Jeremy Brown

Younger Children in Same School Year More Likely To Be Diagnosed with Depression, ADHD and Intellectual Disability Interview with:

Jeremy Brown

Jeremy Brown

Jeremy Brown BA MSc
London School of Hygiene & Tropical Medicine What is the background for this study?

Response: Given the way schools typically work, children in the same year as each other can be almost a whole year apart in terms of age. We’ve known for a while that children who are young in their year at school are also more likely to be diagnosed as having hyperactivity disorders and tend to do less well academically than the older children in the year. They also seem to be at increased risk of suicide. This is thankfully an extremely rare occurrence in children, but there is little evidence about whether younger children are more likely to be diagnosed with depression.

We used electronic health records for just over a million children in the UK to see if there was any association between how old the children were in their year and whether they got diagnosed with ADHD, intellectual disability and depression. What are the main findings?

Response: For all three (ADHD, intellectual disability and depression), we found a roughly 30% increased risk comparing the youngest quarter of children in the year with the oldest.

To put the findings in context, each year around 800,000 children start primary school in the UK. Based on the results of the study we would predict that amongst these children, about 500 more of the youngest quarter in the year might be diagnosed with depression compared with the oldest (2,200 v 1,700), over the whole course of their schooling up to 16 years old.

For ADHD, we’d expect 3,500 of the oldest children and 4,700 of the youngest children to be diagnosed – an excess of 1,200.

For intellectual disability we’d expect similar numbers to what we see with depression – about 1,600 in the oldest group and 2,100 in the youngest group – an excess of 500. What should readers take away from your report?

Response: Younger children in the school year are slightly more likely to be diagnosed with depression, ADHD and intellectual disability. Fortunately, the overall risk of depression remains low. What recommendations do you have for future research as a result of this work?

Response: Further research into the causes of these associations, and into interventions to minimise these effects, is needed. In some countries parents of relatively young children can defer school entry for a year, but whether this helps is unclear. Research to see whether the association with depression persists into early adulthood could also be informative. 

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Root A, Brown JP, Forbes HJ, et al. Association of Relative Age in the School Year With Diagnosis of Intellectual Disability, Attention-Deficit/Hyperactivity Disorder, and Depression. JAMA Pediatr. Published online September 23, 2019. doi:10.1001/jamapediatrics.2019.3194


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Last Updated on September 25, 2019 by Marie Benz MD FAAD