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Educational attainment trajectories among children and adolescents with depression, and the role of sociodemographic characteristics: longitudinal data-linkage study

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Wickersham, Alice 
Dickson, Hannah 
Jones, Rebecca 
Pritchard, Megan 
Stewart, Robert 


Background: Depression is associated with lower educational attainment, but there has been little investigation of long-term educational trajectories in large cohorts with diagnosed depression. Aims: To describe the educational attainment trajectories of children with a depression diagnosis in secondary care, and to investigate whether these trajectories vary by socio-demographic characteristics. Method: We identified new referrals to South London and Maudsley’s NHS Foundation Trust between 2007 and 2013 who received a depression diagnosis at under 18 years old. Linking their health records to the National Pupil Database, we standardised their performance on three assessments (typically undertaken ages 6-7 years [school Year 2], 10-11 [Year 6], and 15-16 [Year 11]) relative to the local reference population in each academic year. We used mixed models for repeated measures to estimate attainment trajectories. Results: In our sample of 1492 children, the median age of depression diagnosis was 15 years (IQR=14-16). Their attainment showed a decline between school Years 6 and 11. Attainment was consistently lower among males and those eligible for free school meals. Black ethnic groups also showed lower attainment than white ethnic groups between Years 2 and 6, but showed a less pronounced drop in attainment at Year 11. Conclusions: Those who receive a depression diagnosis during their school career show a drop in attainment in Year 11. While this pattern was seen among multiple socio-demographic groups, gender, ethnicity and socioeconomic status predict more vulnerable subgroups within this clinical population who might benefit from additional educational support or more intensive treatment.



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BJPsych Open

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