweden. 2. The bidirectional relationship between mental health problems and academic performance among Swedish adolescents, as well as heterogeneous patterns associated with gender and socioeconomic groups. 3. The effects of parental somatic and psychiatric health problems on the probability of youths leaving upper secondary education before completion in Sweden and potential gender differences in these effects. 4. The relationship between having a sibling with health problems and a healthy sibling’s school grades in the final year of compulsory education in Sweden and how socioeconomic background modifies this relationship.

Theoretical framework: Key concepts applied in the thesis are health and illness. The ability to perform things in life, the ability to act, determines whether a person is healthy or ill. Illness (or poor health, treated as a synonymous term) entails a reduced ability to act in relation to one’s life situation and its demands. Family is viewed from a systems theory perspective. Poor health of a parent reduces his or her ability to maintain regular roles, which may require reorganisation of the family system. Siblings’ health problems can affect other children in the family by inducing concerns and occupying and diverting parents’ time and attention. All of this could be psychosocially stressful in many ways, not least for children in the family and their ability in relation to schooling.

Data and methods: The research objectives were addressed by utilising social and medical microdata from Swedish administrative registers covering the entire population in Sweden. Data pertaining to different populations, collectively covering the period from 1987 to 2017, were used in four studies designated Studies I–IV. Educational achievement was measured in terms of teacher-assigned school grades awarded by the end of compulsory school and in upper secondary school, as well as completion (or non-completion) of an upper secondary education. Poor health was measured through data on outpatient visits to specialist healthcare facilities, psychotropic drug prescriptions and admissions/discharges from Swedish hospitals. Socioeconomic background was measured by parental level of education. The data were analysed by fitting linear and logistic regression models as well as cross-lagged path models.

Results and conclusions: Empirical results of Study I showed that specific diagnosed mental disorders have varying, largely disadvantageous, associations with educational achievements of students that differ between boys and girls. Documentation of this in Sweden adds to evidence that mental disorders have a negative overall association with educational achievement, despite substantial variation in support and educational systems across countries. The results of Study II provided no support for a bidirectional relationship between mental health and academic performance of students aged 15-16 to 18-19 years. However, they support a unidirectional relationship, as a negative relationship was found between school grades at graduation from compulsory school and rates of subsequent psychotropic medication use in upper secondary school. The relationship was equal in size for both boys and girls but mainly among adolescents with the highest educated parents.

Study III showed that having a mother or a father with psychiatric, but not somatic, illness that necessitated hospitalisation after completing compulsory schooling was associated with an increased probability of leaving upper secondary school before completion. No significant gender-based differences in this were found. Results presented in Study IV showed that having one or more siblings with health problems that necessitated recurrent hospitalisations was associated with lower grades. Children with ill siblings were also less likely to be eligible for an upper secondary education compared to children whose siblings did not have poor health. Socioeconomic background did not affect this educational disadvantage.

Results presented in this thesis clearly corroborate the importance of health for children’s education. Children’s educational achievements at the end of compulsory school are inversely related to mental health problems in their adolescence. Thus, academic competence may have positive effects on certain aspects of young people’s mental health, which underscores the importance of promoting opportunities for youth to do as well as they can in school. The reciprocal aspect of the relationship between mental health and academic performance among school-aged children remains an important issue that requires further investigation. However, health is not just an individual issue; parents’ and siblings’ health problems can affect children and have negative ‘spillover’ effects on their schooling and educational achievements. This underlines the importance of a psychosocial perspective when identifying children’s difficulties in school. Taken together, health, and thus the school’s student health task, is highly associated with academic achievement and schools’ pedagogical responsibilities.

Place, publisher, year, edition, pages
Umeå: Umeå Universitet, 2022. p. 66
Series
Studier i socialt arbete vid Umeå universitet : avhandlings- och skriftserie, ISSN 0283-300X ; 99
Keywords
Educational acchievements, Health, Bidirectionality, Family, Parents, Siblings, Register data
National Category
Social Work
Research subject
Sociology; Psychiatry; Public health
Identifiers
urn:nbn:se:umu:diva-192131 (URN)978-91-7855-732-5 (ISBN)
Public defence
2022-03-04, UB.A.210, Lindellhallen 1, Umeå, 10:00 (English)
Opponent
Supervisors
Available from: 2022-02-11 Created: 2022-02-02 Last updated: 2022-02-03Bibliographically approved

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Bortes, CristianNilsson, KarinaStrandh, Mattias

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