{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,11]],"date-time":"2026-10-11T05:16:46Z","timestamp":1791695806980,"version":"4.3.4"},"reference-count":40,"publisher":"BMJ","issue":"7","license":[{"start":{"date-parts":[[2021,7,20]],"date-time":"2021-07-20T00:00:00Z","timestamp":1626739200000},"content-version":"unspecified","delay-in-days":19,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000269","name":"Economic and Social Research Council","doi-asserted-by":"publisher","award":["ES\/R005400\/1"],"award-info":[{"award-number":["ES\/R005400\/1"]}],"id":[{"id":"10.13039\/501100000269","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2021,6,22]]},"published-print":{"date-parts":[[2021,7]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This study examines whether there is an independent association between mental difficulties in adolescence and educational attainment at age 16.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Longitudinal study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Nationally representative data from the UK Household Longitudinal Study (UKHLS) were linked to the National Pupil Database for England.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>Respondents (N=1100) to the UKHLS between 2009 and 2012 were linked to the National Pupil Database to investigate longitudinal associations between mental difficulties at ages 11\u201314 and educational attainment at age 16 (General Certificate of Secondary Education (GCSE)).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Primary outcome measure<\/jats:title>\n                    <jats:p>Not gaining five or more GCSE qualifications at age 16, including English and maths at grade A*\u2013C.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>An atypical total mental health difficulty score measured using the Strengths and Difficulties Questionnaire at ages 11\u201314 predicted low levels of educational attainment at age 16 (OR: 3.11 (95% CI: (2.11 to 4.57)). Controlling for prior attainment and family sociodemographic factors, happiness with school (\/work) and parental health, school engagement and relationship with the child partially attenuated the association, which was significant in the fully adjusted model (2.05, 95%\u2009CI (1.15 to 3.68)). The association was maintained in the fully adjusted model for males only (OR: 2.77 (95% CI (1.24 to 6.16)) but not for females. Hyperactivity disorder strongly predicted lower attainment for males (OR: 2.17 (95% CI: (1.11 to 4.23)) and females (OR: 2.85 (95% CI (1.30 to 6.23)).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Mental difficulties at ages 11\u201314 were independently linked to educational success at age 16, highlighting an important pathway through which health in adolescence can determine young people\u2019s life chances.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2020-046792","type":"journal-article","created":{"date-parts":[[2021,7,25]],"date-time":"2021-07-25T20:30:12Z","timestamp":1627245012000},"page":"e046792","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":34,"title":["Adolescent mental health difficulties and educational attainment: findings from the UK household longitudinal study"],"prefix":"10.1136","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0023-4398","authenticated-orcid":false,"given":"Neil R","family":"Smith","sequence":"first","affiliation":[{"name":"Policy Research Centre, NatCen Social Research, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lydia","family":"Marshall","sequence":"additional","affiliation":[{"name":"Policy Research Centre, NatCen Social Research, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muslihah","family":"Albakri","sequence":"additional","affiliation":[{"name":"Policy Research Centre, NatCen Social Research, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melanie","family":"Smuk","sequence":"additional","affiliation":[{"name":"London School of Hygiene & Tropical Medicine, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ann","family":"Hagell","sequence":"additional","affiliation":[{"name":"Association for Young People's Health, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8716-3897","authenticated-orcid":false,"given":"Stephen","family":"Stansfeld","sequence":"additional","affiliation":[{"name":"Psychiatry, Barts and the London, Queen Marys School of Medicine and Dentistry, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2021,7,25]]},"reference":[{"key":"2025121401123337000_11.7.e046792.1","unstructured":"Digital NHS . 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