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Background: A significant proportion of young people in Sweden do not graduate from upper secondary school with a complete diploma, which may be crucial for their mental health. A diploma influences both perceived and actual future prospects, including access to tertiary education and employment opportunities. Additionally, education fosters personal control and problem-solving skills relevant to stress management and self-esteem. Therefore, this study explores the association between obtaining an upper secondary diploma and the severity and co-occurrence of depression and anxiety symptoms among emerging adults in Sweden. Methods: Data from a population-based cohort of Swedish 21-year-olds ( n =3255) were analysed. Depression and anxiety symptoms were measured using the Patient Health Questionnaire-4 (PHQ-4). Registry data provided information on upper secondary education, sex, immigrant background, and parental education. Multinomial logistic regression was used. Results: Participants without an upper secondary diploma were at a higher risk of experiencing the most severe outcomes; that is, severe symptoms ( vs . normal/mild) and co-occurring depression and anxiety symptoms ( vs . no symptoms) compared with those with an academic diploma. They also had a higher risk of depression only, but not anxiety only. Additionally, compared with participants with an academic diploma, those with a vocational upper secondary diploma exhibited an elevated risk of depression only. Conclusions: This study highlights the link between an upper secondary diploma and mental health in emerging adulthood. It also suggests that depression, anxiety, and their co-occurrence may have distinct determinants. The findings indicate that initiatives to support school completion and re-engagement could have significant public health benefits .
Saminathen et al. (Thu,) studied this question.