title: Long-term effects of mental disorders on educational attainment in the National Comorbidity Survey ten-year follow-up.
abstract: OBJECTIVE
  The study sought to examine the association of mental disorders with educational attainment in a community sample.
  
  
  METHODS
  Data were from 5001 respondents aged 15-54 in the 1990-1992 National Comorbidity Survey (NCS), re-interviewed in the 2001-2003 NCS follow-up (NCS-2). Discrete-time survival analysis was used to examine the association of disorders present at baseline (NCS) or having first onset after the baseline (assessed in NCS-2) with educational outcomes among 3954 eligible respondents. Mental disorders were categorized into internalizing fear disorders (simple phobia, social phobia, panic disorder with/without agoraphobia and agoraphobia without panic disorder), internalizing anxiety-misery disorders (major depressive disorder, generalized anxiety disorder and post-traumatic stress disorder), externalizing disorders (alcohol and drug use disorders, conduct disorder) and bipolar disorder. Analyses were conducted separately in students and non-students at baseline.
  
  
  RESULTS
  Among students, baseline bipolar and externalizing disorders, as well as fear, anxiety-misery and externalizing disorders with onset after baseline were associated with lower odds of high school graduation; baseline anxiety-misery disorders with lower odds of going to college; and baseline externalizing disorders and bipolar disorder with onset after baseline with lower odds of college graduation. Among non-students, baseline fear disorders were associated with lower odds of high school graduation and bipolar disorder with lower odds of going to college. Assuming that the regression coefficients represent causal effects, mental disorders accounted for 5.8-11.0% of high school and 3.2-11.4% of college non-completion.
  
  
  CONCLUSIONS
  Expanding access to mental health services for youth might have a net positive societal value by helping to prevent some of these adverse educational outcomes.
authors.affiliation: Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, 624 North Broadway, Room 797, Baltimore, MD, USA. rmojtab1@jhu.edu.
authors.forename: Ramin
authors.initials: R
authors.lastname: Mojtabai
authors.affiliation: Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, 624 North Broadway, Room 797, Baltimore, MD, USA.
authors.forename: Elizabeth A
authors.initials: EA
authors.lastname: Stuart
authors.affiliation: Department of Health Care Policy, Harvard Medical School, Boston, MA, USA.
authors.forename: Irving
authors.initials: I
authors.lastname: Hwang
authors.affiliation: Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, 624 North Broadway, Room 797, Baltimore, MD, USA.
authors.forename: William W
authors.initials: WW
authors.lastname: Eaton
authors.affiliation: Department of Health Care Policy, Harvard Medical School, Boston, MA, USA.
authors.forename: Nancy
authors.initials: N
authors.lastname: Sampson
authors.affiliation: Department of Health Care Policy, Harvard Medical School, Boston, MA, USA.
authors.forename: Ronald C
authors.initials: RC
authors.lastname: Kessler
mesh_terms: D000293:Adolescent; D000328:Adult; D015897:Comorbidity; D004522:Educational Status; D005260:Female; D005500:Follow-Up Studies; D006306:Health Surveys; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology*; D008875:Middle Aged; D014481:United States / Q000453:epidemiology; D055815:Young Adult
keywords: Burden of mental illness; Education; Epidemiology; Mental illness; Social consequences