{
  "abstract": "Archivist has often been concerned that the academic pressure has a part in young people presenting to paediatric clinics with mental health disorders, self-harm and somatic symptoms related to stress. So, is there an association between academic pressure and adolescent depressive symptoms and self-harm? Guo X et al (The Lancet Child & Adolescent Health 2026:10; 265–272. https://doi.org/10.1016/S2352-4642(25)00342-6] have presented a longitudinal, prospective study in England using the ALSPAC (Avon Longitudinal Study of Parents and Children (Avon, UK) data base which examines this question. This large, highly important and respected data base is a great source of epidemiological data, and it includes young people who were born in 1991–1992. Their hypothesis was that higher levels of academic pressure would be associated with higher levels of depressive symptoms and self-harm. The identified 4714 adolescents (2725 (57·8%) female) and the primary exposure of interest was academic pressure measured at age 15 years. What is academic pressure? The team used items from a school experiences questionnaire (total scores 0–9) and outcomes were depressive symptoms assessed with the Short Mood and Feelings Questionnaire at five moments from the age of 16 years to 22 years and a self-harm questionnaire at four moments between age 16 years and 24 years. In fully adjusted models, a 1-point increase in academic pressure at age 15 years was associated with a 0·43 (95% CI 0.36 to 0.51) point increase in depressive symptoms. This association was largest when depressive symptoms were assessed at age 16 years (0.53, 0.42–0.64) but remained at age 22 years (0.35, 0.23–0.47). For self-harm, each 1-point increase in academic pressure was associated with 8% higher odds of self-harm (adjusted OR 1.08, 1.01–1.16), with no differences over time. These findings do support the hypothesis that academic pressure is a potential modifiable risk factor for adolescent depressive symptoms and possibly self-harm. Paediatricians and other clinicians need to be aware of this association when managing this vulnerable age group. Graeme Fairchild et al (The Lancet Child & Adolescent Health 2026;10:234-235. https://doi.org/10.1016/S2352-4642(26)00010-6) discuss this long shadow of academic pressure by starting off summarising recent funding changes in Wales, Northern Ireland and England to the post-16 educational programmes. Young adults have to stay in school now until they are 18 years old. They require at least grade 4 (equivalent to grade C in the previous grading system) in English and Maths General Certificates of Secondary Education to progress to further study or training. The academic pressure is now building up as more students have to retake exams, yet the resit pass rates remain low. Is this adding to the increase in mental health issues we are seeing in young people? There appears to be a clear association between academic pressure and poor youth mental health, but it is important to remember that even though this is a longitudinal study (many have simply been cross-sectional), causality has not been shown.",
  "authors": [
    {
      "affiliations": [],
      "name": "BMJ Publishing Group Ltd and Royal College of Paediatrics and Child Health"
    }
  ],
  "title": "Academic pressure and adolescent depressive symptoms and self-harm",
  "uid": "9a96796a-3563-591d-8382-3afa084bab00"
}