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Is bipolar disorder more common in highly intelligent people? A cohort study of a million men

Abstract

Anecdotal and biographical reports have long suggested that bipolar disorder is more common in people with exceptional cognitive or creative ability. Epidemiological evidence for such a link is sparse. We investigated the relationship between intelligence and subsequent risk of hospitalisation for bipolar disorder in a prospective cohort study of 1 049 607 Swedish men. Intelligence was measured on conscription for military service at a mean age of 18.3 years and data on psychiatric hospital admissions over a mean follow-up period of 22.6 years was obtained from national records. Risk of hospitalisation with any form of bipolar disorder fell in a stepwise manner as intelligence increased (P for linear trend <0.0001). However, when we restricted analyses to men with no psychiatric comorbidity, there was a ‘reversed-J’ shaped association: men with the lowest intelligence had the greatest risk of being admitted with pure bipolar disorder, but risk was also elevated among men with the highest intelligence (P for quadratic trend=0.03), primarily in those with the highest verbal (P for quadratic trend=0.009) or technical ability (P for quadratic trend <0.0001). At least in men, high intelligence may indeed be a risk factor for bipolar disorder, but only in the minority of cases who have the disorder in a pure form with no psychiatric comorbidity.

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Acknowledgements

This work was conducted in The University of Edinburgh Centre for Cognitive Ageing and Cognitive Epidemiology which is supported by the Biotechnology and Biological Sciences Research Council, the Economic and Social Research Council, the Engineering and Physical Sciences Research Council and the Medical Research Council, as part of the Lifelong Health and Wellbeing Initiative (G0700704/84698). David Batty is a UK Wellcome Trust Fellow. Finn Rasmussen is supported by the Swedish Council for Working Life and Social Research. The study sponsors had no role in the study design, the collection of data, or in the preparation of this manuscript.

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Correspondence to C R Gale or F Rasmussen.

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Gale, C., Batty, G., McIntosh, A. et al. Is bipolar disorder more common in highly intelligent people? A cohort study of a million men. Mol Psychiatry 18, 190–194 (2013). https://doi.org/10.1038/mp.2012.26

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  • DOI: https://doi.org/10.1038/mp.2012.26

Keywords

  • bipolar disorder
  • cognitive ability
  • comorbidity
  • intelligence

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