Teen school stress tied to lasting depression and self-harm risk

Feeling under pressure to achieve at school at the age of 15 is linked to depressive symptoms and risk of self-harm into adulthood, a large UK study has shown.

Reducing academic stress in teenagers could cut the risk of future mental health issues, the team from University College London concluded.

The findings come amidst rising rates of depression among young people over the past decade.

A report from the Centre for Mental Health in 2024 found that children and young people’s mental health has been deteriorating across the UK, compounded by the impact of Covid-19, the cost-of-living crisis and rising inequality.

Research has also shown children with high-level mental health needs struggling to access care with referrals bounced back to the GP in many cases.

The latest study looked at evidence from 4,714 adolescents who had taken part in the Children of the 90s birth cohort study and had filled out a questionnaire at the age of 15 when they were working towards their GCSE exams.

Participants were asked whether they worry a lot about getting their schoolwork done, feel a lot of pressure from home to do well in school, and the importance of achieving at least five GCSEs.

The responses were compared with a depressive symptom scale tracked repeatedly in survey responses from ages 16 to 22, and self-harm assessed up to the age of 24.

It showed strong evidence that academic pressure at age 15 is linked to higher depressive symptoms at age 16.

The association persists for years, the team also reported in The Lancet Child and Adolescent Health.

Study participants who experienced high levels of academic pressure when they were 15 continued to report more depressive symptoms at each time point up to age 22, the analysis showed.

Each one-point increase on a nine-point scale of academic pressure at age 15 was associated with 8% increased odds of self-harm, through mid-late adolescence and into the early 20s, the researchers said

Academic pressure at age 15 was also associated with greater risk of self-harm as late as age 24.

In a secondary analysis, the researchers also found that an impact earlier in life, with academic pressure at age 11 and 14 also linked to depressive symptoms.

Those taking part in the were aged 15 in 2006-07, so the findings do not reflect the impacts of later policy changes or of the Covid-19 pandemic, the team pointed out.

Senior author Professor Gemma Lewis, a psychiatric epidemiologist in the UCL Division of Psychiatry, said: ‘In recent years, rates of depression have been rising among young people in the UK and in other countries, and academic pressure also appears to be on the rise.

‘Young people report that academic pressure is one of their biggest sources of stress. A certain amount of pressure to succeed in school can be motivating, but too much pressure can be overwhelming and may be detrimental to mental health.’

She added: ‘We found that young people who felt more pressured by schoolwork at age 15 went on to report higher levels of depressive symptoms, for multiple years into adulthood.’

The researchers noted that alleviating academic pressure for teenagers could have benefits to mental health and should be considered by schools and educational policymakers.

This could involve reducing tests and assessments or supporting the development of social and emotional skills.

Professor Lewis said current approaches to help pupils with mental health tend to be focused on helping individual pupils cope.

‘We hope to address academic pressure at the whole-school level by addressing the school culture.’