Psychosomatic complaints and school failure: A prospective Swedish national cohort study

Background Psychosomatic complaints — health issues without a clear medical cause and often used as indicators of adolescent mental distress — have increased in Sweden and elsewhere during recent decades. Yet, evidence on their long-term influence remains limited, including links to educational outcomes. Education is a key determinant of future living conditions, and school failure in adolescence can have long-lasting impacts. In Sweden, graduation from upper secondary school represents an important educational milestone. This study examined associations between psychosomatic complaints at age 16 and (1) ineligibility for upper secondary school at age 16, and (2) non-graduation from upper secondary school by age 20. Methods Data was obtained from Futura01, a Swedish national cohort of adolescents attending grade 9 (the final year of compulsory school, age 16) in spring of 2017 (n = 5,346). Psychosomatic complaints were assessed using self-reports on the frequency of headache, stomach ache, and sleep difficulties. Registry data provided information on upper secondary school eligibility and graduation. Covariates included sex, parental education, migration background, living arrangements, and psychiatric conditions. Linear probability models were performed. Results Higher levels of psychosomatic complaints at age 16 were associated with increased probabilities of ineligibility for upper secondary school at age 16 and, among eligible students, subsequent non-graduation from upper secondary school by age 20, even after adjusting for covariates. Conclusions Psychosomatic complaints in adolescence may negatively influence educational attainment, potentially contributing to later socioeconomic and health disadvantages. These findings underscore the importance of addressing adolescent health complaints to support educational success.