Study links academic pressure at 15 to depression and self-harm into the 20s

Academic pressure at age 15 may increase the risk of depression and self-harm well into a person's 20s, a study published online Feb. 12 in The Lancet Child & Adolescent Health says. Teens who felt overwhelmed by schoolwork at age 15 continued to report higher levels of depressive symptoms every year until at least age 22, with the biggest link at age 16.

Researchers tracked 4,714 young people from the Children of the 90s cohort to see how their teenage stress levels, particularly during high-stakes exam periods, influenced their adult lives. Age 15 is around the time children in the United Kingdom take their General Certificate of Secondary Education exams.

The cohort includes parents and their children born in the southwest of England in 1991 and 1992, who completed surveys over the years, including information about depression symptoms. In a separate analysis, researchers also found that high stress as early as ages 11 and 14 was linked to future depression, suggesting the problem begins long before the final high school years.

The findings regarding self-harm were particularly stark. At age 15, for every one-point increase on the study's nine-point scale of academic pressure, there was an 8% increase in the odds of a student self-harming. This elevated risk remained detectable until the participants reached age 24.

The researchers conclude that academic pressure is a potentially modifiable risk factor for depression and self-harm and call for "whole-school" interventions. This would involve changing the very culture of education — potentially by reducing the number of exams and focusing more on building social and emotional skills.

The researchers noted that their findings do not reflect the impacts of COVID-19 or later policy changes as the participants were 15 years of age in 2006 to 2007. They note that more data is needed and caution that the study was observational, so the findings cannot prove cause and effect.