Exam pressure at fifteen linked to higher risk of depression and self-harm in early adulthood
23 February 2026
Researchers from the Wolfson Centre for Young People’s Mental Health at Cardiff University were involved in a major new study finding that teenagers who feel under intense academic pressure are more likely to experience depression and self-harm in the years that follow.
The findings led by University College of London, published in The Lancet Child and Adolescent Health and covered earlier this month by The Guardian, highlight the potential long-term impact of exam-related stress during mid-adolescence.
The study followed 4,800 young people in England from the age of fifteen into their mid-twenties.
At fifteen, participants were asked how much pressure they felt from schoolwork, exams, and expectations around academic achievements. Researchers then tracked their mental health over time, including symptoms of depression and experiences of self-harm.
“Young people who reported feeling higher levels of academic pressure at 15 were more likely to experience depressive symptoms between the ages of 16 and 22. They were also at greater risk of reporting self-harm and suicide attempts by their mid-twenties.”
Importantly, these associations were still present even after researchers took into account earlier emotional difficulties and a range of social and family factors.
Professor Rice added: “This suggests that academic pressure itself may play a meaningful role in shaping longer-term mental health outcomes.
We found that reducing academic pressure could be one potential way of improving later mental health outcomes. While exams and achievement are central to education systems, the findings raise important questions about how schools, policymakers and families can support young people to succeed without compromising their wellbeing.”
The research adds to growing evidence that adolescence is a sensitive period for mental health. Experiences during this time, including stress related to school and performance, may have effects that extend well beyond the exam hall.
Researchers at the Wolfson Centre are committed to understanding why increasing numbers of young people experience anxiety, depression, and self-harm, and how these difficulties can be prevented.
This work forms part of a wider programme of research at the Centre examining how school experiences relate to changing patterns of youth mental health. For example, a recent study of 11 to 16-year-olds in Wales tracked trends between 2002 and 2021 and found that perceived schoolwork pressure rose over time, particularly among older girls, alongside increases in emotional problems.
Professor Rice concluded: “Together, these studies suggest that understanding why young people experience high levels of pressure at school is a pressing public health priority. Identifying how academic demands on young people are shifting, and how best to support young people to cope with them, will be key to preventing further rises in mental health difficulties.”
The paper, The association between academic pressure and adolescent depressive symptoms and self-harm: a longitudinal, prospective study in England is published in The Lancet and available to read online.