No full-text available
To read the full-text of this research,
you can request a copy directly from the authors.
Mental illness, suicide and creativity: 40-Year prospective total population study
... The STAI furthermore allows for a standardized interpretation taking into account inherent anxiety level differences in different populations (based on age, student status, etc.). In addition to anxiety tests, a battery of creativity tests which measure convergent and divergent thinking, including the Creativity Behavioral Inventory (CBI), Remote Associates Test (RAT), and Alternative Uses Task (AUT), were used to examine human creativity due to previous reports of the correlation between creativity and mental illness (Andreasen, 1987;Runco and Richards, 1997;Kyaga et al., 2011;Kyaga et al., 2012). The researchers analyzing the psychology data were different from those performing DNA analysis, to keep the information about SNP carriers blind to those analyzing psychological data. ...
... LYNX2 expression is not confined to the anxiety-related circuit, and thus some of the elevated anxiety phenotype could be amplified or blunted by effects from other regions or influence other processes that were not measured here. Another potential explanation for the lower percentage of carriers exhibiting low levels of anxiety diagnoses, could be rooted in the fact that this variant/alternate allele subpopulation also displays heightened scores used to measure human creativity, indicating a potential, previously suggested, association between creativity and anxiety (Kyaga et al., 2012). Studies show that creative outlets may be used to temporarily decrease anxiety supporting this potential correlation (Müller et al., 2008;King et al., 2013). ...
... This mouse model does, however, demonstrate heightened responses to a nAChR agonist in the prefrontal cortex, measured by EPSC rate, suggesting a physiological consequence and possible alterations in circuit function (Tekinay et al., 2009) and behaviors (Sherafat et al., 2021) outside the amygdala. Further characterization of the allele in humans has the potential to shed light on the neural processes enabling novel or creative thought and/or provide a biological explanation for the correlation between creative individuals and mental illness (Andreasen, 1987;Runco and Richards, 1997;Kyaga et al., 2011;Kyaga et al., 2012). ...
Introduction
Anxiety disorders are among the most common mental illnesses in the US. An estimated 31.1% of U.S. adults experience any anxiety disorder at some time in their lives. Understanding some of the molecular underpinnings of anxiety could lead to improved treatments over current strategies focusing on symptom relief rather than root causes. One significant neurotransmitter system exerting control over anxiety is the nicotinic receptor subdivision of the cholinergic system. The murine Lynx2 gene, encoding a protein modulator of nicotinic acetylcholine receptors, is expressed in anxiety-related neural circuitry in rodents and has been functionally associated with anxiety-like behavior.
Methods
We examined variations in the human LYNX2 (LYPD1) gene and their potential effects on anxiety levels in a cohort of 624 participants. Participants completed validated anxiety questionnaires (e.g., STICSA and STAI), which assessed both their current anxiety and their general tendency to experience anxiety. Possible functional alterations due to one such mutation was assessed through atomic force microscopy (AFM) and computational modeling.
Results
We identified a previously unreported single nucleotide polymorphism (SNP) in the mature protein-coding region of LYNX2 that was associated with significantly higher than normal anxiety scores. These elevated scores resembled those seen in patients clinically diagnosed with generalized anxiety disorder and panic disorder, although this genetically defined subpopulation did not typically report such diagnoses. Through computational modeling of the homopentameric α7 nicotinic receptor subtype and in vitro atomic force microscopy (AFM), we discovered that a specific LYNX2 SNP is linked to a reduced binding affinity between the LYNX2 protein and nAChRs, offering a potential functional explanation for the role that this mutation may play in anxiety.
Discussion
A polymorphism in LYNX2, which codes for an inhibitory modulator of nicotinic acetylcholine receptors, has the potential to lead to sensitized nicotinic receptor activity in anxiety-related circuits. The LYNX2 protein has been shown to bind to multiple nicotinic acetylcholine receptor subtypes, including α4β2, α7, and α3β4 subtypes, each of which have been shown to be involved in affective behaviors. This work suggests that a subpopulation of individuals harboring a deleterious mutation in LYNX2 may predispose them to anxiety through abnormal nicotinic receptor control. In the future, this work may lead to the development of a biomarker for anxiety or a diagnostic tool for the early detection of individuals with susceptibility to anxiety.
... A connection between creativity and mental disorders has been the subject of theoretical as well as empirical investigations 4 . Empirical studies and meta-analyses show the existence of discrepancies: some confirm a connection (with a variety of proposed causal mechanisms), while others refute this association (for an in-depth look into these discrepancies, see [5][6][7][8] ). This lack of consensus could be due to methodology issues. ...
... When addressing the association between mental disorders and creativity, initial studies focused on schizophrenia. More recently, a relationship has been found between creativity and bipolar disease and other mood disorders [5][6][7][8]14 . Therefore, some results claim creativity and psychopathology to be positively associated, others show no association, and others still show a negative association 8,9 . ...
... The inverted-U model may be the key to understanding why studies with clinical and non-clinical samples report different conclusions. Studies done with clinical samples frequently conclude that psychopathology and creativity are not related 5,68 , or even that these traits are negatively related 69 . But note that, in the inverted-U model, clinical samples are at the extreme end of the distribution and therefore, the expected creativity capacity is low because the harm from too many psychopathology symptoms overcomes the creativity capacity. ...
