School achievement in adolescence and the risk of mental disorders in early adulthood : a Finnish nationwide register study
Weckström, T., Elovainio, M., Pulkki-Råback, L., Suokas, K., Komulainen, K., Mullola, S., Böckerman, P., & Hakulinen, C. (2023). School achievement in adolescence and the risk of mental disorders in early adulthood : a Finnish nationwide register study. Molecular Psychiatry, 28(7), 3104-3110. https://doi.org/10.1038/s41380-023-02081-4
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Molecular PsychiatryAuthors
Date
2023Discipline
Empirical MicroeconomicsPäätöksentekoa tukeva taloustiede ja talouden kilpailukyky (painoala)TaloustiedeEmpirical MicroeconomicsPolicy-Relevant Economics and Competitiveness of Economy (focus area)EconomicsCopyright
© The Author(s) 2023
School grades in adolescence have been linked to later psychiatric outcomes, but large-scale nationwide studies across the spectrum of mental disorders are scarce. In the present study, we examined the risk of a wide array of mental disorders in adulthood, as well as the risk of comorbidity, associated with school achievement in adolescence. We used population-based cohort data comprising all individuals born in Finland over the period 1980–2000 (N = 1,070,880) who were followed from age 15 or 16 until a diagnosis of mental disorder, emigration, death, or December 2017, whichever came first. Final grade average from comprehensive school was the exposure, and the first diagnosed mental disorder in a secondary healthcare setting was the outcome. The risks were assessed with Cox proportional hazards models, stratified Cox proportional hazard models within strata of full-siblings, and multinomial regression models. The cumulative incidence of mental disorders was estimated using competing risks regression. Better school achievement was associated with a smaller risk of all subsequent mental disorders and comorbidity, except for eating disorders, where better school achievement was associated with a higher risk. The largest associations were observed between school achievement and substance use disorders. Overall, individuals with school achievement more than two standard deviations below average had an absolute risk of 39.6% of a later mental disorder diagnosis. By contrast, for individuals with school achievement more than two standard deviations above average, the absolute risk of a later mental disorder diagnosis was 15.7%. The results show that the largest mental health burden accumulates among those with the poorest school achievement in adolescence.
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Nature Publishing GroupISSN Search the Publication Forum
1359-4184Keywords
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https://converis.jyu.fi/converis/portal/detail/Publication/183023611
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This study was supported by the Finnish Cultural Foundation (CH), the Jenny and Antti Wihuri Foundation (TW), the Academy of Finland (grant no. 339390 to ME and grant no. 347405 to SM), Jalmari and Rauha Ahokas Foundation (KS), the Finnish Psychiatric Association (KS), and European Research Council (ERC) under the European Union’s Horizon 2020 research and innovation programme (Grant agreement No. 101040247 to CH). Open Access funding provided by University of Helsinki including Helsinki University Central Hospital. ...License
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