The notion that smarter people are more likely to be diagnosed with mental illness is not new. Research has, time and time again, attempted to understand the link between intelligence and a greater likelihood of depression, anxiety, and other mental health disorders. Plenty of creative thinkers — like Vincent Van Gogh, Ernest Hemingway, and Jackson Pollock — suffered from bipolar disorder and other mental health issues.

But to what extent do intelligence (IQ), creativity, and even education level have to do with mental illness? Plenty of the research on the subject has come up with contradicting results, but a new study offers more clues for bipolar disorder and schizophrenia specifically. The study, published in Psychological Medicine, examined both intelligence and educational performance when it came to both bipolar and schizophrenic patients.

In the study, the researchers examined 494 bipolar disorder I (BD-I) patients, 952 schizophrenia spectrum (SCZ) patients, and 2,231 relatives of the BD-I and SCZ patients. They also examined 1,104 healthy controls and 100 of their siblings. The results showed that bipolar disorder I patients were actually the most likely to have completed the highest level of education compared to the other groups, despite the fact that they had lower IQs than the controls. Schizophrenia patients, meanwhile, had lower IQs and educational levels than controls. Bipolar disorder I and schizophrenia patients had similar IQ levels, but bipolar disorder I patients had the highest educational levels.

“Although bipolar disorder I patients had a lower IQ than controls, they were more likely to have completed the highest level of education,” the researchers wrote. “This contrasts with schizophrenia patients, who showed both intellectual and educational deficits compared to healthy controls. Since relatives of bipolar disorder I patients did not demonstrate superior educational performance, our data suggest that high educational performance may be a distinctive feature of bipolar disorder patients.”

A past study out of Karolinska Institute in Sweden and King’s College London in the UK found that bipolar disorder was possibly up to four times more common in young people who were straight-A students. Receiving excellent grades in school was “associated with increased risk for bipolar disorder” particularly among students who excelled in humanities rather than sciences, Dr. James MacCabe, the lead author, noted. “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.”

The results don't necessarily mean that people with higher levels of education have an increased risk of bipolar disorder. In addition, more research will be needed in order for psychologists to conclude that bipolar disorder is certainly linked to education.

Source: Vreeker A, Boks M, Abramovic L, Verkooijen S, Bergen A, Hillegers M. High educational performance is a distinctive feature of bipolar disorder: a study on cognition in bipolar disorder, schizophrenia patients, relatives and controls. Psychological Medicine, 2016.