Creativity and mental disorders are sometimes seen as intertwined, but research is still unclear on whether, how much, and why. Here we explore the potential role of shared genetic factors behind creativity and symptoms of borderline personality disorder (BPD, characterized by mood swings and randomness of thoughts). Data were collected from 6745 twins (2378 complete pairs) by the Netherlands Twin Register on BPD scores (PAI-BOR questionnaire) and working in a creative profession (proxy for creativity). First, we tested whether there is an association between BPD symptoms and creative professions. Results confirmed that individuals scoring higher on the BPD spectrum are more likely to have a creative profession (Cohen’s d = 0.16). Next, we modeled how much of this association reflects underlying genetic and/or environmental correlations—by using a bivariate classical twin design. We found that creativity and BPD were each influenced by genetic factors (heritability = 0.45 for BPD and 0.67 for creativity) and that these traits are genetically correlated rG = 0.17. Environmental influences were not correlated. This is evidence for a common genetic mechanism between borderline personality scores and creativity which may reflect causal effects and shed light on mechanisms.
... not the case for all (European Expert Network on Culture and Audiovisual, EENCA, 2021). Economic uncertainty, exclusion from important arenas (Orian et al., 2017;Taylor and O′Brien, 2017;Wolff, 1981), and mental illness (Kyaga et al., 2013)-possibly all interrelated-are unfortunately still common among artists and cultural workers. ...
... Nevertheless, being left alone with doubts and fears about the quality and process of artistic work and lacking social networks might make people more vulnerable, and some researchers have explained the prevalence of mental health problems among, for instance, authors, and related this to the amount of lone work (Runco, 2007). Another explanation from Kyaga's (2013) research group found that authors, as a population, were overrepresented in diagnoses of schizophrenia and bipolar disorder, and argued that people with these diagnoses also risk ending up being excluded or alienated due to their problems; and therefore their isolation might not just be a consequence of their choice of profession, but they might not have had a choice of anything but self-employment from the start. This might be particularly true for authors in register studies, as Kyaga and his colleagues used to obtain data, in which not only those who made a living from their writing were included but all patients who self-identified as authors, including those who struggled to support themselves and possibly never would be let in through any gates (to publish). ...
... In psychological research, individual differences have been described between different professions in terms of personality as well as mental health issues, which may partly be explained by vulnerability factors in structures and working conditions. In fact, in comparison to other branches, the prevalence of certain specific mental health illnesses is higher in some creative professions (Andreasen, 1987;Kyaga et al., 2013;2011). In a large register study with over one million participants, Kyaga and colleagues (2013) found that creative professions-both artists and scientists-were more likely to have bipolar disorder (referring to a fluctuation between manic and depressive states) compared with the control group of mixed professions. ...
... For example, individuals with b ip ol ar disorder are overrepresented i n cr e a t ive o c c up a t ions, s u c h a s s c i en t i fic a n d a r t is tic f i e ld s 2 1 ,22 . T h i s association is also observed among their unaffected first-degree relatives 21,22 , suggesting that a heritable, disease-independent component drives this relationship. Supporting this hypothesis, a positive association was later confirmed between bipolar disorder PGS and membership in artistic societies or engagement in creative professions 23 . ...
... Our work further expands findings on the overlap in genetic correlations between psychiatric disorders, school performance and creativity 56 ; replicates and further extends the link between creativity and neuropsychiatric diagnoses 9,14,15,21,22 ; and identifies new associations between neuropsychiatric traits and broad employment categories. Importantly, at the individual level, our work shows that utilizing PGS of neuropsychiatric traits towards informing or predicting membership in a professional category does not hold much potential since PGS explain a very small part of the variance. ...
Polygenic scores (PGS) enable the exploration of pleiotropic effects and genomic dissection of complex traits. Here, in 421,889 individuals with European ancestry from the Million Veteran Program and UK Biobank, we examine how PGS of 17 neuropsychiatric traits are related to membership in 22 broad professional categories. Overall, we find statistically significant but weak (the highest odds ratio is 1.1 per PGS standard deviation) associations between most professional categories and genetic predisposition for at least one neuropsychiatric trait. Secondary analyses in UK Biobank revealed independence of these associations from observed fluid intelligence and sex-specific effects. By leveraging aggregate population trends, we identified patterns in the public interest, such as the mediating effect of education attainment on the association of attention-deficit/hyperactivity disorder PGS with multiple professional categories. However, at the individual level, PGS explained less than 0.5% of the variance of professional membership, and almost none after we adjusted for education and socio-economic status.
... Using the stringent search terms outlined above, a systematic literature search retrieved 29 database records (Figure 1). After excluding a double entry, as well as reports that did not meet inclusion criteria based on the title and abstract, a full-text review was performed on the six remaining articles to determine their eligibility [20][21][22][23][24][25]. Four of these six articles were excluded, after the full-text review, for the following reasons: Two papers did not provide detailed timelines linking disease progression and creativity on a case-by-case basis [23,24]. ...
