title: The impact of psychological distress on the educational achievement of adolescents at the end of compulsory education.
abstract: BACKGROUND
  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.
  
  
  METHODS
  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.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Centre for Psychiatry, Old Anatomy Building, Barts and the London Queen Mary's School of Medicine and Dentistry, University of London, Charterhouse Square, London EC1M 6BQ, UK. c.rothon@qmul.ac.uk
authors.forename: Catherine
authors.initials: C
authors.lastname: Rothon
authors.forename: Jenny
authors.initials: J
authors.lastname: Head
authors.forename: Charlotte
authors.initials: C
authors.lastname: Clark
authors.forename: Emily
authors.initials: E
authors.lastname: Klineberg
authors.forename: Vicky
authors.initials: V
authors.lastname: Cattell
authors.forename: Stephen
authors.initials: S
authors.lastname: Stansfeld
mesh_terms: D000293:Adolescent; D003863:Depression / Q000453:epidemiology; D004522:Educational Status; D005260:Female; D006801:Humans; D008131:London; D008297:Male; D037141:Mandatory Programs; D008603:Mental Health; D011446:Prospective Studies; D013315:Stress, Psychological / Q000453:epidemiology*; D011795:Surveys and Questionnaires