Association Between Anxiety and Depression in Primary School Pupils with Reading Difficulty

Abstract

Introduction: Children with a reading difficulty may be at risk of a learning problem in class, which could affect their mental health.

Objectives: This study aimed to determine an association between reading difficulty and anxiety depression among pupils at primary schools.

Methods: The cross-sectional study was conducted in 1,154 pupils who are studying in Grade 2 at 8 primary schools in Pathum Thani province, Thailand. All pupils were assessed in their reading abilities by the Thai Reading Test, consisting of reading meaningful Thai words and 3 Thai short stories in allotted time. Reading difficulty was defined as the number of students who had a test score less than the 10th percentile. Generalized anxiety disorder and significant school avoidance were screened for by using the Thai version of the Screen for Child Anxiety Related Emotional Disorders (SCARED). Depression was screened for by using the Thai version of The Short Mood and Feelings Questionnaire (SMFQ).

Results: There were 877 pupils who completed the tests with the response rate of 80%. The mean age was 7.0 years (SD = 0.4 years). The prevalence of generalized anxiety disorder, significant school avoidance, and depression were 18.4%, 32.2%, and 36.0%, respectively. According to multivariable logistic regression analysis controlled by sex, school affiliation, parental education level, and family income, reading difficulty was significantly associated with school avoidance with the odds ratio of 2.2 (95% confidence interval: 1.5 -3.3, P < .001) and depression with the odds ratio of 1.8 (95% confidence interval: 1.2-2.6, P = .005). However, reading difficulty was not significantly associated with generalized anxiety disorder.

Conclusions: School avoidance and depression are associated with a reading difficulty, which can be screened and detected at an early primary school. To provide appropriate assistance to children with a reading difficulty, there should be assessment, supervision, and follow-up of emotional problems from early on so that they can develop properly in intellectual, emotional, and social aspects.