Depression in late teens linked to high school drop out

Older teens struggling with depression are more than twice as likely to drop out of high school as peers without that mental illness or those who recovered from a bout of depression earlier in life, Canadian researchers say.

Understanding that current or recent depression raises dropout risk may encourage schools to put a higher priority on mental health services, the study team writes in the Journal of Adolescent Health.

“This is the first study of its kind to look at depression symptoms in the year before dropout,” lead author Dr. Veronique Dupere, associate professor at the school of psycho-education at the University of Montreal, told Reuters Health by phone. “The role of depression in deciding to drop out was underestimated in previous studies because the timing was not properly considered. Depression is not stable. It tends to come and go,” she said.

For the new analysis, researchers asked 6,773 students in 12 disadvantaged high schools with high dropout rates in and around Montreal to complete a screening questionnaire at the beginning of the school year. The brief assessment, conducted from 2012 to 2015, measured students’ risk for dropout, and also asked for their sociodemographic information and their family’s employment, education and structure.

During a second round of interviews one year later, a subset of students were asked to participate in face-to-face meetings with a graduate student who assessed their mental health. Students who dropped out of school in the year following their initial screening were also assessed for their mental health. Researchers compared these students to a similar group, also in the program, who didn’t drop out.

Almost a quarter of the 183 adolescents who dropped out of school had clinically significant depression in the few months before quitting, researchers found. Dupere said rates of conduct disorders and attention-deficit/hyperactivity disorder (ADHD) were higher among the dropouts and the matched at-risk peers than among the average students. But ADHD was not a factor significantly distinguishing dropouts and matched at-risk students, although conduct disorder might be.

In 2015, an estimated three million adolescents aged 12 to 17 in the U.S. had experienced at least one major depressive episode in the past year, according to the National Institute of Mental Health. For many individuals, major depression can end up limiting their ability to carry out major life activities. “School dropout portends other bad outcomes, like the inability to gain employment, involvement in substance abuse and problems with the juvenile justice system,” said Dr. Laura Mufson of Columbia University Medical Center in New York City, who wasn’t involved in the study.

More than one in eight young people ages 16 to 24 are neither working nor in school, according to the Social Science Research Council’s Measure of America project. That estimate is based on data from the U.S. Census Bureau’s 2013 American Community Survey. “I’m excited about the study because we need data like this,” Dr. Tamar Mendelson of the Johns Hopkins Bloomberg School of Public Health in Baltimore, Maryland, told Reuters Health by phone.

“I think the problem of school dropout is really critical,” said Mendelson, who wasn’t involved in the new study. “Depression and other mental health issues can sometimes fall through the cracks. Administrators may not understand all the issues and the best course to take. Data like this is helpful in highlighting the risks associated between depression and school dropout.”

One limitation of the study is that a lot of teenagers have anxiety along with depression, Mufson noted. “The researchers looked at ADHD and conduct disorders. They left out anxiety and it’s highly linked to school dropout,” she said in a phone interview. Dupere emphasized that no cause-and-effect conclusions can be drawn from her research. “I believe studies like the one we did should be replicated in other places, as well, to see if the results are the same.”