Longitudinal studies indicate that a lower IQ score increases risk of
schizophrenia. Preliminary evidence suggests there is no such effect for nonpsychotic
bipolar disorder. To our knowledge, there are no prior population-based, longitudinal
studies of premorbid IQ score and risk of developing severe depression requiring
To investigate the association between premorbid IQ score and risk of
developing schizophrenia, other nonaffective psychoses, bipolar disorder,
and severe depression and to investigate effects of confounding and examine
possible causal pathways by which IQ may alter these risks.
Historical cohort study, using record linkage for hospital admissions
during a 27-year follow-up period.
Survey of Swedish conscripts (1969-1970).
Population-based sample of 50 087 male subjects. Data were available
on IQ score at conscription and on other social and psychological characteristics.
Main Outcome Measures
International Classification of Diseases, Eighth Revision or Ninth Revision diagnoses of schizophrenia,
bipolar disorder, severe depression, and other nonaffective psychoses.
There was no association between premorbid IQ score and risk of bipolar
disorder. Lower IQ was associated with increased risk of schizophrenia, severe
depression, and other nonaffective psychoses. Risk of schizophrenia was increased
in subjects with average IQ compared with those with high scores, indicating
that risk is spread across the whole IQ range.
Lower IQ score was associated with increased risk for schizophrenia,
severe depression, and other nonaffective psychoses, but not bipolar disorder.
This finding indicates that at least some aspects of the neurodevelopmental
etiology of bipolar disorder may differ from these other disorders.