Depression, Generalize Anxiety Disorder, and School Avoidance in Early School Years in Pupils with Poor Reading Ability

Background: Children with poor reading ability may be at risk of early mental health problems. Objective: To determine an association between poor reading ability and generalize anxiety, school avoidance and depression among pupils in early school years. Materials and Methods: The cross-sectional study was conducted in 1,038 pupils studying in Grade 2 in 8 primary schools in Thailand. All pupils were individually assessed in their reading abilities by the Thai Standard Reading Tests. Generalized anxiety disorder and significant school avoidance were screened by using the Thai version of the Screen for Child Anxiety Related Emotional Disorders (SCARED). Depression was screened by using the Thai version of the Short Mood and Feelings Questionnaire (SMFQ). Results: A total of 877 pupils completed the tests. The mean age was 7.0 years (SD 0.4 years). The prevalence of generalized anxiety disorder, significant school avoidance, and depression were 18.4% (95% CI 15.8 to 20.9), 32.2% (95% CI 29.1 to 35.3), and 36.0% (95% CI 32.9 to 39.2), respectively. Poor reading ability was significantly associated with school avoidance with the odds ratio of 2.2 (95% CI 1.5 to 3.3, p<0.001) and depression with the odds ratio of 1.8 (95% CI 1.2 to 2.6, p=0.005), but was not significantly associated with generalized anxiety disorder. Conclusion: Poor reading ability was associated with school avoidance and depression in early school years. Emotional problems should be screened early in those with poor reading ability. Keywords: Poor reading ability; Anxiety; Depression; School avoidance; Mental health