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Am J Psychiatry 1995; 152:1026-1032
Copyright © 1995 by American Psychiatric Association
Social consequences of psychiatric disorders, I: Educational attainment
RC Kessler, CL Foster, WB Saunders and PE Stang
Institute for Social Research, University of Michigan, Ann Arbor 48106- 1248, USA.
OBJECTIVE: This is the first in a series of investigations of the social
consequences of psychiatric disorders based on the National Comorbidity
Survey. Data on the relationship between preexisting psychiatric disorders
and subsequent educational attainment are presented. METHOD: The National
Comorbidity Survey is a nationally representative survey of 8,098
respondents in the age range 15-54 years. A subsample of 5,877 respondents
completed a structured psychiatric interview and a detailed risk factor
battery. Diagnoses of DSM-III-R anxiety disorders, mood disorders,
substance use disorders, and conduct disorder were generated, and survival
analyses were used to project data on school terminations to the total U.S.
population. RESULTS: Early-onset psychiatric disorders are present in more
than 3.5 million people in the age range of the National Comorbidity Survey
who did not complete high school and close to 4.3 million who did not
complete college. The most important disorders are conduct disorder among
men and anxiety disorders among women. The proportion of school dropouts
with psychiatric disorders has increased dramatically in recent cohorts,
and persons with psychiatric disorders currently account for 14.2% of high
school dropouts and 4.7% of college dropouts. CONCLUSIONS: Early-onset
psychiatric disorders probably have a variety of adverse consequences. The
results presented here show that truncated educational attainment is one of
them. Debate concerning whether society can afford universal insurance
coverage for the treatment of mental disorders needs to take these
consequences into consideration.
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