{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T18:00:43Z","timestamp":1783706443774,"version":"3.55.0"},"reference-count":37,"publisher":"Royal College of Psychiatrists","issue":"4","license":[{"start":{"date-parts":[[2018,3,6]],"date-time":"2018-03-06T00:00:00Z","timestamp":1520294400000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Br J Psychiatry"],"published-print":{"date-parts":[[2018,4]]},"abstract":"<jats:sec id=\"S0007125017000691_sec_a1\"><jats:title>Background<\/jats:title><jats:p>Mental disorders in children and adolescents have an impact on educational attainment.<\/jats:p><\/jats:sec><jats:sec id=\"S0007125017000691_sec_a2\"><jats:title>Aims<\/jats:title><jats:p>To examine the temporal association between attainment in education and subsequent diagnosis of depression or self-harm in the teenage years.<\/jats:p><\/jats:sec><jats:sec id=\"S0007125017000691_sec_a3\" sec-type=\"methods\"><jats:title>Method<\/jats:title><jats:p>General practitioner, hospital and education records of young people in Wales between 1999 and 2014 were linked and analysed using Cox regression.<\/jats:p><\/jats:sec><jats:sec id=\"S0007125017000691_sec_a4\" sec-type=\"results\"><jats:title>Results<\/jats:title><jats:p>Linked records were available for 652 903 young people and of these 33 498 (5.1%) developed depression and 15 946 (2.4%) self-harmed after the age of 12 but before the age of 20. Young people who developed depression over the study period were more likely to have achieved key stage 1 (age 7 years) but not key stage 2 (age 11) (hazard ratio (HR) = 0.79, 95% CI 0.74\u20130.84) milestones, indicating that they were declining in academic attainment during primary school. Conversely, those who self-harmed were achieving as well as those who did not self-harm in primary school, but showed a severe decline in their attainment during secondary school (HR = 0.72, 95% CI 0.68\u20130.78).<\/jats:p><\/jats:sec><jats:sec id=\"S0007125017000691_sec_a5\" sec-type=\"conclusion\"><jats:title>Conclusions<\/jats:title><jats:p>Long-term declining educational attainment in primary and secondary school was associated with development of depression in the teenage years. Self-harm was associated with declining educational attainment during secondary school only. Incorporating information on academic decline with other known risk factors for depression\/self-harm (for example stressful life events, parental mental health problems) may improve risk profiling methods.<\/jats:p><\/jats:sec><jats:sec id=\"S0007125017000691_sec_a6\"><jats:title>Declaration of interest<\/jats:title><jats:p>None.<\/jats:p><\/jats:sec>","DOI":"10.1192\/bjp.2017.69","type":"journal-article","created":{"date-parts":[[2018,3,6]],"date-time":"2018-03-06T09:53:09Z","timestamp":1520329989000},"page":"215-221","source":"Crossref","is-referenced-by-count":44,"title":["School achievement as a predictor of depression and self-harm in adolescence: linked education and health record study"],"prefix":"10.1192","volume":"212","author":[{"given":"Muhammad A","family":"Rahman","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charlotte","family":"Todd","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ann","family":"John","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacinta","family":"Tan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Kerr","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert","family":"Potter","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan","family":"Kennedy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frances","family":"Rice","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sinead","family":"Brophy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"170","published-online":{"date-parts":[[2018,3,6]]},"reference":[{"key":"S0007125017000691_ref15","unstructured":"UNICEF. Unicef Report Card 13. Fairness for Children: A League Table of Inequality in Child Well-Being in Rich Countries. UNICEF, 2015 (http:\/\/www.unicef.org.uk\/Documents\/Campaigns-documents\/RC12-ENG-FINAL.pdf)."