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Straight-A students have a much higher risk of developing bipolar disorder

03 February 2010

Scientists from the Institute of Psychiatry, King’s College London and colleagues from the Karolinska Institutet in Stockholm, Sweden, have published first ever scientific evidence that exceptional intellectual ability is associated with bipolar disorder.

This belief has often been reflected in the writings of famous authors and throughout history – scientists have been unable to pinpoint whether this is true.

Lead researcher Dr James MacCabe, Senior Lecturer at the Institute of Psychiatry, King’s College London, said: 'We found that achieving an A-grade is associated with increased risk for bipolar disorder, particularly in humanities and to a lesser extent in science subjects. A-grades in Swedish and Music had particularly strong associations, supporting the literature which consistently finds associations between linguistic and musical creativity and bipolar disorder.'

Several possible explanations for the link were put forward; people in a state of hypomania (a mild period of mania or elevated mood) can often be witty and inventive, and able to link ideas in innovative ways; people with bipolar disorder often experience unusually strong emotional responses, which may help their talent in art, music and literature. Third, people with hypomania often have extraordinary stamina and can keep concentrating for long periods of time.

These types of cognitive style may help students perform better in creative school subjects – but also predispose them to bipolar disorder in later life.

The researchers used results taken from Sweden’s annual compulsory exams taken by 15-16 year olds annually between 1988 and 1997.

Comparisons were drawn between the Swedish hospital discharge register to test associations between the students’ academic achievement and admission to hospital with a diagnosis of bipolar disorder between the ages of 17 and 31. A total of 713,876 individuals were included in the study.

They found that students with excellent school performance were almost four times as likely to develop bipolar disorder as adults, compared to those with average grades. This increased risk remained after the researchers considered other factors such as parental education and socio-economic status.

Students with the poorest grades were also at a moderately increased risk of bipolar disorder. They were almost twice as likely to develop bipolar compared to those with average grades.

Some people who go on to develop bipolar disorder, particularly those with depressive symptoms, may have cognitive styles that impair their academic performance. It is also possible that disturbed behaviour, substance misuse or undiagnosed depression may affect their studies.

The research also showed that the association between high grades and risk of later bipolar disorder appears to be stronger in males than females. But more research is needed in this area.

The study, ‘Excellent school performance at age 16 and risk of adult bipolar disorder: national cohort study’, was published in the February issue of the British Journal of Psychiatry. For a copy of the paper, please follow this link:



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