Educational consequences of mental disorders treated in hospital. A 31-year follow-up of the Northern Finland 1966 Birth Cohort

Background. Mental disorders often begin during the formative years of educ ation. They may disrupt education and lead to social underachievement. Methods. We examined the impact of mental disorders treated in hospital (ag es 16-29) on educational attainment up to 31 years in the Northern Finland 1966 Birth Cohort (N = 10581). People discharged due to mental illness were grouped by DSM-III-R diagnoses (of schizophrenia, other psychoses and non- psychotic disorders) and were compared with those having no such hospital t reatment. Associations between diagnoses and educational outcome (completio n of basic level, upper secondary or tertiary education) were analysed stra tified by age at onset (early onset < 22 years v. later), and adjusted for confounding by perinatal risk, early motor development, maternal education, family structure, parental social class, and school achievement using pros pective data from earlier assessments and logistic regression analysis. Results. Twelve per cent of the comparison group completed basic level educ ation, 62 % upper secondary, and 26 % tertiary education. People with early onset disorder tended to stagnate in the basic level. Early onset schizoph renia and all non-psychotic cases had 3- to 6-fold adjusted odds for this o utcome. Many with early onset schizophrenia completed secondary education, but none completed the tertiary level. Hospitalization for non-psychotic di sorder increased the risk of underachievement in tertiary education for tho se with early onset. Conclusions, Mental disorder treated in hospital truncates education. Failu re to complete higher education may contribute to the "social exclusion" of the mentally ill through reduced opportunities in later occupational life and failure to accumulate social capital.