Mental Illness And Creativity Revisited

By Neuroskeptic | October 11, 2011 6:51 am

A new study offers support for the theory that mental illness is associated with “creative” achievement.

The idea that madness is close to creative genius is a popular one. From the nutty professor to the tortured genius, there’s no end of sterotypes, and pop culture seemingly offers plenty of examples, from Van Gogh and his ear to Charlie Sheen and his bi-winning.

But is it true?

A new study says yes. Kyaga et al looked at everyone in Sweden who had been treated as an inpatient for either schizophrenia, bipolar disorder, or depression, between 1973 and 2003. In total that meant about 300,000 people (two thirds of that was depression).

They then matched this up with the Swedish national census which asks people their occupation. They looked to see whether the psychiatric cases were more likely to have been employed in a “creative” profession. They defined that as visual artists (photographers, designers, etc.) non-visual artists (musicians, actors, authors) and academics (university teachers).

Finally, they pulled up the records on the patients’ relatives, to see what their jobs were. This is one of those studies that could only happen in Scandinavia, because only those countries keep such comprehensive ( rather scarily so) info about their citizens.

They found that being bipolar, or being a close relative of someone who’s bipolar, was associated with having a creative job. For schizophrenia, the picture was more complex: being a schizophrenia inpatient was not linked to being a creative in itself, but being related to someone with schizophrenia was. The effects were fairly modest.

For depression (not bipolar, just plain unipolar depression), there was no link at all, or even a slightly lower level.

The correlation wasn’t driven by differences in IQ (yes, they had data on that too, for males, thanks to military service records.) Creative types had higher IQs on average while psych inpatients had slightly lower IQs than others. So correcting for IQ made the associations even stronger.

So it looks as though being bipolar, at any rate, is linked to creativity, and so is having bipolar and schizophrenia in the family – if you believe these findings. Should we?

This study was huge and the data are, on the face of it, very comprehensive. However, it turns out that many people didn’t state their occupation, especially the patients. Only 45% of people with schizophrenia gave a valid answer, compared to 75% of the bipolar and depressed. In the controls, it was about 80%.

That’s a serious issue. The authors did try to get around this by looking at the siblings of the patients with missing data. For schizophrenia, siblings of missing data schizophrenics were more creative than for the ones with full data, and for bipolar there was no difference. So the effects are not due to nonreporting of non-creative jobs.

Another possible confound is family background and environment. Indeed, the fact that people with bipolar were no more likely to be in a creative job than their relatives who weren’t bipolar (or, at least, never received inpatient treatment) rather supports this view. Maybe the relatives shared genes with the patients meaning that their creativity was associated with bipolar, but we can’t know that.

One reassuring piece of evidence against the idea that these results were driven by a general correlation between psychiatric hospitalization and “middle class professions” is that there was no association with the “non-creative” job of accountancy and auditing (sorry accountants and auditors).

Overall, while this is an interesting study, and while I find the proposed link between mental illness and creativity plausible, we need more detailed research to ensure that the correlation isn’t just a reflection of socioeconomic factors.

ResearchBlogging.orgKyaga, S., Lichtenstein, P., Boman, M., Hultman, C., Langstrom, N. Landen, M. (2011). Creativity and mental disorder: family study of 300 000 people with severe mental disorder The British Journal of Psychiatry DOI: 10.1192/bjp.bp.110.085316

CATEGORIZED UNDER: mental health, papers, schizophrenia
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  • http://twitter.com/#!/literarti Angela

    Fascinating post, as always, but I'm troubled by the ways in which 'creativity' itself is defined in this kind of research. It's interesting they included academics – but surely artists and academics don't have a monopoly on creativity?

    There's a terrific collection of essays edited by Louis Sass and David Schuldberg exploring some of these issues further: “Creativity in the Schizophrenia Spectrum: A Special Issue of the Creativity Research Journal,” (Creativity Research Journal Volume 13, Number 1, 2001) http://www.tandfonline.com/toc/hcrj20/13/1

  • http://www.blogger.com/profile/17108271846135929803 Nervous Neuron

    Did they correct for unemployment rates or was it recorded as a 'non creative' job? It could be that schizophrenics have a higher rate of unemployment than the bipolars.