... After excluding a double entry, as well as reports that did not meet inclusion criteria based on the title and abstract, a full-text review was performed on the six remaining articles to determine their eligibility [20][21][22][23][24][25]. Four of these six articles were excluded, after the full-text review, for the following reasons: Two papers did not provide detailed timelines linking disease progression and creativity on a case-by-case basis [23,24]. The other two papers dealt with the creative work of well-known individuals and public figures but only in two non-visual domains, i.e., writing [21] and music/poetry writing [22]. ...
Creativity and the production of artwork can have an impact on the course and treatment of comorbid severe mental illness and neurodegeneration. We report on a 70-year-old male patient with highly original artistic behavior, who suffered from lifelong recurrent major depression and subsequently developed symptoms of progressive bulbar palsy (PBP). In the context of a systematic literature review, we detail the patient’s personal and artistic biographies and portray artwork from his artistic portfolio together with his disease history, clinical examination, psychopathological and neuropsychological evaluations, blood and cerebrospinal fluid analyses, neuroimaging, neurophysiological testing, and psychotherapeutic treatment. The patient’s 1–2-year history of primarily bulbar motor symptoms and signs aligned with electromyography, showing widespread signs of continuing denervation/chronic neurogenic changes. Slight impairments in semantic fluency, executive control, and visuoconstructive abilities were observed in neuropsychological testing, in conjunction with right-sided medial temporal lobe atrophy in an MRI. He was prescribed medication, including extended-release venlafaxine, trazodone, pramipexole, and zolpidem, and took his medication regularly, usually at high doses. For most of his life, the patient had attributed professional “success” and artistic output to, at times, excessive alcohol consumption. Later, however, his interest in creative work continued despite alcohol reduction and cessation. Psychotherapy grounded him in reality via goal-centered behaviors, making him realize that his physical and mental ailments rather hindered his creative output. In summary, creative behavior can be utilized in the treatment of patients with psychiatric conditions (affective or addictive disorders) and/or neurodegenerative diseases. In the reported case, specific psychopharmacology and psychotherapy that address goal-directed self-efficacy experiences of reality were critical to the patient’s treatment.
... Scientific creativity. Prior research has also identified scientific occupations as creative occupations 8,71 , because scientists are required to generate innovative and useful ideas in conducting academic research. Such scientific occupations are not limited to those in natural and biological sciences, but also include those in social sciences, engineering, and mathematics. ...
... To ensure the reliability and validity of our coding, we developed a coding scheme based on previous literature that defined four occupation groups 8,69,71 . Two independent raters coded all the occupations by carefully reviewing the structure of U.K. SOC 2000, the U.S. O*NET and SOC systems, and the detailed descriptions of the tasks and duties of each occupation described in the occupation classification systems, as well as the crosscountry crosswalk on the basis of International Labor Organization's International Standard Classification of Occupations (ISCO-88 and ISCO-08) to ensure accuracy and reliability of the coding results. ...
Creativity is one defining characteristic of human species. There have been mixed findings on how creativity relates to well-being, and little is known about its relationship with career success. We conduct a large-scale genome-wide association study to examine the genetic architecture of occupational creativity, and its genetic correlations with well-being and career success. The SNP-h² estimates range from 0.08 (for managerial creativity) to 0.22 (for artistic creativity). We record positive genetic correlations between occupational creativity with autism, and positive traits and well-being variables (e.g., physical height, and low levels of neuroticism, BMI, and non-cancer illness). While creativity share positive genetic overlaps with indicators of high career success (i.e., income, occupational status, and job satisfaction), it also has a positive genetic correlation with age at first birth and a negative genetic correlation with number of children, indicating creativity-related genes may reduce reproductive success.
... The idea that mental illness and artistic creativity may be linked together dates back to ancient times, but to date no academic consensus has been reached on this topic. Epidemiological, population-based studies suggest that people with bipolar disorder and their family members are over-represented in creative professions such as science and the arts (1)(2)(3), and the other way around: persons with creative occupations (2) and relatives of persons in creative occupations (4), have significantly increased risk of suffering from, amongst others, schizophrenia and bipolar disorder. Psychometric, clinical, neuroscientific and genetic research further suggests a correlation between (the likelihood of having) a bipolar or psychotic disorders and (heightened levels of) creativity or being involved in creative occupations (5)(6)(7)(8)(9)(10)(11)(12). ...
... The idea that mental illness and artistic creativity may be linked together dates back to ancient times, but to date no academic consensus has been reached on this topic. Epidemiological, population-based studies suggest that people with bipolar disorder and their family members are over-represented in creative professions such as science and the arts (1)(2)(3), and the other way around: persons with creative occupations (2) and relatives of persons in creative occupations (4), have significantly increased risk of suffering from, amongst others, schizophrenia and bipolar disorder. Psychometric, clinical, neuroscientific and genetic research further suggests a correlation between (the likelihood of having) a bipolar or psychotic disorders and (heightened levels of) creativity or being involved in creative occupations (5)(6)(7)(8)(9)(10)(11)(12). ...
Aim
To explore the self-perceived relationships between experiences of creativity and mental illness and to understand the meanings behind these relationships.
Background
The idea that mental illness and artistic creativity are somehow related dates back to ancient times. There is some evidence for an actual correlation, but many questions remain unanswered on the nature and direction of the relationship. Qualitative contributions to the debate are scarce, and mainly focus on the potential benefits of participation in the arts for people with mental illness.
