Abstract :
[en] Unhealthy behaviors such as alcohol, tobacco, cannabis and hard drugs uses and depressive symptoms are common in early adolescence and they are well known to affect physical, mental and cognitive functions. These factors can thus favor persistent school difficulties. Socioeconomic factors are known to favor unhealthy behaviors and depressive symptoms as well as school difficulties. This study assessed the associations of unhealthy and depressive symptoms with learning difficulty, low school performance, and school dropout ideation, and the confounding roles of socioeconomic factors in early adolescence. Design: Cross-sectional study. Methods: The sample included 1,559 middle-school adolescents from north-eastern France (mean age 13.5, SD 1.3), who completed a self-administered questionnaire including gender, birth date, socioeconomic factors (father’s socioeconomic category, family structure, parents’ education, parent death, nationality, family income, and social supports), last-30-day alcohol, tobacco, cannabis and hard drugs uses, depressive symptoms (Kandel scale, score>90th percentile), learning difficulty, low school performance (last-trimester mark <10/20), and school dropout ideation at 16 years (school is compulsory until this age). Learning difficulty was measured using an 8-item scale including lesson comprehension, concentration/lesson learning, keeping up the pace/constraint, relaxing/rest, class atmosphere, home learning atmosphere, teacher pressure, and parent pressure; Cronbach alpha coefficient 0.81, score>90th percentile). The school difficulties were chosen to measure various difficulty levels. Data were analyzed using logistic models to compute gender-age-grade-adjusted odds ratios (OR1) and the contributions of socioeconomic factors. Findings: Learning difficulty, low school performance, and school dropout ideation affected respectively 14.1%, 8.2%, and 3.8% of students. These school difficulties were linked with alcohol use: OR1 1.72 (95%CI 1.26-2.33), 1.51 (1.03-2.21), and 3.43 (1.96-6.01), respectively. Higher OR1 were found for tobacco use: 3.82 (2.64-5.52), 5.81 (3.83-8.82), and 6.31 (3.53-11.28), respectively; cannabis use: OR1 3.61 (2.23-5.86), 4.12 (2.41-7.04), and 6.89 (3.45-13.76), respectively; hard drugs uses: OR1 6.37 (3.41-11.89), 5.05 (2.53-10.08), and 10.85 (4.99-23.55), respectively; and depressive symptoms: OR1 7.21 (5.06-10.27), 1.84 (1.16-2.93), 3.14 (1.64-6.03), respectively. The socioeconomic factors considered explained respectively <4%, 15-37%, 10%-31%, 20%-43%, and 20%-68% of the associations of school difficulties with alcohol, tobacco, cannabis, and hard drugs uses and depressive symptoms. Conclusions: Unhealthy behaviors and depressive symptoms were strongly associated with school difficulties. Socioeconomic factors highly confounded their associations. Public policy to improve school achievement, and thus community participation in adulthood, should focus on unhealthy behaviors and mental disorders, especially among students with socioeconomic difficulties. Causal relationships could not be advanced (study cross-sectional nature).
