Longitudinal associations between school absence and mental health problems in adolescents in England: a retrospective cohort study using linked administrative data.
Sophie Epstein, Brian C F Ching, Alice Wickersham, Rina Dutta, Craig Morgan, Tamsin Ford, Richard D Hayes, Johnny Downs
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引用次数: 0
Abstract
Background: School absence is associated with mental health problems in adolescents, but most studies are cross-sectional. Longitudinal studies where school absence precedes mental health problems are needed to infer whether school absence is associated with later mental health problems. We aimed to investigate the association between school absence among 14- to 15-year-olds and later mental health problems at ages 16-17 in England.
Methods: A retrospective cohort study using an existing linkage between the Millennium Cohort Study (MCS) and the National Pupil Database (NPD), representing 8438 adolescents. We explored different absence thresholds and used logistic regression to examine associations between school absence and later mental health problems.
Results: A threshold of >10% of half-day school sessions missed identified 18% of adolescents who reported mental health problems at follow-up. At this threshold, high school absence was associated with increased odds of later mental health problems after adjusting for covariates (girls = 1.44, 95% CI 1.05-1.98; boys OR = 1.49, 95% CI 1.04-2.13). The strength of associations between absence and later mental health problems increased with longer durations of absence.
Conclusion: We found a longitudinal association between high levels of school absence (>10% of sessions) and later mental health problems in a nationally representative sample of adolescents in England. High levels of school absence can be used as an early marker of increased risk of mental health problems in the general population. School absence may contribute to the development of later mental health problems in adolescents.
背景：缺课与青少年心理健康问题有关，但大多数研究是横断面的。如果缺课先于心理健康问题，则需要进行纵向研究，以推断缺课是否与后来的心理健康问题有关。我们的目的是调查英国14- 15岁青少年缺课与16-17岁后期心理健康问题之间的关系。方法：使用千年队列研究（MCS）和国家学生数据库（NPD）之间的现有联系进行回顾性队列研究，代表8438名青少年。我们探索了不同的缺勤阈值，并使用逻辑回归来检验缺勤与后来的心理健康问题之间的关系。结果：在随访中，有18%的青少年报告了心理健康问题，而缺课率的阈值为10%。在这个阈值上，调整协变量后，高中缺课与后期心理健康问题的几率增加有关（女孩= 1.44,95% CI 1.05-1.98；男孩OR = 1.49, 95% CI 1.04-2.13）。缺勤和后来的心理健康问题之间的联系强度随着缺勤时间的延长而增加。结论：我们发现，在英格兰一个具有全国代表性的青少年样本中，高水平的缺课（上课时间的10%）与后来的心理健康问题之间存在纵向关联。在一般人群中，高水平的缺课可以作为心理健康问题风险增加的早期标志。缺课可能导致青少年后期出现心理健康问题。
期刊介绍：
Child and Adolescent Mental Health (CAMH) publishes high quality, peer-reviewed child and adolescent mental health services research of relevance to academics, clinicians and commissioners internationally. The journal''s principal aim is to foster evidence-based clinical practice and clinically orientated research among clinicians and health services researchers working with children and adolescents, parents and their families in relation to or with a particular interest in mental health. CAMH publishes reviews, original articles, and pilot reports of innovative approaches, interventions, clinical methods and service developments. The journal has regular sections on Measurement Issues, Innovations in Practice, Global Child Mental Health and Humanities. All published papers should be of direct relevance to mental health practitioners and clearly draw out clinical implications for the field.
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