},{"key":"S0007125017000691_ref13","doi-asserted-by":"publisher","DOI":"10.1177\/0022146512462888"},{"key":"S0007125017000691_ref21","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2016-013167"},{"key":"S0007125017000691_ref35","doi-asserted-by":"publisher","DOI":"10.1007\/s10802-006-9044-9"},{"key":"S0007125017000691_ref26","doi-asserted-by":"publisher","DOI":"10.1038\/nrn2353"},{"key":"S0007125017000691_ref2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1469-7610.2007.01855.x"},{"key":"S0007125017000691_ref25","doi-asserted-by":"publisher","DOI":"10.1097\/chi.0b013e31803065c7"},{"key":"S0007125017000691_ref16","doi-asserted-by":"publisher","DOI":"10.1016\/j.adolescence.2009.07.004"},{"key":"S0007125017000691_ref33","doi-asserted-by":"publisher","DOI":"10.1016\/S2215-0366(17)30004-4"},{"key":"S0007125017000691_ref34","first-page":"324","article-title":"Protective factors in children's responses to stress and disadvantage","volume":"8","author":"Rutter","year":"1979","journal-title":"Ann Acad Med Singapore"},{"key":"S0007125017000691_ref22","doi-asserted-by":"publisher","DOI":"10.1186\/s12911-016-0274-7"},{"key":"S0007125017000691_ref28","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(13)62116-9"},{"key":"S0007125017000691_ref19","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.g2384"},{"key":"S0007125017000691_ref32","doi-asserted-by":"publisher","DOI":"10.1037\/0022-006X.59.2.341"},{"key":"S0007125017000691_ref5","doi-asserted-by":"publisher","DOI":"10.1136\/injuryprev-2015-041616"},{"key":"S0007125017000691_ref36","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.f5270"},{"key":"S0007125017000691_ref1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(11)60827-1"},{"key":"S0007125017000691_ref3","doi-asserted-by":"publisher","DOI":"10.1001\/archpsyc.60.7.709"},{"key":"S0007125017000691_ref4","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(12)61729-2"},{"key":"S0007125017000691_ref6","unstructured":"Craig J , Faulconbridge J , Humphrey A , Rogers A , Law D , Taylor J , British Psychological Society response to the House of Commons Health Committee: Children's and adolescent mental health and CAMHS. (https:\/\/www1.bps.org.uk\/system\/files\/consultationpapers\/responses\/BPS-response-Childrens-and-adolescent-mental-health-and-CAMHS-Approved.pdf)."},{"key":"S0007125017000691_ref11","doi-asserted-by":"publisher","DOI":"10.1016\/j.socscimed.2013.04.026"},{"key":"#cr-split#-S0007125017000691_ref7.1","unstructured":"3. Boffey D. A&Es hit by children's mental health crisis. The Guardian 2015"},{"key":"#cr-split#-S0007125017000691_ref7.2","unstructured":"4. December (https:\/\/www.theguardian.com\/uk-news\/2015\/dec\/26\/child-mental-health-accident-and-emergency-nhs)."},{"key":"S0007125017000691_ref8","unstructured":"Children's Society. The Good Childhood Report 2015. Children's Society, 2015 (http:\/\/www.childrenssociety.org.uk\/good-childhood-report-2015)."},{"key":"S0007125017000691_ref9","doi-asserted-by":"publisher","DOI":"10.1017\/S0954579410000337"},{"key":"S0007125017000691_ref10","doi-asserted-by":"publisher","DOI":"10.1016\/j.socscimed.2007.12.019"},{"key":"S0007125017000691_ref14","doi-asserted-by":"publisher","DOI":"10.1016\/j.adolescence.2014.02.010"},{"key":"S0007125017000691_ref12","unstructured":"Chanfrreau J , Lloyd C , Byron C , Roberts C , Craig R , De Feo D , Predicting Wellbeing. NatCen Social Research for the Department of Health, 2013 (www.natcen.ac.uk\/media\/205352\/predictors-of-wellbeing.pdf)."},{"key":"S0007125017000691_ref17","doi-asserted-by":"publisher","DOI":"10.1016\/S2215-0366(17)30002-0"},{"key":"S0007125017000691_ref18","unstructured":"National Institute for Health and Care Excellence. Depression in Children and Young People: Identification and Management. NICE, 2005 (https:\/\/www.nice.org.uk\/guidance\/cg28\/chapter\/1-recommendations)."},{"key":"S0007125017000691_ref20","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2474-11-197"},{"key":"S0007125017000691_ref23","doi-asserted-by":"publisher","DOI":"10.1002\/mpr.1559"},{"key":"S0007125017000691_ref24","unstructured":"World Health Organization. International Statistical Classification of Diseases and Related Health Problems. WHO, 2010 (http:\/\/www.who.int\/classifications\/icd\/ICD10Volume2_en_2010.pdf)."},{"key":"S0007125017000691_ref27","volume-title":"Why People Die by Suicide","author":"Joiner","year":"2005"},{"key":"S0007125017000691_ref29","doi-asserted-by":"publisher","DOI":"10.1176\/ajp.156.1.133"},{"key":"S0007125017000691_ref30","doi-asserted-by":"publisher","DOI":"10.1192\/bjp.179.3.230"},{"key":"S0007125017000691_ref31","doi-asserted-by":"publisher","DOI":"10.1037\/0033-295X.106.3.458"}],"container-title":["The British Journal of Psychiatry"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S0007125017000691","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2019,4,14]],"date-time":"2019-04-14T22:46:20Z","timestamp":1555281980000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S0007125017000691\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,3,6]]},"references-count":37,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2018,4]]}},"alternative-id":["S0007125017000691"],"URL":"https:\/\/doi.org\/10.1192\/bjp.2017.69","relation":{},"ISSN":["0007-1250","1472-1465"],"issn-type":[{"value":"0007-1250","type":"print"},{"value":"1472-1465","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,3,6]]}}}