Skip to main content Accessibility help

School success in childhood and subsequent prodromal symptoms and psychoses in the Northern Finland Birth Cohort 1986

  • M. Lassila (a1) (a2), T. Nordström (a1) (a2), T. Hurtig (a3) (a4) (a5), P. Mäki (a2) (a3) (a6) (a7) (a8), E. Jääskeläinen (a1) (a2) (a6), E. Oinas (a1) and J. Miettunen (a1) (a2)...



Low IQ is a risk factor for psychosis, but the effect of high IQ is more controversial. The aim was to explore the association of childhood school success with prodromal symptoms in adolescence and psychoses in adulthood.


In the general population-based Northern Finland Birth Cohort 1986 (n = 8 229), we studied the relationship between teacher-assessed learning deficits, special talents and general school success at age 8 years and both prodromal symptoms (PROD-screen) at age 15–16 years and the occurrence of psychoses by age 30 years.


More prodromal symptoms were experienced by those talented in oral presentation [boys: adjusted odds ratio (OR) 1.49; 95% confidence interval 1.14–1.96; girls: 1.23; 1.00–1.52] or drawing (boys: 1.44; 1.10–1.87). Conversely, being talented in athletics decreased the probability of psychotic-like symptoms (boys: OR 0.72; 0.58–0.90). School success below average predicted less prodromal symptoms with boys (OR 0.68; 0.48–0.97), whereas above-average success predicted more prodromal symptoms with girls (OR 1.22; 1.03–1.44). The occurrence of psychoses was not affected. Learning deficits did not associate with prodromal symptoms or psychoses.


Learning deficits in childhood did not increase the risk of prodromal symptoms in adolescence or later psychosis in this large birth cohort. Learning deficits are not always associated with increased risk of psychosis, which might be due to, e.g. special support given in schools. The higher prevalence of prodromal symptoms in talented children may reflect a different kind of relationship of school success with prodromal symptoms compared to full psychoses.


Corresponding author

Author for correspondence: M. Lassila, E-mail:


Hide All
Agnew-Blais, J, Seidman, LJ, Fitzmaurice, GM, Smoller, JW, Goldstein, JM and Buka, SL (2017) The interplay of childhood behavior problems and IQ in the development of later schizophrenia and affective psychoses. Schizophrenia Research 184, 4551.
Alaräisänen, A, Miettunen, J, Lauronen, E, Räsänen, P and Isohanni, M (2006) Good school performance is a risk factor of suicide in psychoses: a 35-year follow up of the Northern Finland 1966 Birth Cohort. Acta Psychiatrica Scandinavica 114, 357362.
Andreasen, NC (1987) Creativity and mental illness: prevalence rates in writers and their first-degree relatives. The American Journal of Psychiatry 144, 12881292.
Barajas, A, Ochoa, S, Obiols, JE and Lalucat-Jo, L (2015) Gender differences in individuals at high-risk of psychosis: a comprehensive literature review. The Scientific World Journal 2015, 430735.
Baruch, I, Hemsley, DR and Gray, JA (1988) Differential performance of acute and chronic schizophrenics in a latent inhibition task. The Journal of Nervous and Mental Disease 176, 598606.
Bracken, BA and Brown, EF (2006) Behavioral identification and assessment of gifted and talented students. Journal of Psychoeducational Assessment 24, 112122.
Carson, SH (2011) Creativity and psychopathology: a shared vulnerability model. Canadian Journal of Psychiatry. Revue Canadienne De Psychiatrie 56, 144153.
Chen, F, Wang, L, Heeramun-Aubeeluck, A, Wang, J, Shi, J, Yuan, J and Zhao, X (2014) Identification and characterization of college students with attenuated psychosis syndrome in China. Psychiatry Research 216, 346350.
David, AS, Malmberg, A, Brandt, L, Allebeck, P and Lewis, G (1997) IQ and risk for schizophrenia: a population-based cohort study. Psychological Medicine 27, 13111323.
Davidson, M, Reichenberg, A, Rabinowitz, J, Weiser, M, Kaplan, Z and Mark, M (1999) Behavioral and intellectual markers for schizophrenia in apparently healthy male adolescents. The American Journal of Psychiatry 156, 13281335.
Di Prinzio, P, Morgan, VA, Björk, J, Croft, M, Lin, A, Jablensky, A and McNeil, TF (2018) Intellectual disability and psychotic disorders in children: association with maternal severe mental illness and exposure to obstetric complications in a whole-population cohort. American Journal of Psychiatry 175, 12321242.
Enns, MW, Larsen, DK and Cox, BJ (2000) Discrepancies between self and observer ratings of depression. The relationship to demographic, clinical and personality variables. Journal of Affective Disorders 60, 3341.
Filatova, S, Koivumaa-Honkanen, H, Khandaker, GM, Lowry, E, Nordström, T, Hurtig, T, Moilanen, K and Miettunen, J (2018) Early motor developmental milestones and schizotypy in the Northern Finland Birth Cohort Study 1966. Schizophrenia Bulletin 44, 11511158.
Frissen, A, Lieverse, R, Marcelis, M, Drukker, M and Delespaul, P and GROUP Investigators (2015) Psychotic disorder and educational achievement: a family-based analysis. Social Psychiatry and Psychiatric Epidemiology 50, 15111518.
Fuller, R, Nopoulos, P, Arndt, and , S, O'Leary, D, Ho, BC and Andreasen, NC (2002) Longitudinal assessment of premorbid cognitive functioning in patients with schizophrenia through examination of standardized scholastic test performance. The American Journal of Psychiatry 159, 11831189.
Griffiths, A, Kouvonen, A, Pentti, J, Oksanen, T, Virtanen, M, Salo, P, Väänänen, A, Kivimäki, M and Vahtera, J (2014) Association of physical activity with future mental health in older, mid-life and younger women. European Journal of Public Health 24, 813818.
Heinimaa, M, Salokangas, RK, Ristkari, T, Plathin, M, Huttunen, J, Ilonen, T, Suomela, T, Korkeila, J and McGlashan, TH (2003) PROD-screen – a screen for prodromal symptoms of psychosis. International Journal of Methods in Psychiatric Research 12, 92104.
Helling, I, Ohman, A and Hultman, CM (2003) School achievements and schizophrenia: a case-control study. Acta Psychiatrica Scandinavica 108, 381386.
Higier, RG, Jimenez, AM, Hultman, CM, Borg, J, Roman, C, Kizling, I, Larsson, H and Cannon, TD (2014) Enhanced neurocognitive functioning and positive temperament in twins discordant for bipolar disorder. The American Journal of Psychiatry 171, 11911198.