Design
An explorative, interpretive study.
Methods
Twenty-four professional and semi-professional artists with self-reported experience with mental illness, were recruited purposively. Unstructured in-depth interviews were conducted and transcripts were subjected to interpretive analysis, guided by a hermeneutic phenomenological frame.
Results
Participants experience a range of interactions between artistic creativity and mental illness. Three constitutive patterns describe what these interactions look like: “flow as a powerful force”; “ambiguous self-manifestation”; and “narrating experiences of suffering.”
Conclusion
The findings show that both the concept of creativity and the concept of mental illness, as well as their interrelationships, are layered and complex phenomena that can take on different meanings in people’s lives. The findings provide starting points for further research that goes beyond the polarized academic debate. Understanding the experiences of artists with mental illness can help shape the role of art in public mental health and mental health care.
... For example, in the Epidemiological Catchment Area study, mean ratings of occupational creativity were significantly higher for those with bipolar I disorder (4.54 on a scale of 0-100) as compared to those with no diagnosis of BD (3.07; Tremblay et al., 2010). In a Swedish population cohort study of more than one million people, BD (including BD I or II) was the only psychiatric illness to be elevated across creative occupations (Kyaga et al., 2013). ...
... Creative Occupational Status. We coded current and previous positions for creativity, including musicians, authors, or writers, PhD-level engagement in scientific research at universities, and other creative occupations, consistent with previous work on creativity in BD (Kyaga et al., 2011(Kyaga et al., , 2013. Due to experimental error, details about occupational creativity were not gathered for three people who were employed. ...
Drawing on literature linking bipolar disorder (BD) to both creativity and heightened motivation, our aim was to examine whether heightened motivation might contribute to creativity in those with and without BD. To examine this, we recruited persons with (n = 49) and without diagnoses (n = 37) of BD, oversampling those from creative occupations. We gathered measures of creativity (Creative Accomplishment Questionnaire, Compound Remote Associates task, and the Unusual Uses Test) and motivation (The Willingly Approached Set of Statistically Unlikely Pursuits [WASSUP] scale, and the Effort Discounting Task). Trials on the Effort Discounting Task varied in effort required and potential monetary earnings to provide parameters for sensitivity to effort levels and sensitivity to reward. Our primary hypotheses were that motivation (insensitivity to effort and insensitivity to reward on the Effort Discounting Task, higher WASSUP scores) would correlate with higher creativity. Findings suggested a more specific profile of how motivation indices related to creativity: Higher ambition (WASSUP) correlated with significantly higher lifetime creative accomplishment (Creative Achievement Questionnaire). Our secondary hypotheses were that those in the bipolar group would show higher motivation than the control group. Findings for one of the three motivation indices supported this hypothesis: The BD group showed lower sensitivity to level of reward than controls did, suggesting that their performance was less dependent on potential monetary earnings. This work is novel in distinguishing several aspects of motivation and providing specificity regarding which facets of motivation relate to creativity and BD. We discuss limitations.
... Researchers have long examined links between creativity and mental illness and disorders (Andreasen, 2008;Jamison, 1996;Jamison, 1995;Ludwig, 1989), suggesting that those in creative industries may be more likely to suffer mental health issues. Although some researchers suggest that those in creative professions are no more likely to suffer from psychiatric disorders than those not in creative professions (Kyaga et al., 2013), research by Entertainment Assist in association with Victoria University found that mental illness is prevalent among workers in the entertainment industry (van den Eynde, Fisher, & Sonn, 2015). A potential implicated as a result of this link between creative industries and mental illness is difficulty with gaining and maintaining employment, especially among those with severe mental illness (Kyaga et al., 2013). ...
... Although some researchers suggest that those in creative professions are no more likely to suffer from psychiatric disorders than those not in creative professions (Kyaga et al., 2013), research by Entertainment Assist in association with Victoria University found that mental illness is prevalent among workers in the entertainment industry (van den Eynde, Fisher, & Sonn, 2015). A potential implicated as a result of this link between creative industries and mental illness is difficulty with gaining and maintaining employment, especially among those with severe mental illness (Kyaga et al., 2013). The culture of working in architecture, and creative industries in general, could play a role in mental health, and will be discussed in section 2. ...
Literature Review
This review was to answer the following three main questions:
1. What research currently exists to indicate the prevalence or incidence of mental illness in the sector (broadly described as comprising practicing architects, and para professionals such as Computer Aided Design (CAD) technicians, students and graduates of architecture programs)?
2. What research currently exists to indicate the triggers, risk factors and early warning signs that could assist the sector to better support those in periods of mental illness? For example, does the isolated nature of sole practice and/or regional practice represent a greater risk or prevalence than, say, larger practice where the group dynamic provides informal support? How do the intense study patterns of studio-based education impact on students?
3. Does existing research suggest any correlation between the triggers and risk factors of mental illness, and any particular part of the sector? For example; risk factors that can be associated to the units of competency, or stages of life from university, registration and practice? For example, are there factors associated with university education? Is stress, anxiety or depression more commonly associated with design, documentation, project delivery or practice management? Are business pressures such as running a practice more likely to be a trigger for stress or anxiety than, say, the enjoyment of being engaged in the creative design process?
