Artistic studies may predict future psychiatric disorders

Naveed Saleh, MD, MS, for MDLinx | July 02, 2018

Students focusing on artistically creative curricula at university are at greater risk for later hospitalization secondary to schizophrenia, bipolar disorder, and unipolar depression, even after sensitivity analyses, according to a new study published in The British Journal of Psychiatry.

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The associations for all three disorders became stronger when the authors used the narrower definition of artistic subjects.

“The notion that mental disorders are associated with enhanced creativity, intelligence, or artistic talent is one of the oldest in psychiatry,” wrote the authors, led by James H. MacCabe, PhD, Institute of Psychiatry, Psychology and Neuroscience, Kings College London, England.

Previous research indicates that certain aspects of intelligence or creativity are potentially linked to bipolar disorder, as well as schizophrenia, and that genetics may play a role in this relationship. In the current population-based study, the researchers aimed to test the hypothesis that creativity is significantly linked to severe mental illness by looking at artistic studies in university, a time that usually precedes the clinical manifestation of such psychoses.

Dr. MacCabe and colleagues designed a case-control study using Swedish population registries, with the exposure defined “as having completed a course of study in an artistically creative subject at university or gymnasieskola (upper secondary school).” 

The team looked at the associations between artistic education and inpatient hospitalization due to schizophrenia (n=20,333), bipolar disorder (n=28,293), and unipolar depression (n=148,365). They also considered a negative exposure (ie, studying for a law degree) and a negative outcome (ie, diabetes).

They performed logistic regression and calculated odds ratios (OR) reflecting exposure and outcome. Finally, the researchers controlled for confounding factors including creativity, educational attainment, and IQ (men only), and considered sibling pairs, or familial factors, in a separate sub-analysis.

Results showed that patients who studied art in a tertiary-education setting demonstrated an increased probability of developing schizophrenia (OR=1.90; 95% CI=1.69-2.12); bipolar disorder (OR=1.62; 95% CI=1.50-1.75); and unipolar depression (OR= 1.39; 95% CI=1.34-1.44).

“We found a moderate association between studying broadly defined artistic subjects and risk for bipolar disorder and unipolar depression,” the researchers wrote. “The association with schizophrenia was of borderline significance. The associations for all three disorders became stronger when we used the narrower definition of artistic subjects.”

These results held when confounding factors, such as age, gender, educational attainment, or IQ, were accounted for; however, the associations slightly lessened on paired-sibling analysis. As expected, diabetes, or the control outcome, was not associated with artistic study. Moreover, the study of law or jurisprudence appeared to protect against severe mental illness.

Of interest, the researchers found that association between studying the visual arts was more strongly associated with severe mental illness than was studying the performing arts.

Dr. MacCabe and co-authors cited certain limitations of their work. First, the concept of creativity is nuanced and hard to pinpoint at a population level. In addition, reverse causation could play a role in this study, with subclinical symptoms of mental illness influencing choice of artistic study in students. Finally, other covariates such as drug misuse could have interfered with results.

“Students of artistic subjects at university are at increased risk of developing schizophrenia, bipolar disorder and unipolar depression in adulthood,” the researchers concluded.

To read more about this study, click here. 

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