Horwood, J, Salvi, G, Thomas, K, Duffy, L, Gunnell, D, Hollis, C, Lewis, G, Menezes, P, Thompson, A, Wolke, D, Zammit, S and Harrison, G (2008) IQ and non-clinical psychotic symptoms in 12-year-olds: results from the ALSPAC birth cohort. The British Journal of Psychiatry: The Journal of Mental Science 193, 185191.
Hui, CL, Leung, CM, Chang, WC, Chan, SK, Lee, EH and Chen, EY (2016) Examining gender difference in adult-onset psychosis in Hong Kong. Early Intervention in Psychiatry 10, 324333.
Isohanni, I, Järvelin, MR, Jones, P, Jokelainen, J and Isohanni, M (1999) Can excellent school performance be a precursor of schizophrenia? A 28-year follow-up in the Northern Finland 1966 Birth Cohort. Acta Psychiatrica Scandinavica 100, 1726.
Jääskeläinen, E, Juola, T, Korpela, H, Lehtiniemi, H, Nietola, M, Korkeila, J and Miettunen, J (2017) Epidemiology of psychotic depression - systematic review and meta-analysis. Psychological Medicine 48, 905918.
Jacobson, JW (1990) Do some mental disorders occur less frequently among persons with mental retardation? American Journal of Mental Retardation 94, 596602.
Jamison, KR (1989) Mood disorders and patterns of creativity in British writers and artists. Psychiatry 52, 125134.
Järvelin, MR, Hartikainen-Sorri, AL and Rantakallio, P (1993) Labour induction policy in hospitals of different levels of specialisation. British Journal of Obstetrics and Gynaecology 100, 310315.
Khandaker, GM, Barnett, JH, White, IR and Jones, PB (2011) A quantitative meta-analysis of population-based studies of premorbid intelligence and schizophrenia. Schizophrenia Research 132, 220227.
Koivukangas, J, Tammelin, T, Kaakinen, M, Mäki, P, Moilanen, I, Taanila, A and Veijola, J (2010) Physical activity and fitness in adolescents at risk for psychosis within the Northern Finland 1986 Birth Cohort. Schizophrenia Research 116, 152158.
Keskinen, E, Marttila, A, Marttila, R, Jones, PB, Murray, GK, Moilanen, K, Koivumaa-Honkanen, H, Mäki, P, Isohanni, M, Jääskeläinen, E and Miettunen, J (2015) Interaction between parental psychosis and early motor development and the risk of schizophrenia in a general population birth cohort. European Psychiatry 30, 719727.
Kremen, WS, Buka, SL, Seidman, LJ, Goldstein, JM, Koren, D and Tsuang, MT (1998) IQ decline during childhood and adult psychotic symptoms in a community sample: a 19-year longitudinal study. The American Journal of Psychiatry 155, 672677.
Kyaga, S, Lichtenstein, P, Boman, M, Hultman, C, Långström, N and Landen, M (2011) Creativity and mental disorder: family study of 300000 people with severe mental disorder. The British Journal of Psychiatry 199, 373379.
Laurens, KR, Luo, L, Matheson, SL, Carr, VJ, Raudino, A, Harris, F and Green, MJ (2015) Common or distinct pathways to psychosis? A systematic review of evidence from prospective studies for developmental risk factors and antecedents of the schizophrenia spectrum disorders and affective psychoses. BMC Psychiatry 15, 205.
MacCabe, JH, Lambe, MP, Cnattingius, S, Torrång, A, Björk, C, Sham, PC, David, AS, Murray, RM and Hultman, CM (2008) Scholastic achievement at age 16 and risk of schizophrenia and other psychoses: a national cohort study. Psychological Medicine 38, 11331140.
MacCabe, JH, Lambe, MP, Cnattingius, S, Sham, PC, David, AS, Reichenberg, A, Murray, RM and Hultman, CM (2010) Excellent school performance at age 16 and risk of adult bipolar disorder: national cohort study. The British Journal of Psychiatry 196, 109115.
MacCabe, JH, Sariaslan, A, Almqvist, C, Lichtenstein, P, Larsson, H and Kyaga, S (2018) Artistic creativity and risk for schizophrenia, bipolar disorder and unipolar depression: a Swedish population-based case-control study and sib-pair analysis. The British Journal of Psychiatry 212, 370376.
Mäki, P, Koskela, S, Murray, GK, Nordström, T, Miettunen, J, Jääskeläinen, E and Veijola, JM (2014) Difficulty in making contact with others and social withdrawal as early signs of psychosis in adolescents – the Northern Finland Birth Cohort 1986. European Psychiatry 29, 345351.
