Psychotropic medication use and academic performance in adolescence: A cross-lagged path analysis

Introduction: The study investigated the directionality of associations between mental health problems and school grades across two timepoints (T1 and T2) during mid to late adolescence; in school year 9 (ages 15-16) and school year 12 (ages 17-18). The study also investigated variation in the associations as a function of gender and across socioeconomic groups. Methods: Longitudinal data from several Swedish administrative registers were utilised. Information on prescribed psychotropic drugs was used as a proxy for mental health problems, and teacher-assigned school grades were used to measure academic performance. The study sample comprised 85 186 individuals (50.7% girls) born in 1991 who were alive and resident in Sweden in 2010. Directions of associations were analysed by estimating a series of cross-lagged path models. Results: The model with the best fit to data showed that higher school grades at T1 were associated with relatively lower rates of mental health problems by T2, for both boys and girls, mainly in socioeconomic groups with the highest educated parents. This association was equal in size across all of the socioeconomic groups that were explored. Conclusions: Performing well in school is equally important for boys' and girls' subsequent mental health, but only among adolescents in socioeconomic groups with the highest educated parents. The results underscore the importance of promoting opportunities for youth to do as well as they can in school.