Send to

Choose Destination
BMJ Open. 2019 Nov 14;9(11):e031595. doi: 10.1136/bmjopen-2019-031595.

The association between depression and later educational attainment in children and adolescents: a systematic review protocol.

Author information

Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
NIHR Maudsley Biomedical Research Centre, South London and Maudsley NHS Foundation Trust, London, UK.
Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
University of Exeter Medical School, University of Exeter, Exeter, UK.
Department of Psychiatry, University of Cambridge, Cambridge, UK.



Depression represents a major public health concern for children and adolescents, and is thought to negatively impact subsequent educational attainment. However, the extent to which depression and educational attainment are directly associated, and whether other factors play a role, is uncertain. Therefore, we aim to systematically review the literature to provide an up-to-date estimate on the strength of this association, and to summarise potential mediators and moderators on the pathway between the two.


To identify relevant studies, we will systematically search Embase, PsycINFO, PubMed, Education Resources Information Centre and British Education Index, manually search reference lists and contact experts in the field. Studies will be included if they investigate and report on the association between major depression diagnosis or depressive symptoms in children and adolescents aged 4-18 years (exposure) and later educational attainment (outcome). Two independent reviewers will screen titles, abstracts and full texts according to eligibility criteria, perform data extraction and assess study quality according to a modified version of the Newcastle-Ottawa Scale. If sufficiently homogeneous studies are identified, summary effect estimates will be pooled in meta-analysis, with further tests for study heterogeneity, publication bias and the effects of moderators using meta-regression.


Because this review will make use of already published data, ethical approval will not be sought. The review will be submitted for publication in a peer-reviewed journal, presented at practitioner-facing conferences, and a lay summary will be written for non-scientific audiences such as parents, young people and teachers. The work will inform upcoming investigations on the association between child and adolescent mental health and educational attainment.




adolescent psychiatry; child & depression & education & epidemiology; mood disorders; training

Supplemental Content

Full text links

Icon for HighWire Icon for PubMed Central
Loading ...
Support Center