Academic pressure at age 15 linked to depression

Pressure to achieve at school at age 15 is linked to depressive symptoms and risk of self-harm, and the association appears to persist into adulthood, finds a study led by University College London (UCL) researchers.

The authors of the new study, published in The Lancet Child & Adolescent Health, say their findings suggest that reducing academic pressure in schools could reduce depression and self-harm among young people.

Senior author Professor Gemma Lewis (UCL Psychiatry) said: "In recent years, rates of depression have been rising among young people in the UK and in other countries, and academic pressure also appears to be on the rise. Young people report that academic pressure is one of their biggest sources of stress. A certain amount of pressure to succeed in school can be motivating, but too much pressure can be overwhelming and may be detrimental to mental health.

"We found that young people who felt more pressured by schoolwork at age 15 went on to report higher levels of depressive symptoms, for multiple years into adulthood."

For their study, the researchers reviewed evidence from 4,714 adolescents from the Children of the 90s birth cohort study (Avon Longitudinal Study of Parents and Children – ALSPAC), a longitudinal cohort study of parents and their children born in the southwest of England in 1991 and 1992, who have been surveyed at regular intervals.

The authors of the current paper used questionnaire responses from when study participants were aged 15, close to the time of GCSE exams, to reflect academic pressure. Young people reported whether they worry a lot about getting their schoolwork done, whether they feel a lot of pressure from home to do well in school, and the importance of achieving at least five GCSEs.

Depressive symptoms were tracked repeatedly in survey responses from ages 16 to 22, and self-harm was assessed up to age 24.

The researchers found strong evidence that academic pressure at age 15 is linked to higher depressive symptoms at age 16, and the association persists for multiple years. Study participants who experienced high levels of academic pressure when they were 15 continued to report more depressive symptoms at each time point up to age 22.

Each one-point increase on a nine-point scale of academic pressure at age 15 was associated with 8% increased odds of self-harm, through mid-late adolescence and into the early 20s. Academic pressure at age 15 was associated with greater risk of self-harm as late as age 24.

In a secondary analysis, the researchers also found that academic pressure at age 11 and 14 was linked to depressive symptoms.

The researchers say their findings suggest that alleviating academic pressure for teenagers could have benefits to mental health, and should be considered by schools and educational policymakers. Potential solutions might involve reducing tests and assessments or supporting the development of social and emotional skills.

They say they hope to develop a whole-school intervention, aiming to change the school environment, culture and values, in a way that could reduce academic pressure and improve mental health and wellbeing.

Professor Lewis said: "Current approaches to help pupils with mental health tend to be focused on helping individual pupils cope; we hope to address academic pressure at the whole-school level by addressing the school culture."

The authors say that more up-to-date data is still needed to understand how current pressures may be linked to mental health, as the study participants were aged 15 in 2006-07, so the findings do not reflect the impacts of later policy changes or of the Covid-19 pandemic. They caution that the study was observational, so the findings cannot prove cause and effect. They also note that they did not use a standardised measure of academic pressure, and the measure they used combined both external pressure (such as from parents or teachers) and internal pressure which could be driven by the pupil's own worries and priorities.

The study was funded by Wellcome and the Royal Society.

Tolu Fashina-Ayilara, Senior Policy and Influencing Officer at mental health charity Mind, commented: "UCL's study highlights the significant harm academic pressure can have on young people's mental health. This supports Mind's previous research, in which almost four in five young people (78%) reported that school had made their mental health worse. Evidence like this shows why we need to take increasing rates of poor mental health among young people seriously and explore the social, emotional, and economic pressures driving these trends. This focus is crucial to reduce the number of young people struggling with their mental health and making sure all young people have the right support to thrive."