Abstract
Emotional disorder may be associated with absence from school, but the existing evidence is methodologically weak. We studied the relationships between anxiety, depression and emotional difficulties, and school absence (total, authorised and unauthorised) using data from the 2004 British Child and Adolescent Mental Health Survey (BCAMHS). The BCAMHS was a cross-sectional, community survey of 7977 5- to 16-year-olds. Emotional disorder was assessed using the Development and Wellbeing Assessment (DAWBA), and emotional difficulties using the Strengths and Difficulties Questionnaire (SDQ) completed by teachers and parents. Teachers reported days absent in the previous school term. Multivariable negative binomial regression was used to examine the impact of emotional disorder and difficulties on absence. Age, gender and general health were explored as moderators. Anxiety, depression and emotional difficulties were associated with higher rates of all types of absence [rate ratios for total absence: anxiety 1.69 (1.39–2.06) p < 0.001; depression 3.40 (2.46–4.69) p < 0.001; parent-reported emotional difficulties 1.07 (1.05–1.10) p < 0.001; teacher-reported emotional difficulties 1.10 (1.08–1.13) p < 0.001]. The strongest association was observed for depression and unauthorised absence. Relationships were stronger for secondary compared to primary school children. Health and educational professionals should be aware that children with poor attendance may be experiencing emotional ill health, regardless of absence type. The absence may provide a useful tool to identify those who require additional mental health support. Findings highlight the widespread burden of emotional disorder and the need to support those with emotional ill health in continuing to access education.
Highlights
Emotional disorders are among the most common psychiatric disorders in children and adolescents, with worldwide point prevalence estimates of 7% for anxiety and 3% for depression [1]
Previous research has suggested that behavioural disorders are related to school absence, unauthorised absence or truancy [28, 29], the present study focuses on anxiety and depression because these disorders are so frequently unrecognised by adults around the child, in education settings [30]
Children for whom absence data were missing differed in several domains to those for whom absence data were available, but bias was minimised by including all of these variables in multiple imputation models [41]
Summary
Emotional disorders are among the most common psychiatric disorders in children and adolescents, with worldwide point prevalence estimates of 7% for anxiety and 3% for depression [1]. Learning difficulty was assessed by asking parents and teachers to estimate the child’s mental age as a percentage of their chronological age. Children were deemed to have a severe, moderate, borderline, or no learning difficulty if their parent or teacher estimated their mental age to be 40% or less, 60% or less, 80% or less, or more than 80% of their chronological age, respectively [36].
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