Matheson, SL, Shepherd, AM, Laurens, KR and Carr, VJ (2011) A systematic meta-review grading the evidence for non-genetic risk factors and putative antecedents of schizophrenia. Schizophrenia Research 133, 133142.
Mullola, S, Ravaja, N, Lipsanen, J, Alatupa, S, Hintsanen, M, Jokela, M and Keltikangas-Järvinen, L (2012) Gender differences in teachers’ perceptions of students’ temperament, educational competence, and teachability. The British Journal of Educational Psychology 82(Pt 2), 185206.
Munro, JC, Russell, AJ, Murray, RM, Kerwin, RW and Jones, PB (2002) IQ in childhood psychiatric attendees predicts outcome of later schizophrenia at 21 year follow-up. Acta Psychiatrica Scandinavica 106, 139142.
Myrbakk, E and von Tetzchner, S (2008) Psychiatric disorders and behavior problems in people with intellectual disability. Research in Developmental Disabilities 29, 316332.
Nelson, B and Rawlings, D (2010) Relating schizotypy and personality to the phenomenology of creativity. Schizophrenia Bulletin 36, 388399.
Nordentoft, M (2007) Prevention of suicide and attempted suicide in Denmark. Epidemiological studies of suicide and intervention studies in selected risk groups. Danish Medical Bulletin 54, 306369.
Paus, T, Keshavan, M and Giedd, JN (2008) Why do many psychiatric disorders emerge during adolescence? Nature Reviews Neuroscience 9, 947957.
Richards, R (2001) Creativity and the schizophrenia spectrum: more and more interesting. Creativity Research Journal 13, 111132.
Schulz, J, Sundin, J, Leask, S and Done, DJ (2014) Risk of adult schizophrenia and its relationship to childhood IQ in the 1958 British birth cohort. Schizophrenia Bulletin 40, 143151.
Ström, K and Hannus-Gullmets, B (2015) From special (class) teacher to special educator – the Finnish case. In Cameron, DL and Thygesen, R (eds), Transitions in the Field of Special Education. Theoretical Perspectives and Implications for Practice. Münster: Waxmann, pp. 115134.
Sussmann, JE, McIntosh, AM, Lawrie, SM and Johnstone, EC (2009) Obstetric complications and mild to moderate intellectual disability. The British Journal of Psychiatry 194, 224228.
Taanila, A, Ebeling, H, Kotimaa, A, Moilanen, I and Järvelin, MR (2004) Is a large family a protective factor against behavioural and emotional problems at the age of 8 years? Acta Paediatrica 93, 508517.
Therman, S, Heinimaa, M, Miettunen, J, Joukamaa, M, Moilanen, I, Mäki, P and Veijola, J (2011) Symptoms associated with psychosis risk in an adolescent birth cohort: improving questionnaire utility with a multidimensional approach. Early Intervention in Psychiatry 5, 343348.
van der Werf, M, Hanssen, M, Köhler, S, Verkaaik, M, Verhey, FR, RISE Investigators, van Winkel, R, van Os, J and Allardyce, J (2014) Systematic review and collaborative recalculation of 133693 incident cases of schizophrenia. Psychological Medicine 44, 916.
Verdoux, H and van Os, J (2002) Psychotic symptoms in non-clinical populations and the continuum of psychosis. Schizophrenia Research 54, 5965.
Walker, NP, McConville, PM, Hunter, D, Deary, IJ and Whalley, LJ (2002) Childhood mental ability and lifetime psychiatric contact: a 66-year follow-up study of the 1932 Scottish mental ability survey. Intelligence 30, 233245.
Wiles, NJ, Jones, GT, Haase, AM, Lawlor, DA, Macfarlane, GJ and Lewis, G (2008) Physical activity and emotional problems amongst adolescents: a longitudinal study. Social Psychiatry and Psychiatric Epidemiology 43, 765772.
Zammit, S, Allebeck, P, David, AS, Dalman, C, Hemmingsson, T, Lundberg, I and Lewis, G (2004) A longitudinal study of premorbid IQ Score and risk of developing schizophrenia, bipolar disorder, severe depression, and other nonaffective psychoses. Archives of General Psychiatry 61, 354360.


Type Description Title
Supplementary materials

Lassila et al. supplementary material
Tables S1-S2

 Word (19 KB)
19 KB

School success in childhood and subsequent prodromal symptoms and psychoses in the Northern Finland Birth Cohort 1986

  • M. Lassila (a1) (a2), T. Nordström (a1) (a2), T. Hurtig (a3) (a4) (a5), P. Mäki (a2) (a3) (a6) (a7) (a8), E. Jääskeläinen (a1) (a2) (a6), E. Oinas (a1) and J. Miettunen (a1) (a2)...


Altmetric attention score

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed