Abstract
BackgroundAccumulating evidence suggests that several adult mental disorders, particularly psychoses, are preceded by impairments in cognitive function, reflected in scholastic underachievement. This study investigates the association between scholastic underachievement and general mental health problems in adolescence, using delay in school progression as a marker of poor scholastic performance.MethodCross-sectional secondary school survey comprising 10,803 adolescents. Participants completed the Strengths and Difficulties Questionnaire (SDQ) to assess mental health problems. The association of delayed school progression with the SDQ was investigated using logistic regression with SDQ as outcome and delayed school progression as primary exposure of interest while adjusting for socio-demographic characteristics, adverse life events, school-related factors, risk taking behaviour, healthy lifestyle and physical health.ResultsUnadjusted analysis showed an association between delayed school progression and total mental health problems (OR 1.83, 95% CI 1.27 – 2.63) in adolescents. After adjusting for other risk factors (socio-demographic factors and life events) in a logistic regression model the association between delayed school progression en mental health problems was attenuated (OR 1.33, 95% CI 0.86 – 2.05).ConclusionDelayed school progression is associated with general mental health problems in adolescence, but this relationship is heavily confounded by other factors. A causal relationship between impaired cognitive function such as poor scholastic performance and general mental health at adolescence is less likely and delayed school progression may merely be considered an indicator of risk for mental health problems.Electronic supplementary materialThe online version of this article (doi:10.1186/s12888-014-0244-5) contains supplementary material, which is available to authorized users.
Highlights
Accumulating evidence suggests that several adult mental disorders, psychoses, are preceded by impairments in cognitive function, reflected in scholastic underachievement
Unadjusted analysis showed an association between delayed school progression and total mental health problems in adolescents
After adjusting for other risk factors in a logistic regression model the association between delayed school progression en mental health problems was attenuated
Summary
Accumulating evidence suggests that several adult mental disorders, psychoses, are preceded by impairments in cognitive function, reflected in scholastic underachievement. About one-third of all children experience mental health problems that affect everyday functioning [1,2]. Without adequate treatment these symptoms often persist into adulthood [3]. Several studies show that poor cognitive function or intellectual achievement is present before the onset of several mental disorders. Some studies suggest that pre-morbid low intellectual functioning is related to overall risk of psychiatric disorders in adulthood [8,9]. Various mechanisms have been suggested to underlie this relationship, including the hypothesis that impairments in IQ or other cognitive functioning reflect neurodevelopmental changes which may predispose to psychiatric disorders [10,11]
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