The impact of psychological distress on the educational achievement of adolescents at the end of compulsory education

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Poor academic performance at school can have a substantial effect on opportunities in adult life and as such it is imperative that researchers establish the chief causes of underachievement. This paper examines performance at the General Certificate of Secondary Education (GCSE), examined at age 16, with reference to psychological distress and depressive symptoms as measured at age 13–14.


The data come from a school based prospective epidemiological study of a representative multiethnic sample of adolescents attending East London secondary schools in Tower Hamlets, Hackney, and Newham. Logistic regression analysis was carried out using STATA to test for differences in the impact of different types of psychological distress on achievement.


The overall score for psychological distress, as measured by the Strengths and Difficulties Questionnaire (SDQ), was negatively associated with achievement at GCSE for both boys (OR = 0.41, 95% CI 0.24–0.69) and girls (OR = 0.60, 95% CI 0.41–0.87). There was evidence for an association between achievement and depressive symptoms, as measured by the Short Moods and Feelings Questionnaire (SMFQ), for boys only (OR = 0.58, 95% CI 0.43–0.79). There was weak evidence for an interaction between ethnicity and SMFQ for girls. Results from a subset of analyses adjusting for prior achievement suggested that the association between psychological distress at age 13–14 and GCSE achievement could not be explained simply by achievement at age 13–14.


The results suggest that psychological distress is associated with educational achievement. Low achievement at school can have a substantial effect on opportunities in adult life. This implies a greater need for support within the school for children with psychological difficulties in order to achieve the best possible outcomes in the long term.

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Yasmin Khatib provided invaluable comments on a draft of the paper. We are grateful for the support of the schools, parents and students involved in this study. We also thank the field team, including Wendy Isenwater, Giash Ahmed, Sarah Brentnall, Sultana Choudry-Dormer and Franca Davenport for the collection of data. This research was approved by the East London and City Research Ethics Committee. The research was funded by the East London and The City Health Authority and by the ESRC under the Human Capability and Resilience Programme. Tower Hamlets, City and Hackney and Newham Primary Care Trusts provided additional funding. The research is independent from the funders. The first author is funded by a Medical Research Council Special Training Fellowship in Health Services and Health of the Public Research.

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Correspondence to Catherine Rothon.

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Rothon, C., Head, J., Clark, C. et al. The impact of psychological distress on the educational achievement of adolescents at the end of compulsory education. Soc Psychiat Epidemiol 44, 421–427 (2009) doi:10.1007/s00127-008-0452-8

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  • adolescents
  • mental health
  • SDQ
  • SMFQ
  • achievement