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We exploit a school reform that shifted the introduction of grades from grade 8 to grade 6, resulting in first exposure to grading at different ages between cohorts. Our results show that girls exposed to earlier grading are more likely to be diagnosed with internalizing disorders, such as depression and anxiety, by the end of compulsory school. This effect is particularly pronounced among students with low to moderate academic achievement. We also find suggestive evidence that both girls and boys exposed to earlier grading face an increased risk of being diagnosed with alcohol\u2010related disorders. These findings highlight that early exposure to grading may have unintended adverse effects on adolescent mental health. Education systems should acknowledge these potential risks and consider implementing complementary mental health support when revising grading policies.<\/jats:p>","DOI":"10.1002\/hec.4982","type":"journal-article","created":{"date-parts":[[2025,7,9]],"date-time":"2025-07-09T15:01:28Z","timestamp":1752073288000},"page":"1731-1746","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Adolescent Mental Health: Impact of Introducing Earlier Compulsory School Grades"],"prefix":"10.1002","volume":"34","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9630-4313","authenticated-orcid":false,"given":"Anna","family":"Linder","sequence":"first","affiliation":[{"name":"Department of Clinical Sciences Malm\u00f6 Health Economics Unit Lund University  Malm\u00f6 Sweden"},{"name":"Centre for Economic Demography Lund University  Lund Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ulf\u2010G.","family":"Gerdtham","sequence":"additional","affiliation":[{"name":"Department of Clinical Sciences Malm\u00f6 Health Economics Unit Lund University  Malm\u00f6 Sweden"},{"name":"Centre for Economic Demography Lund University  Lund Sweden"},{"name":"Department of Economics Lund University  Lund Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6737-3969","authenticated-orcid":false,"given":"Gawain","family":"Heckley","sequence":"additional","affiliation":[{"name":"Department of Clinical Sciences Malm\u00f6 Health Economics Unit Lund University  Malm\u00f6 Sweden"},{"name":"Centre for Economic Demography Lund University  Lund Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,7,9]]},"reference":[{"key":"e_1_2_15_2_1","doi-asserted-by":"publisher","DOI":"10.1037\/\/0021\u2010843x.87.1.49"},{"key":"e_1_2_15_3_1","article-title":"Equilibrium Grade Inflation With Implications for Female Interest in STEM Majors","author":"Ahn T.","year":"2019","journal-title":"National Bureau of Economic Research Working Paper Series No."},{"key":"e_1_2_15_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.labeco.2015.02.002"},{"key":"e_1_2_15_5_1","unstructured":"Bremberg S. andC. 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