  • http://www.blogger.com/profile/06647064768789308157 Neuroskeptic

    Angela: Agreed. I think in this dataset, occupation was the only way of measuring creativity, clearly it's an inexact proxy.

    NN: Good point. The authors say “Individuals without
    information on occupation (including those reporting no
    occupation or unspecified occupation) were excluded from the
    analyses.”

    This might tend to increase the proportion of creative jobs amongst the people with a job, if you assume that the unemployed people “would have had” a non-creative job if they did have one, so the number of noncreative jobs was reduced, so it is a confound…

  • http://www.blogger.com/profile/03994169558252043919 Tiel Aisha Ansari

    I'd call occupation a poor proxy for creativity. It's damn difficult to earn a living as an artist, at least in the US. Plenty of practicing artists have “day” jobs, even if part-time or temporary. It would be interesting to see how the results would differe if subjects were asked to self-identify as artists, separate from their occupation.

  • http://www.blogger.com/profile/18036252084351183448 Oats

    I believe that on average, Schizophrenic Patients have more unemployment than Bipolar Patients. However, Bipolar patients have a higher unemployment rate than typical people. Would like to know how they accounted for this though.

    @Tiel, it is difficult earning as an artist. This is equally true for both typical and bipolar or schizophrenic patients. The job market won't be any easier for someone with mental illness.

    This is not a new topic of discussion. It has been around for a while, and promoted with Kay Redfield Jamison's book Touched With Fire. What is new is that they have numbers to actually show that this is a trend and not just something psychologists are making up.

    Obviously you can't get all the details of a scientific paper from a news article or blog, so I think it would be nice to link to a site where someone could purchase a copy of the original paper.

    I'm glad they did this. Concrete evidence to support the theories. :)

  • http://www.blogger.com/profile/09558506776197746442 BrianW

    Couldn't it also be that mental illness makes one particularly ill-suited for a non-creative job, while having more modest effects (in either direction) on ability to carry out a creative job?

  • http://www.blogger.com/profile/00727402494799099736 katiedid

    Have there been any large meta-analysis (Cochrane collaboration, for instance) on this topic? There have been papers showing correlations with such varied jobs that I find any of it hard to believe. For example, I've read about creative jobs from mathematics to professional artist. I think people like to romanticize mental illness and really want the link to be there but I have a very hard time believing that it is.

  • http://talentdevelop.com Douglas Eby

    Research on supposed “links” between mental illness and creativity is a fascinating topic. But very complex. Dr. Scott Barry Kaufman, for example, notes a link between schizotypy and creative achievement.
    See my post Creative Thinking and Schizophrenia.
    http://blogs.psychcentral.com/creative-mind/2010/07/creative-thinking-and-schizophrenia/

    Dr. Judith Schlesinger writes: “There’s still no concrete, empirical proof that highly creative people are any more likely to be mood-disordered than any other group.”
    From my post Madness and creativity: do we need to be crazy?
    http://talentdevelop.com/3423/madness-and-creativity-do-we-need-to-be-crazy/

  • http://www.blogger.com/profile/09036341287285545932 Retriever

    I'd agree that occupation is a pretty unreliable method of assessing creativity, especially in this economy, and especially in the population of people who either have suffered mental difficulties or who have relatives with them. This is for the following reasons:
    –work in the arts is notoriously hard to find (especially with health insurance in the US) so most people with chronic health conditions know that they have to find a day job.
    –people with even well managed bipolar disorder know that their illness will come and go repeatedly . If one is working at a dreary, NON creative job, one can often continue working despite flights of mood, or have coworkers cover for one. If one has a highly responsible or creative job, on the other hand, one can fail and be fired when the depression hits and one becomes uninspired. Data entry can be done even when one is near catatonic…
    –also, people with wildly ill relatives often find it easier to take non-creative jobs that are “beneath” them or less than their potential because so much of their emotional and physical energy is taken up with the insanity at home. If one is staying up all night with a manic child, one finds it difficult running a department by day or writing brilliant lesson plans, etc. Mental illness sucks the life out of the family caregivers (when relatives of mine in the UK were looking after a bipolar quadraplegic relative, they got household help, nurse's aids, respite care, etc. But in the US, families get nothing).

