OBJECTIVE: To determine the prevalence of frequent absence (>20% of the school year) for reasons recorded as "medical" in secondary schools; to test the hypothesis that it is associated with physical symptoms and psychiatric disorder and not with serious organic disease; to assess unmet need for psychiatric management. DESIGN: Survey using routinely collected data and case-control study SETTING: Local authority secondary schools in Edinburgh, UK. PARTICIPANTS: School students in the first 4 years of secondary school: cases were those with frequent medical absence and controls those with a good attendance record (best 10% of year group), matched for age, gender and school class. MEASURES: Period prevalence of frequent absences. Cases and controls (students and their parents) completed questionnaires about the students' symptoms. Students were given a psychiatric diagnostic interview and a medical examination. The records of specialist medical services used by the students were reviewed. RESULTS: A substantial minority (2.2%) of students had frequent medical absences. Only seven of 92 (8%) cases had a serious organic disease and 10 of 92 (11%) had symptom-defined syndromes; the remainder had physical symptoms and minor medical illness. Frequent medical absence was strongly associated with psychiatric disorder (45% in cases vs 17% in controls, p<0.001, 95% CI for odds ratio 1.37 to 4.02). Only 14 of the 41 cases (34%) with a psychiatric diagnosis had attended NHS psychiatric services. CONCLUSIONS: Frequent absence for medical reasons is common, and more comprehensive management, including psychiatric assessment, is required to prevent long-term adverse consequences.
OBJECTIVE: To determine the prevalence of frequent absence (>20% of the school year) for reasons recorded as "medical" in secondary schools; to test the hypothesis that it is associated with physical symptoms and psychiatric disorder and not with serious organic disease; to assess unmet need for psychiatric management. DESIGN: Survey using routinely collected data and case-control study SETTING: Local authority secondary schools in Edinburgh, UK. PARTICIPANTS: School students in the first 4 years of secondary school: cases were those with frequent medical absence and controls those with a good attendance record (best 10% of year group), matched for age, gender and school class. MEASURES: Period prevalence of frequent absences. Cases and controls (students and their parents) completed questionnaires about the students' symptoms. Students were given a psychiatric diagnostic interview and a medical examination. The records of specialist medical services used by the students were reviewed. RESULTS: A substantial minority (2.2%) of students had frequent medical absences. Only seven of 92 (8%) cases had a serious organic disease and 10 of 92 (11%) had symptom-defined syndromes; the remainder had physical symptoms and minor medical illness. Frequent medical absence was strongly associated with psychiatric disorder (45% in cases vs 17% in controls, p<0.001, 95% CI for odds ratio 1.37 to 4.02). Only 14 of the 41 cases (34%) with a psychiatric diagnosis had attended NHS psychiatric services. CONCLUSIONS: Frequent absence for medical reasons is common, and more comprehensive management, including psychiatric assessment, is required to prevent long-term adverse consequences.
Authors: Yvonne T M Vanneste; Jolanda J P Mathijssen; Ien A M van de Goor; Carin M C Rots-de Vries; Frans J M Feron Journal: BMC Public Health Date: 2016-10-21 Impact factor: 3.295
Authors: Madelon K Van der Vlis; Marjolein Lugtenberg; Yvonne T M Vanneste; Wenda Berends; Wico Mulder; Rienke Bannink; Amy Van Grieken; Hein Raat; Marlou L A de Kroon Journal: BMC Public Health Date: 2017-06-29 Impact factor: 3.295