Background
Emotional disorder may be associated with absence from school, but the existing evidence is
methodologically weak. We studied the relationships between anxiety, depression and emotional
difficulties, and school absence (total, authorised and unauthorised) using data from the 2004 British
Child and Adolescent Mental Health ...
Background
Emotional disorder may be associated with absence from school, but the existing evidence is
methodologically weak. We studied the relationships between anxiety, depression and emotional
difficulties, and school absence (total, authorised and unauthorised) using data from the 2004 British
Child and Adolescent Mental Health Survey (BCAMHS).
Method
The BCAMHS was a cross-sectional, community survey of 7977 five to 16 year olds. Emotional
disorder was assessed using the Development and Wellbeing Assessment (DAWBA), and emotional
difficulties using the Strengths and Difficulties Questionnaire (SDQ) completed by teachers and
parents. Teachers reported days absent in the previous school term. Multivariable negative binomial
regression was used to examine the impact of emotional disorder and difficulties on absence. Age,
gender and general health were explored as moderators.
Results
Anxiety, depression and emotional difficulties were associated with higher rates of all types of
absence (rate ratios for total absence: anxiety 1.69 (1.39 to 2.06) p<0.001; depression 3.40 (2.46 to
4.69) p<0.001; parent-reported emotional difficulties 1.07 (1.05 to 1.10) p<0.001; teacher-reported
emotional difficulties 1.10 (1.08 to 1.13) p<0.001). The strongest association was observed for
depression and unauthorised absence. Relationships were stronger for secondary compared to
primary school children.
Conclusions
Health and educational professionals should be aware that children with poor attendance may be
experiencing emotional ill health, regardless of absence type. Absence may provide a useful tool to
identify those who require additional mental health support. Findings highlight the widespread
burden of emotional disorder and the need to support those with emotional ill health in continuing
to access education.