Anxiety and school absenteeism without permission among adolescents in 69 low- and middle-income countries.

Background: Anxiety disorders are common among adolescents. In high-income countries, anxiety is a known contributor to truancy and school refusal, but this association has been understudied in low- and middle-income countries (LMICs).

Methods: We used complex samples analysis to examine the association between self-reported worry-induced insomnia (an indicator of anxiety) and unauthorized school absenteeism among 268,142 adolescents from 69 LMICs that participated in the Global School-based Student Health Survey (GSHS).