BMJ  2003;327:472 (30 August), doi:10.1136/bmj.327.7413.472

Paper

Child psychiatric disorder and relative age within school year: cross sectional survey of large population sample

¹ Department of Child and Adolescent Psychiatry, Institute of Psychiatry, King's College London, London SE5 8AF, ² Child and Adolescent Psychiatry, Imperial College School of Medicine (St Mary's), London W2 1PG

Objective To test the hypothesis that younger children in a school year are at greater risk of emotional and behavioural problems.

Design Cross sectional survey.

Setting Community sample from England, Scotland, and Wales.

Participants 10 438 British 5-15 year olds.

Main outcome measures Total symptom scores on psychopathology questionnaires completed by parents, teachers, and 11-15 year olds; psychiatric diagnoses based on a clinical review of detailed interview data.

Results Younger children in a school year were significantly more likely to have higher symptom scores and psychiatric disorder. The adjusted regression coefficients for relative age were 0.51 (95% confidence interval 0.36 to 0.65, P < 0.0001) according to teacher report and 0.35 (0.23 to 0.47, P = 0.0001) for parental report. The adjusted odds ratio for psychiatric diagnoses for decreasing relative age was 1.14 (1.03 to 1.25, P = 0.009). The effect was evident across different measures, raters, and age bands. Cross national comparisons supported a "relative age" explanation based on the disadvantages of immaturity rather than a "season of birth" explanation based on seasonal variation in biological risk.

Conclusions The younger children in a school year are at slightly greater psychiatric risk than older children. Increased awareness by teachers of the relative age of their pupils and a more flexible approach to children's progression through school might reduce the number of children with impairing psychiatric disorders in the general population.

CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

Related Articles

Child psychiatric disorder and relative age in school year: Holding back may cause more harm than good

Thomas Radecki
BMJ 2003 327: 1286. [Extract] [Full Text] [PDF]

Child psychiatric disorder and relative age in school year: Holding back may cause more harm

Robyn M Greenwell
BMJ 2003 327: 1286. [Extract] [Full Text]

Child psychiatric disorder and relative age in school year: Children need to be regarded as individuals in education

Jolanda Challita
BMJ 2003 327: 1286. [Extract] [Full Text]

Child psychiatric disorder and relative age in school year: Peer effects need to be considered

Woody Caan
BMJ 2003 327: 1287. [Extract] [Full Text]

Relative age in the school year influences mental health
BMJ 2003 327: 0. [Full Text]

This article has been cited by other articles:

• Lien, L., Lien, N., Heyerdahl, S., Thoresen, M., Bjertness, E. (2006). Consumption of Soft Drinks and Hyperactivity, Mental Distress, and Conduct Problems Among Adolescents in Oslo, Norway. Am. J. Public Health 96: 1815-1820 [Abstract] [Full text]  
• Radecki, T. (2003). Child psychiatric disorder and relative age in school year: Holding back may cause more harm than good. BMJ 327: 1286-1286 [Full text]  
• Caan, W. (2003). Child psychiatric disorder and relative age in school year: Peer effects need to be considered. BMJ 327: 1287-1287 [Full text]  
• Greenwell, R. M (2003). Child psychiatric disorder and relative age in school year: Holding back may cause more harm. BMJ 327: 1286-1286 [Full text]  
• Challita, J. (2003). Child psychiatric disorder and relative age in school year: Children need to be regarded as individuals in education. BMJ 327: 1286-1286 [Full text]  

Rapid Responses:

Read all Rapid Responses

Holding Back May Cause More Harm

Thomas E. Radecki
bmj.com, 29 Aug 2003 [Full text]

Peer effects and mental health promotion in schools

Woody Caan
bmj.com, 30 Aug 2003 [Full text]

Re: Holding Back May Cause More Harm

Robyn M. Greenwell
bmj.com, 30 Aug 2003 [Full text]

Meeting children's needs .

Jolanda Challita
bmj.com, 31 Aug 2003 [Full text]

What Are the Specific DSM4 Psychiatric Diagnoses?

Dr P V Finn Cosgrove
bmj.com, 1 Sep 2003 [Full text]

Importance of preterm birth

Stefano Palazzi
bmj.com, 2 Sep 2003 [Full text]

Relative age suggests a transactional process

Laurence Jerome
bmj.com, 2 Sep 2003 [Full text]