Teenagers and children are at heightened risk of mental health issues during periods of exam stress, researchers have found.
Academics from University College London (UCL) reviewed 52 studies involving students who attended either a primary school, secondary school or sixth-form college around the world between 1991 and 2022. In 48 of the studies, they found a link between academic pressure within the school year and anxiety and depressive symptoms.
The UCL report noted that mental health-related hospital admissions among Canadian adolescents were highest from January to April and October to November but lowest during periods of school closure in July, August and December.
A similar study in England found that stress-related emergency admissions were highest for teenagers during term-time and lowest during holidays.
Suicide attempts by adolescents were also rarer during non-school months of June, July, and August in two US studies assessing the rate of hospital admissions for them across the year, researchers said.
Mixed anxiety and depressive symptoms were the most commonly-assessed outcome of the review, with eight out of 20 studies reporting a link between academic pressure and psychosomatic symptoms.
The authors wrote: “Positive associations between measures of academic pressure and the mental health outcome of interest were found in 17 of the 19 studies investigating depressive symptoms, five of the six studies investigating anxiety symptoms, and in four of the five studies assessing suicidal ideation. All but one of the nine studies investigating timing with the school year found suicides, suicide attempts, mental health-related hospital presentations, and non-suicidal self-injury were lowest during school closure, suggesting a potential association with academic pressure within term time.”
The survey comes as teenagers across England prepare to receive their A-level results next Thursday. Nearly 95,000 fewer A* and A grades will be awarded to sixth-formers compared with last year, education experts have warned.
The paper’s authors admitted that their review had “several limitations”, including the fact that the term “academic pressure” was used inconsistently across studies. Most studies analysed by the UCL team were cross-sectional, meaning it was impossible to determine which happened first — exposure to high levels of academic pressure or mental health problems.
If the relationship is causal, the researchers argued that “modifying academic pressure through interventions at an individual, school or policy-level could reduce the rising incidence of adolescent mental health problems”.
The lead author, Thomas Steare, told the Standard: “Adolescents are increasingly feeling pressure from schools, parents, or themselves to achieve higher grades, and there are concerns extensive testing and exams are causing undue stress.”
