Mental health and school dropout across educational levels and genders: a 4.8-year follow-up study.

BACKGROUND: Education is a key determinant of future employment and income prospects of young people. Poor mental health is common among young people and is related to risk of dropping out of school (dropout). Educational level and gender might play a role in the association, which remains to be studied. METHODS: Mental health was measured in 3146 Danish inhabitants aged 16-29 years using the 12-Item Short-Form Health Survey and examined across genders and educational levels. For students, educational level at baseline was used; for young people who were not enrolled in school at baseline (non-students), the highest achieved educational level was used. The risk of dropout in students was investigated in administrative registers over a 4.8-year period (1(st) March 2010-31(th) December 2014). Odds ratios (OR) and 95 % confidence intervals (CI) were calculated for mental health and in relation to dropout in logistic regression models, adjusting for age, gender, educational level, parental education, parental income and ethnicity. RESULTS: Poor mental health was present in 24 % (n = 753) of the participants, 29 % (n = 468) in females and 19 % (n = 285) in males (p < 0.0001). The prevalence differed from 19 to 39 % across educational levels (p < 0.0001). Females had a statistically significantly higher adjusted risk of poor mental health than males (OR = 1.8, CI = 1.5-2.2). Among the students the lowest risk was found at the elementary level (OR = 1.3, CI = 0.8-2.3), while students in higher education had a statistically significantly higher risk (OR = 1.9, CI = 1.2-2.9). The lowest-educated non-students had the highest OR of poor mental health (OR = 3.3, CI = 2.1-5.4). Dropout occurred in 8 % (n = 124) of the students. Poor mental health was associated to dropout in vocational (OR = 1.8, CI = 1.0-3.2) and higher education (OR = 2.0, CI = 1.0-4.2). For males in higher education, poor mental health was a predictor of dropout (OR = 5.2, CI = 1.6-17.3), which was not seen females in higher education (OR = 1.2, CI = 0.5-3.1). CONCLUSIONS: Poor mental health was significantly associated to dropout among students in vocational and higher education. Males in higher education had five times the risk of dropout when reporting poor mental health, while no such association was found for females.

The relationship between self-reported mental health and redeemed prescriptions of antidepressants: a register-based cohort study.

BACKGROUND: Poor mental health is a major problem in most western societies, especially predominant among young adults. However, associations of self-reported poor mental health with subsequent psychiatric or medical treatment are unknown. We examined the relation between self-reported mental health and redeeming prescriptions of antidepressants among three age groups. METHODS: We analyzed data from 16,233 individuals aged 16 years and over randomly selected to participate in the 2010 North Denmark Region Health Survey completed in February 2010. Mental health was defined according to the Short-Form 12 instrument (SF-12) and dichotomized into poor and good. Outcome data were retrieved from administrative information on redeemed prescriptions of antidepressants between February 2010 and December 2012. Crude cumulative incidence curves were produced to illustrate the probability of redeeming new prescriptions of antidepressants over time. Cox regression analysis was used to estimate risk of redeeming prescriptions of antidepressants when having poor mental health, adjusted for preselected explanatory covariates. RESULTS: Among the young (16-29 years-old), 620 (23 %) participants suffered from poor mental health. Among the adults (30-59 years-old) and elderly (60 years-old or over), 1592 (18 %) participants and 723 (15 %) reported poor mental health, respectively. Overall, women were more likely than men to rate their mental health as poor. For all age groups, there was an increased probability for redeeming prescriptions of antidepressants when having poor mental health. The hazard ratio [HR] for redeeming prescriptions of antidepressants for those reporting poor versus good mental health, adjusted for sex, ethnicity, marital status, education level, occupational status, smoking and physical activity was 3.1 (95 % confidence interval [CI] 2.20-4.29) for young participants. For adults, the HR was 2.3 (95 % CI 1.86-2.78) and for elderly, it was 3.5 (95 % CI 2.66-4.57). CONCLUSION: Self-reported poor mental health was more frequent among younger than older participants. Overall, antidepressants were the most often used treatment. An increased probability of redeeming antidepressant prescriptions when having self-reported poor mental health was observed in all age groups. These findings suggest that frequent reporting of poor mental health is a common issue for all age groups that needs more attention.