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2015 ; 172
(3
): 259-65
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IQ and schizophrenia in a Swedish national sample: their causal relationship and
the interaction of IQ with genetic risk
#MMPMID25727538
Kendler KS
; Ohlsson H
; Sundquist J
; Sundquist K
Am J Psychiatry
2015[Mar]; 172
(3
): 259-65
PMID25727538
show ga
OBJECTIVE: The authors sought to clarify the relationship between IQ and
subsequent risk for schizophrenia. METHOD: IQ was assessed at ages 18-20 in
1,204,983 Swedish males born between 1951 and 1975. Schizophrenia was assessed by
hospital diagnosis through 2010. Cox proportional hazards models were used to
investigate future risk for schizophrenia in individuals as a function of their
IQ score, and then stratified models using pairs of relatives were used to adjust
for familial cluster. Finally, regression models were used to examine the
interaction between IQ and genetic liability on risk for schizophrenia. RESULTS:
IQ had a monotonic relationship with schizophrenia risk across the IQ range, with
a mean increase in risk of 3.8% per 1-point decrease in IQ; this association was
stronger in the lower than the higher IQ range. Co-relative control analyses
showed a similar association between IQ and schizophrenia in the general
population and in cousin, half-sibling, and full-sibling pairs. A robust
interaction was seen between genetic liability to schizophrenia and IQ in
predicting schizophrenia risk. Genetic susceptibility for schizophrenia had a
much stronger impact on risk of illness for those with low than high
intelligence. The IQ-genetic liability interaction arose largely from IQ
differences between close relatives. CONCLUSIONS: IQ assessed in late adolescence
is a robust risk factor for subsequent onset of schizophrenia. This association
is not the result of a declining IQ associated with insidious onset. In this
large, representative sample, we found no evidence for a link between genius and
schizophrenia. Co-relative control analyses showed that the association between
lower IQ and schizophrenia is not the result of shared familial risk factors and
may be causal. The strongest effect was seen with IQ differences within families.
High intelligence substantially attenuates the impact of genetic liability on the
risk for schizophrenia.