Can excellent school performance be a precursor of schizophrenia?: A 28-year follow-up in the Northern Finland 1966 birth cohort

Objective: Poor scholastic performance is known to pre-date adult schizophrenia. We studied the 1966 North Finland general population birth cohort (n = 11017) in order to determine whether excellent school performance was a risk or protective factor. Method: Data on school marks at the age of 16 years were linked to data on psychiatric morbidity. Tn total, 89 subjects (58 boys) developed DSM-III-R schizophrenia between the ages of 16 and 28 years. Results: Six (115) of the pre-schizophrenic boys (6/54) had excellent mean school marks, compared to only 3% (166/5245) of the comparison group (OR 3.8. 95% CI 1.6-9.3, adjusted for parental social class, place of residence and birth order). Conclusion: These results may be a chance phenomenon and require replication. However, adult schizophrenia may be linked to excellent school performance. This result may be relevant both to the preservation of schizophrenia in the population, and to mechanisms of developing schizophrenia.