BJPsych Open. 2026 Sep 14;12(5):e237. doi: 10.1192/bjo.2026.12091.
ABSTRACT
BACKGROUND: Problematic teacher-pupil relationships (TPR) affect children’s educational outcomes and mental health, particularly for children with psychiatric disorders and neurodevelopmental conditions, yet few population-based studies have explored this association.
AIMS: To estimate the association between problematic TPRs and psychiatric disorder classifications including neurodevelopmental conditions and poor mental health, and whether this varied by informant.
METHOD: A cross-sectional analysis of the Mental Health in Children and Young People 2017 survey (n = 6634) was performed. Mental health was assessed using the Strengths and Difficulties Questionnaire, whereas classification of psychiatric disorders, including neurodevelopmental conditions, was assessed using the Development and Well-Being Assessment. TPR quality was evaluated through reports from parents and children (aged >11 years). Bivariable and multivariable regression analyses were stratified by age (5-10 years, n = 3509; 11-16 years, n = 3010), controlling for covariates. Multiple imputation was used to address missing data.Data-set information: NatCen Social Research (2024), Mental Health in Children and Young People 2017, UK Data Service, SN 8467.
RESULTS: Problematic TPRs were associated with increased odds of any psychiatric disorder in children aged 5-10 years (adjusted odds ratio = 4.80, 95% CI: 2.74-8.40) and 11-16 years (adjusted odds ratio = 4.07, 95% CI: 2.76-6.01). Strengths and Difficulties Questionnaire total difficulties scores were higher by 4.26 points (95% CI: 3.09-5.42) and 3.93 points (95% CI: 3.04-4.83) for children aged 5-10 and 11-16 years, respectively. Problematic TPRs were also associated with attention-deficit hyperactivity disorder, with no significant differences between informant types. Teacher recognition of poor mental health did not moderate these associations.
CONCLUSIONS: These findings support the importance of TPRs in school policy and of supporting teachers to foster positive relationships in schools.
PMID:42734076 | DOI:10.1192/bjo.2026.12091
