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Risk for psychiatric and substance use disorders as a function of transitions in Sweden's public educational system: a national study.

Publication ,  Journal Article
Kendler, KS; Keefe, RSE; Ohlsson, H; Sundquist, J; Sundquist, K
Published in: Psychol Med
January 2024

BACKGROUND: To clarify, in a national sample, associations between risk for seven psychiatric and substance use disorders and five key transitions in Sweden's public educational system. METHODS: Swedish-born individuals (1972-1995, N = 1 997 910) were followed through 12-31-2018, at mean age 34.9. We predicted, from these educational transitions, risk for major depression (MD), obsessive-compulsive disorder (OCD), bipolar disorder (BD), schizophrenia (SZ), anorexia nervosa (AN), alcohol use disorder (AUD), and drug use disorder (DUD), assessed from Swedish national registers, by Cox regression, censoring individuals with onsets ⩽17. We also predicted risk from the deviation of grades from family-genetic expectations (deviation 1) and from changes in grades from ages 16 to 19 (deviation 2). RESULTS: We observed four major risk patterns across transitions in our disorders: (i) MD and BD, (ii) OCD and SZ, (iii) AUD and DUD, and (iv) AN. Failing early educational transitions had the greatest impact on risk for OCD and SZ while for other disorders, not progressing from basic to upper high school had the largest effect. Completing vocational v. college-prep upper high school was strongly associated with risk for AUD and DUD, had little relation with MD, OCD, BD, and SZ risk, and was protective for AN. Deviation 1 predicted risk most strongly for SZ, AN, and MD. Deviation 2 predicted risk most strongly for SZ, AUD, and DUD. CONCLUSIONS: The pattern of educational transitions and within family and within person development deviations are strongly and relatively specifically associated with future risk for seven psychiatric and substance-use disorders.

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Published In

Psychol Med

DOI

EISSN

1469-8978

Publication Date

January 2024

Volume

54

Issue

1

Start / End Page

117 / 124

Location

England

Related Subject Headings

  • Sweden
  • Substance-Related Disorders
  • Schizophrenia
  • Psychiatry
  • Humans
  • Depressive Disorder, Major
  • Bipolar Disorder
  • Alcoholism
  • Adult
  • 5203 Clinical and health psychology
 

Citation

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Chicago
ICMJE
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Kendler, K. S., Keefe, R. S. E., Ohlsson, H., Sundquist, J., & Sundquist, K. (2024). Risk for psychiatric and substance use disorders as a function of transitions in Sweden's public educational system: a national study. Psychol Med, 54(1), 117–124. https://doi.org/10.1017/S003329172300048X
Kendler, Kenneth S., Richard S. E. Keefe, Henrik Ohlsson, Jan Sundquist, and Kristina Sundquist. “Risk for psychiatric and substance use disorders as a function of transitions in Sweden's public educational system: a national study.Psychol Med 54, no. 1 (January 2024): 117–24. https://doi.org/10.1017/S003329172300048X.
Kendler KS, Keefe RSE, Ohlsson H, Sundquist J, Sundquist K. Risk for psychiatric and substance use disorders as a function of transitions in Sweden's public educational system: a national study. Psychol Med. 2024 Jan;54(1):117–24.
Kendler, Kenneth S., et al. “Risk for psychiatric and substance use disorders as a function of transitions in Sweden's public educational system: a national study.Psychol Med, vol. 54, no. 1, Jan. 2024, pp. 117–24. Pubmed, doi:10.1017/S003329172300048X.
Kendler KS, Keefe RSE, Ohlsson H, Sundquist J, Sundquist K. Risk for psychiatric and substance use disorders as a function of transitions in Sweden's public educational system: a national study. Psychol Med. 2024 Jan;54(1):117–124.
Journal cover image

Published In

Psychol Med

DOI

EISSN

1469-8978

Publication Date

January 2024

Volume

54

Issue

1

Start / End Page

117 / 124

Location

England

Related Subject Headings

  • Sweden
  • Substance-Related Disorders
  • Schizophrenia
  • Psychiatry
  • Humans
  • Depressive Disorder, Major
  • Bipolar Disorder
  • Alcoholism
  • Adult
  • 5203 Clinical and health psychology