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The enduring gap in educational attainment in schizophrenia according to the last 50 years of published research: a meta-analysis

A. Crossley, Nicolás, Alliende, Luz María, Czepielewski, Leticia S., Aceituno, David, Paz Castañeda, Carmen, Diaz, Camila, Iruretagoyena, Barbara, Mena, Carlos, Mena, Cristian, Pablo Ramirez-Mahaluf, Juan, Tepper, Ángeles, Vasquez, Javiera, Fonseca, Lais, Machado, Viviane, Hernández, Camilo E., Vargas-Upegui, Cristian, Gomez-Cruz, Gladys, Kobayashi-Romero, Luis F., Moncada-Habib, Tomas, Arango, Celso, Barch, Deanna, Carter, Cameron, Correll, Christoph U., Freimer, Nelson B., McGuire, Philip, Evans-Lacko, Sara ORCID: 0000-0003-4691-2630, Undurraga, Eduardo A, Bressan, Rodrigo, Gama, Clarissa S., Lopez-Jaramillo, Carlos, de la Fuente-Sandoval, Camilo, Gonzalez-Valderrama, Alfonso, Undurraga, Juan and Gadelha, Ary (2022) The enduring gap in educational attainment in schizophrenia according to the last 50 years of published research: a meta-analysis. The Lancet Psychiatry. ISSN 2215-0366 (In Press)

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Abstract

Background. Educational attainment is associated with well-being and health. Unfortunately, patients with schizophrenia achieve lower levels of education. Several effective interventions can ameliorate this. However, the magnitude of the education gap in schizophrenia and changes over time are unclear. Methods. We performed a systematic review and meta-analysis including all studies reporting on patients with schizophrenia and describing their years of education, with or without healthy controls. There were no other design constraints on studies. 22 reviewers participated in retrieving data from a search in PubMed and PsycINFO (January 1st, 1970, to November 24th, 2020). We estimated the birth date of participants from their mean age and publication date, and metaanalyzed these data, focusing on educational attainment, the education gap, and changes over time. The protocol was registered in PROSPERO (CRD42020220546). Outcomes. From 32,593 initial references, we included 3,321 studies reporting on 318,632 patients alongside 138,675 healthy controls (170,941 women and 275,821 men from studies describing gender; ethnicity was not collected). Patients educational attainment increased over time mirroring the controls.  However, patients achieved 19 months less than patients, and this remained unchanged throughout the decades. Studies were biased to include more educated patients and controls than their respective larger population, but results were unchanged in studies with groups with similar parental education. Interpretation. Patients with schizophrenia have faced persistent inequality in educational attainment in the last century, despite advances in psychosocial and pharmacological treatment. Reducing this gap should become a priority to improve their functional outcomes.

Item Type: Article
Official URL: https://www.thelancet.com/journals/lanpsy/home
Divisions: Personal Social Services Research Unit
Date Deposited: 01 Apr 2022 13:42
Last Modified: 17 Jun 2022 16:54
URI: http://eprints.lse.ac.uk/id/eprint/114566

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