There exists a dearth of research around the mental health concerns facing architects, when students, when seeking employment, and when employed.
For the purpose of this review only, the term ‘architect’ may also refer to all those engaged in the sector, including students and CAD technicians.
Mental health is considered to be a ‘state of wellbeing in which the individual realises his or her own abilities, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to his or her community’ (World Health Organization (WHO), Department of Mental Health and Substance Abuse, Victorian Health Promotion Foundation, & University of Melbourne, 2004). WHO estimates that more than 450 million people around the world suffer from mental disorders, and by 2030, depression alone will be the number one cause of disability. Suicide is currently the leading cause of death among Australians aged 15-44 (ABS, 2016).
Mental Health Promotion (MHP) is defined as ‘interventions designed to maximize mental health and well-being by increasing coping capacity of communities and individuals and by improving environments that affect mental health’ (Donovan & Anwar-McHenry, 2014, p. 1).
According to the Australian Institute of Architects (2016), Architecture influences ‘all aspects of the built environment and brings together the arts, environmental awareness, sciences and technology. By combining creative design with technical knowledge, architects create the physical environment in which people live, which in turn, influences quality of life.’
... 185 Although the field of neuroscience of creativity remains polarized on the nature of the link between creativity and mental illness, 2,101 with some scholars even questioning its validity, [186][187][188] the empirical basis of this association is mainly derived from the raised incidence of severe mental illness, particularly bipolar disorder, and schizophrenia, among eminent and high achievers in creative professions. [189][190][191][192]194 F I G U R E 7 Graphic depiction showing how three creative domains-musical, visuospatial, and kinesthetic-affect brain plasticity in individuals who have suffered brain injuries. The distinct plasticity effect appears in the three creativity domains through enhancing executive functions (EFs), each indicated by arrows. ...
... Creative writers have been singled out as having a propensity toward mental illness and substance abuse. 189,193,[201][202][203][204] There are several open questions about the nature of the association between creativity and mental illness, three of which are highlighted here. The first is the shape of the association, with some researchers arguing for an inverted-U function of sorts (e.g., 32,205,206 ). ...
Can we better understand the unique mechanisms of de novo abilities in light of our current knowledge of the psychological and neuroscientific literature on creativity? This review outlines the state‐of‐the‐art in the neuroscience of creativity and points out crucial aspects that still demand further exploration, such as brain plasticity. The progressive development of current neuroscience research on creativity presents a multitude of prospects and potentials for furnishing efficacious therapy in the context of health and illness. Therefore, we discuss directions for future studies, identifying a focus on pinpointing the neglected beneficial practices for creative therapy. We emphasize the neglected neuroscience perspective of creativity on health and disease and how creative therapy could offer limitless possibilities to improve our well‐being and give hope to patients with neurodegenerative diseases to compensate for their brain injuries and cognitive impairments by expressing their hidden creativity.
... people, and re-enrollment, which included 1,173,763 people -patients hospitalized due to various mental disorders, their relatives, and people from the control group, showed that siblings of patients with bipolar disorder or schizophrenia are more likely to perform a creative -scientific or artistic profession. This phenomenon did not apply to people with recurrent depression or their siblings [32,33]. Simeonova et al. [34] have shown that patients with bipolar disorder and their children are more creative than healthy people and their children. ...
Creativity is a complex phenomenon, which level is affected by variables such as intellectual competence, temperament, personality and emotions. Research shows that patients with bipolar affective disorder have a higher level of creativity than healthy controls. The model of affective temperament developed by Hagop Akiskal enables the research on relationships between predispositions to bipolar disorder and creativity. Previous studies on the relationship between affective temperament and creativity are conducted by comparing temperaments of representatives of creative professions and people outside this group, as well as by studying the relationship between affective temperament and creativity assessed both subjectively and through objective tests. However, the temperamental traits contributing to creative potential have their downside, as they have been linked to higher risk of psychological and emotional problems. They may also be related to poorer educational and academic achievement. The article presents up to date research on the relationship between affective temperament and creativity, as well as mechanisms explaining them. It also discusses the relationship between temperament, mental health, and educational achievement, as well as its implications for psychological and pedagogical interventions.
... Creative people are also more prone to overuse psychoactive substances, commit suicide or have disorders (Cropley et al., 2010). Some research (Kyaga et al., 2013) suggests a connection between creativity and a mild form of schizophrenia as well as with psychopathy (Galang, 2010;Galang et al., 2016). It is interesting because psychopathy is often connected with Machiavellianism, in particular in the meaning of the so-called "dark triad" (compare Pilch, 2013;2015). ...
... Also, a significant association was found between grey matter volume of the dopamine system and individual creativity [30]. Furthermore, significant correlations between schizotypal personality and creativity have been found in non-affected relatives of schizophrenic patients and in the general population [44,45]. Clinical manifestations of the hyperactivity disorder (ADHD) subtype have been found to be associated with enhanced divergent thinking [46]. ...
