Background Studies of the impact of mental disorders on educational (OR=1.4) and impulse control disorders (OR=2.2) were attainment are rare in both high-income and low- and associated with early termination of secondary education. In middle-income (LAMI) countries. LAMI countries, impulse control disorders (OR=1.3) and substance use disorders (OR=1.5) were associated with early Aims . termination of secondary education. To examine the association between early-onset mental disorder and subsequent termination of education. Conclusions Onset of mental disorder and subsequent non-completion of Method education are consistently associated in both high-income Sixteen countries taking part in the World Health and LAMI countries. Organization World Mental Health Survey Initiative were surveyed with the Composite International Diagnostic Declaration of interest Interview (n=41 688). Survival models were used to estimate R.C.K. has been a consultant for GlaxoSmithKline, Kaiser associations between DSM-IV mental disorders and Permanente, Pfizer Inc, Sanofi-Aventis, Shire Pharmaceuticals subsequent non-attainment of educational milestones. and Wyeth-Ayerst; has served on advisory boards for Eli Lilly & Company and Wyeth-Ayerst; and has had research support Results for his epidemiological studies from Bristol-Myers Squibb, Eli In high-income countries, prior substance use disorders were Lilly & Company, GlaxoSmithKline, Johnson & Johnson associated with non-completion at all stages of education Pharmaceuticals, Ortho-McNeil Pharmaceutical mc, Pfizer Inc (OR 1.4-15.2). Anxiety disorders (OR=1.3), mood disorders and Sanofi-Aventis.