    ALso, as others here have noted, it's very difficult for a person (however brilliant and skilled) to stay constantly employed if they become periodically manic or psychotic or suicidally depressed. At least in the US, one loses one's job (and with it, one's health insurance) if this happens more than once or twice. After that, the path to downward professional mobility begins.

    IMHO, one prudent strategy for a non-celebrity in America if they are mentally ill is to hide their mental illness and try to hold onto ANY job they can find with health insurance that will give them decent care and access to a prescription plan. Increasingly, this means trying to work for the government, as private companies will fire people who use too many insurance benefits or have expensive conditions (or whose relatives do).

    When my spouse was working for a small firm, he was told that their insurance underwriters had said they would double the company's annual insurance rates because they had noticed the diagnostic codes on our son's clinic visit (PDD/ Asperger's). So the firm told my spouse that they could not keep him on the regular staff (with benefits) but had to make him a consultant (with no benefits) so that their insurance rates would not go up. This was the reason that I have worked in a very non-creative job–with benefits– these last 15 years…

    One should look at what people love and how they express themselves and how they define themselves, not how they earn a living..An awful lot of famous writers, for example, have had day jobs. William Carlos Williams and T.S. Eliot, for example. And nowadays, countless people like myself blog anonymously, sometimes with fairly large audiences, while their coworkers in the day job haven't a clue. People often have to hide their light under a bushel, especially given how often over-qualified people might threaten a boss if they knew they had written or photographed something that was widely circulated.

    Everyone in my family has either had bats in the belfry or watched the relatives who do for generations, but we are all moderately creative: writers, artists, photographers, dancers, athletes, preachers, public speakers, decorate, poets, entrepreneurs, research scientists, social workers, mathematicians, doctors, professors…

    And I am recommending the most INCREDIBLY BORING day jobs to the younger generation.

  • http://www.blogger.com/profile/02537151821869153861 Andrew Oh-Willeke

    One of the more interesting bit of psychometric literature I've seen on creativity and the creative professions (done by the Johnson O'Connor group) involved a number of different test regimes that were administered to determine if someone was “creative.” They then looked at the results to see which predicted success in a set of creative professions similar to the ones mentioned here.

    The test that provided the best fit was called “ideophoria” which was strictly a measure of how many ideas someone could produce in a period of time without any regard to their quality. Tests designed to capture originality were not nearly so predictive.

    Two other professions that they found were associated with high ideophoria, were sales (also, interestingly enough the profession with the weakest connection between success and IQ), and a “group influencing” profile shared by professions like teachers and politicians.

    If their models were accurate, the confound here may be in the academics, many of whom are group influencing creatives, but some of whom (accountants and astronmers, for example), might not be engaged in very creative enterprises at all.
    “This might tend to increase the proportion of creative jobs amongst the people with a job, if you assume that the unemployed people “would have had” a non-creative job if they did have one, so the number of noncreative jobs was reduced, so it is a confound…”

    I'm inclined to think that the opposite inference is more likely. The exclusion of unemployed schizophenics is probably suppressing rather than enhancing the creativity effect, since inpatient schizophrenics are probably typical of their close relatives but simply unable to hold down a job of any kind because they are institutions.

  • KS

    If this is the case it could be a (probably multigenic) example of heterozygote advantage, like that demonstrated in sickle cell anaemia, in which the heterozygous gene state confers a resistance to malaria, but the homozygous recessive state causes anemia. The same could be the case for creativity and schizophrenia or bipolar.

  • Anonymous

    Being an artist drives you mad.

  • Anonymous

    Found the post fascinating, for many reasons …not least, because before becoming an psychiatric nurse, my career was a “creative” one …and also, I happen to have a close member with schizophrenia.

    Excellent blog btw, very glad I found you :)

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Neuroskeptic is a British neuroscientist who takes a skeptical look at his own field, and beyond. His blog offers a look at the latest developments in neuroscience, psychiatry and psychology through a critical lens.

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