Mental disorders and termination of education in high-income and low- and middle-income countries: epidemiological study

Abstract

Background Studies of the impact of mental disorders on educational attainment are rare in both high-income and low- and middle-income (LAMI) countries. Aims To examine the association between early-onset mental disorder and subsequent termination of education. Method Sixteen countries taking part in the World Health Organization World Mental Health Survey Initiative were surveyed with the Composite International Diagnostic Interview (n=41 688). Survival models were used to estimate associations between DSM–IV mental disorders and subsequent non-attainment of educational milestones. Results In high-income countries, prior substance use disorders were associated with non-completion at all stages of education (OR 1.4–15.2). Anxiety disorders (OR=1.3), mood disorders (OR=1.4) and impulse control disorders (OR=2.2) were associated with early termination of secondary education. In LAMI countries, impulse control disorders (OR=1.3) and substance use disorders (OR=1.5) were associated with early termination of secondary education. Conclusions Onset of mental disorder and subsequent non-completion of education are consistently associated in both high-income and LAMI countries.