Evaluating the causal relationship between educational attainment and mental health

Abstract

We investigate the causal relationship between educational attainment (EA) and mental health using two research designs. First, we compare the relationship between EA and seventeen psychiatric diagnoses within sibship in Dutch national registry data (N = 1.7 million), controlling for unmeasured familial factors. Second, we use two-sample Mendelian Randomization, which uses genetic variants related to EA or psychiatric diagnosis as instrumental variables, to test whether there is a causal relation in either direction. Our results suggest that lower levels of EA causally increase the risk of MDD, ADHD, alcohol dependence, GAD and PTSD diagnoses. We also find evidence of a causal effect in the opposite direction for ADHD. Additionally, we find inconsistent results for schizophrenia, anorexia nervosa, OCD, and bipolar disorder, highlighting the importance of using multiple research designs to understand the complex relationship between EA and mental health.

Competing Interest Statement

The authors have declared no competing interest.

Funding Statement

We thank the Open Data Infrastructure for Social Science and Economic Innovation (ODISSEI: https://ror.org/03m8v6t10) for financing access to Statistics Netherlands microdata via a microdata access grant awarded to P.A.D. and a member discount. P.A.D. is supported by the grant 531003014 from The Netherlands Organisation for Health Research and Development (ZonMW). D.I.B. is supported by the Royal Netherlands Academy of Science (KNAW) Professor Award (PAH/6635). E.v.B. is supported by ZonMW grant 531003014 and VENI grant 451-15-017. M.G.N. is supported by R01MH120219, ZonMW grants 849200011 and 531003014 from The Netherlands Organisation for Health Research and Development, a VENI grant awarded by NWO (VI.Veni.191 G.030) and is a Jacobs Foundation Research Fellow.

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I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained.

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The details of the IRB/oversight body that provided approval or exemption for the research described are given below:

This research was reviewed and approved by the Scientific and Ethical Review Board (VCWE) of the Faculty of Behaviour & Movement Sciences, VU University Amsterdam; application number VCWE-2020-054.

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Data Availability

We analyze restricted access microdata from Statistics Netherlands (CBS). Under strict conditions, these microdata are accessible for statistical and scientific research. For further information on remote access procedures: microdata@cbs.nl. For GWAS summary statistics availability, see original publications. For 23andMe, Inc. dataset access, see https://research.23andme.com/dataset-access.

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