Previous studies have shown that creative thinking is associated with metacontrol, but its neural basis is unknown. The present study explored the neural basis of both by assessing EEG complexity through multiscale entropy. Subjects were engaged in a metacontrol task and an Alternative Uses Task, grouped according to task performance, and the EEG was analysed by multiscale entropy. The results showed that EEG complexity was significantly higher in the high-metacontrol and high-creativity groups than in the low-metacontrol and low-creativity groups, respectively, at high time scales. The metacontrol adaptability score and multipurpose task score were significantly and positively correlated with the EEG complexity at multiple electrode sites. It suggests that metacontrol and creativity are dependent on the activation of long-duration neural networks.
... Extensive research spanning nearly a century has produced empirical evidence linking creativity and psychopathology (Carson, 2010, 295). Studies show that being an author was specifically associated with an increased likelihood of schizophrenia, bipolar disorder, unipolar depression, anxiety disorders, substance abuse, and suicide (Kyaga et al 2013). Brain and cognitive research suggests this link might result from a "Shared Vulnerability," where variations in brain structure and function among neurotypical individuals lead to changes such as cognitive disinhibition (allowing more stimuli into conscious awareness) and an attentional style driven by greater notice is paid to the divergent and aberrant -novelty salience (Ivancovsky et al 2024). ...
The clinical potential of creativity research remains largely unexplored. Philip K. Dick’s deeply personal writings, particularly his journal following a psychotic episode, provide a rare insight into the neuropsychological processes that drive creativity. His unique blend of psychological depth and philosophical science fiction has profoundly impacted literature and popular culture, securing his place as one of the leading science fiction authors of the 20th century. Drawing on his own experiences with mental illness, Dick delved into themes like ontological insecurity, psychosis, dissociation, and drug addiction. Considerable research has explored the connection between madness and creativity. Building on this, the essay will apply clinical nosology to diagnose Dick as a case study, aiming to uncover how his psychopathology influenced his life and creative output. The second part will review recent research on creativity, focusing on factors that enhance our understanding of the roots of his genius. Progressing the neuropsychology of creativity holds significant clinical, social, and economic promise
... Many creative people report that mind-wandering, an aspect of DMN functioning, facilitates creative problem solving (Baird et al., 2012). Low mood due to social rejection also seems associated with greater creativity (Akinola & Mendes, 2008) (Kyaga et al., 2013). In summary milder BPD symptoms, elevated mood, and occasional mild depressive episodes appear positively associated with greater artistic creativity while persistent depression and mania are negatively associated. ...
Many have speculated that events of personal and financial loss in Rembrandt’s life caused depression and that this is revealed by examination of his self-portraits particularly those painted in old age. Some report detecting various physiological diseases associated with aging, including vision impairment, which may have affected his mood and work. Aging and neurodegenerative disease which often accompanies it, are both associated with depression. Recent advances in imaging and computer technology make it possible to empirically examine changes in artistic style which can contribute to understanding artists’ physical and mental health. In the current study changes in contrast, colour and fractal dimension were measured in the entire corpus of Rembrandt’s painted self-portraits and portraits to determine whether changes in style indicate depression or disease. Productivity was also examined as an indirect indicator. Given the high salience attributed to self-images, it also examined whether differences in style could be detected between self-portraits and portraits of related and unrelated others. The results indicate that it is unlikely that Rembrandt suffered from unipolar or bipolar depression, age-related cognitive decline, or neurodegenerative disease. The data are consistent with someone experiencing episodes of low mood consistent with normal grieving and adversity followed by resilient recovery. There is evidence of a gradient in saliency and complexity between self-portraits and related and unrelated portraits, of a less formal style in portraits of related others and of a ‘late’ style identified by leading art historians consistent with macular degeneration. The results are also consistent with an association of aesthetic preference with mid-level fractal values tending towards the Golden Mean long associated with beauty in nature and in art.
... Existing economic analyses have measured creativity through output, such as patents 8,9 , publications 36 , and musical compositions 37 . By contrast, studies of mental health disorders and creativity in psychology and medicine have treated creativity as an individual-level characteristic, proxied by a person's choice of occupation 1,2,19 . ...
Research in psychology and medicine has linked mental health disorders, and particularly bipolar disorder (BD), to employment in creative professions. Little is known, however, about the mechanisms for this link, which could be due to biology (primarily through a person’s genes) or environmental (through socioeconomic status). Using administrative data on mental health diagnoses and occupations for the population of Denmark, we find that people with BD are more likely to be musicians than the population, but less likely to hold other creative jobs. Yet, we also show that healthy siblings of people with BD are significantly more likely to work in creative professions. Notably, people from wealthy families are consistently more likely to work in creative professions, and access to family wealth amplifies the likelihood that siblings of people with BD pursue creative occupations. Nevertheless, family wealth explains only a small share of the correlation between BD and creative employment.
... This is one of the explanations why, in our study, the lowest level of DFA was found among the physicians. In contrast, the scientific literature highlights that individuals with professions that require creativity, such as artists, can be associated with a more frequent occurrence of anxiety [65,66] and other mental disorders [67]. On the other hand, anxious people tend to be very intelligent, and they are usually creative, intuitive, emotional, empathetic, and amiable [66]. ...
Background and Objectives: Research into the relationship between occupation and dental fear and anxiety (DFA) is scarce. This exploratory study aimed to compare the level of DFA and its association with its predictors amongst adults from different occupational groups. Materials and Methods: A cross-sectional study with 422 respondents from four occupational groups (physicians, teachers, industry workers, and artists) was carried out. A questionnaire on previous dental experience using the Dental Anxiety Scale (DAS), Dental Fear Survey (DFS), and Self-Esteem Scale was self-administered electronically. The data analysis involved descriptive statistics and structural equation modeling (SEM). Results: The DFA levels differed significantly across the occupational groups, with the lowest mean scores among physicians (DAS = 9.29 (SE 0.39); DFS-1 = 14.67 (0.63); DFS-2 = 33.94 (1.69)) and the highest mean scores among artists (DAS = 10.74 (0.38); DFS-1 = 17.19 (0.71); DFS-2 = 41.34 (1.92)). A significant impact of self-esteem on DFA was observed among physicians, teachers, and artists, but not among industry workers. Multi-group analysis with SEM revealed differences in the variable association (Chi-squared = 53.75; df = 21; p < 0.001), thus rejecting the hypothesis of the same mechanism underlying DFA across occupational groups. Conclusions: Individuals from various occupations experience DFA at different levels, and there are different mechanisms underlying their DFA. These findings can provide valuable insights for dental practitioners in developing tailored approaches to reduce the feeling of DFA of their patients.
... Interestingly, patients with schizophrenia are known for their so-called "loose associations" (DSM-5; American Psychiatric Association, 2013). Besides this, there are studies linking (subclinical levels of) schizophrenia with creativity (Acar, Chen & Cayirdag, 2018;Kyaga et al., 2013), as well as numerous reports indicating both reduced sensory filtering and diminished N200 and P300 amplitudes (e.g. Bramon et al., 2004;Kim, Kwon, Kang, Youn & Kang, 2004;Oranje & Glenthøj, 2013). ...
... Although prominent cognitive impairment has been identified in patients with BD, evidence exists of a link between BD and creativity. Individuals in creative professions are more to have BD than are controls (Kyaga et al., 2013), and individuals with BD and their healthy first-degree relatives exhibit higher overall creative achievement than do healthy individuals (Richards et al., 1998). One study of 1558 participants found that a higher BD polygenic risk score was associated with not only increased divergent thinking performance but also higher grey matter volumes in the right inferior frontal gyrus (Takeuchi et al., 2021). ...
Objective
Divergent thinking is a critical creative cognitive process. Its neural mechanisms have been well-studied through structural and functional imaging in healthy individuals but are less explored in patients with bipolar disorder (BD). Because of the traditional link between creativity and BD, this study investigated the structural correlates of divergent thinking in patients with BD through surface-based morphometry.
Methods
Fifty-nine patients diagnosed with BD I or BD II (35.3 ± 8.5 years) and 56 age- and sex-matched controls (33.9 ± 7.4 years) were recruited. The participants underwent structural magnetic resonance imaging and an evaluation of divergent thinking by using the Chinese version of the Abbreviated Torrance Test for Adults (ATTA). FreeSurfer 7.0 was used to generate thickness and surface area maps for each participant. Brainwise regression of the association between cortical thickness or surface area and ATTA performance was conducted using general linear models.
Results
Divergent thinking performance did not differ significantly between the patients with BD and the healthy controls. In these patients, total ATTA score was negatively correlated with cortical thickness in the right middle frontal gyrus, right occipital, and left precuneus but positively correlated with the surface area of the right superior frontal gyrus. By contrast, total ATTA scores and cortical thickness or surface area were not significantly correlated among the controls.
Conclusion
The findings indicate that divergent thinking involves cerebral structures for executive control, mental imagery, and visual processing in patients with BD, and the right prefrontal cortex might be the most crucial of these structures.
... The model derived provides useful insights into how to enable creative development for those in similar contexts. To do so, the study links different literatures at the nexus of the industry-specific creative development process (Andreasen 1987;Baas et al. 2016;Gino & Wiltermuth 2014;Hare 1987;Kyaga et al. 2013;Schlesinger 2009). Related to this literature are insights provided by the process of creative destruction described by Schumpeterian theory (Adler et al. 2019;Henrekson & Sanandaji 2019). ...
Orientation: This qualitative study follows a process of inductive theory development.
Research purpose: Focussing on recent ‘pop icon’ musicians, the aim was to weave systemic insights into a holistic model that identifies some characteristics of creative development.
Motivation for the study: Within the diverse literature on creativity, what seems missing is an integrative perspective of similarities in the creative path-dependent development process.
Research design, approach and method: Following an in depth review of publicly available data about iconic Anglophone musical artist-musicians of the period spanning the 1960s–1980s, including Dylan, Cohen, Young and Springsteen, bibliographic and life turning-point analysis was applied to derive propositions about a path-dependent process of creative development.
Main findings: The study finds that such individuals typically trace a ‘path-dependent’ trajectory of creative transition across seven stages. Sequentially, these are the stages of: (1) Pathology, (2) The Rage to Master, (3) Authenticity, (4) Perseverance, (5) Practice, (6) Perspective and (7), Accessing Flow. Drawing insights from Gardner’s theory of creative asynchrony, after which asynchronies that seem to characterise a process of negotiation and transition of conflicts across these stages was derived.
Practical/managerial implications: The model derived provides useful insights into how to enable creative development for those in similar contexts.
Contribution/value-add: The study provides a conceptual ordering of key biographical milestone stages and intrinsic influences explaining aspects of creative development. Thus, the study builds on previous work on the creative career development of individuals in a music industry genre and extends the literatures related to biographical analysis including personality, individual differences and turning points.
... A career as a musician frequently involves working in a competitive field with erratic schedules, financial instability, and unpredictable future directions, which often precipitates acute and chronic levels of anxiety (Holst et al., 2012;Vaag et al., 2013). The ongoing experience of performance anxiety is common for many musicians (Kenny et al., 2004) and may be coupled with an increased susceptibility to mental health issues that are common among people with creative personalities (e.g., artists, poets, and musicians) (Kyaga et al., 2013). It is currently not known whether individuals who pursue a career in music then develop mental health issues as a consequence of the career or if people predisposed to mental health issues are more likely to pursue music as a career. ...
Musicians are at risk of developing music-induced hearing loss (MIHL) and also exhibit increased prevalence of depression, anxiety, and stress. However, the relationship between hearing loss and mental health issues in musicians has not yet been explored. This study conducted a cross-sectional analysis of 32 professional and 35 amateur musicians recruited from local bands and orchestras. KUDUwave software was used to obtain their overall hearing thresholds for both ears over three frequency ranges: 0.5 to 4, 6 to 8, and 9 to 16 kHz. Participants also completed a demographic questionnaire that contained questions related to musical exposure, type of music exposed, years of practice, and so on, and the DASS-21 questionnaire, which assesses the presence of depression, anxiety, and stress symptoms. Professional musicians had significantly greater music exposure compared with amateur musicians, but their hearing thresholds were not significantly different from amateur musicians in 0.5–4, 6–8, or 9–16 kHz frequency ranges. Professional musicians experienced greater symptoms of anxiety compared with amateur musicians, and this occurred independently of their hearing status. Further longitudinal studies are required to explore the causative factors resulting in increased mental health issues in professional musicians and what potential interventions may be implemented to address anxious symptomology in this population.
... The causal mechanisms underlying these associations can only be shown by direct experimental changes in brain activity that concentrate on beta oscillations. From the view of neurochemistry, dopamine (DA), which is essential for stabilizing brain networks 103 , is most likely a key player in schizophrenia psychopathology 104 . Furthermore, the DA levels in neural networks could affect the temporal dynamics of beta oscillations 105 . ...
Paranormal believers’ thinking is frequently biased by intuitive beliefs. Lack of inhibition of these tempting beliefs is considered a key element in paranormal believers’ thinking. However, the brain activity related to inhibitory control in paranormal believers is poorly understood. We examined EEG activities at resting state in alpha, beta, and gamma bands with inhibitory control in paranormal believers and skeptics. The present study shows that paranormal belief is related to the reduced power of the alpha, beta, and gamma frequency bands, and reduced inhibitory control. This study may contribute to understanding the differences between believers and skeptics in brain activity related to inhibitory control in paranormal believers.
... Empirical studies have also shown that scientists are less likely to suffer from mental illness compared with non-scientists (Ludwig, 1995;Rawlings & Locarnini, 2008). In contrast, artists (e.g., writers) have shown increased risk of schizophrenia, unipolar depression, anxiety disorders, bipolar disorder, substance abuse, and suicide (Kyaga et al., 2013). Kaufman found that reduced latent inhibition, which is highly associated with schizophrenia, was significantly correlated with creative achievement in the arts, but not the sciences (Kaufman, 2009). ...
Existing research has consistently supported a relationship between creative achievement and specific personality traits (e.g., openness to experience). However, such work has largely focused on univariate associations, potentially obscuring complex interactions among multiple personality factors, rendering an incomplete picture of the creative personality. We applied a psychometric network approach to characterize the multidimensional personality structure of highly creative individuals in the arts (“artists”) and sciences (“scientists”), using data from three samples (N=4,015): college students, a representative adult sample, and the Big-C project of eminent creative professionals. Replicating past work, we found that artists showed reliably higher levels of openness to experience compared to scientists and a control group of less creative people. Psychometric network analysis revealed that artists were characterized by higher connectivity (i.e., co-occurrence) with other personality traits for openness, indicating that openness may be more heterogeneous in how it co-occurs with other personality traits in highly creative people. Across all three samples, we found that the scientists’ personality network structure was more cohesive than the personality network of artists and the control group, indicating greater homogeneity in the personality characteristics of scientists. Our findings uncover a constellation of traits that give rise to creative achievement in the arts and sciences.
... Si les résultats existants soulignent des répercussions négatives des troubles bipolaires sur la productivité et l'insertion dans l'emploi, fortes et persistantes au cours du temps, la littérature en psychiatrie et en économie s'est également intéressée à des hypothèses alternatives, s'inscrivant dans le courant des recherches sur les liens entre santé mentale et créativité (Borowiecki, 2017). Dans le cas de la bipolarité, ces liens sont notamment représentés dans des films ou au travers de biographies d'artistes ou d'écrivains, et la prévalence des troubles bipolaires apparaît plus élevée dans les professions artistiques et scientifiques (Kyaga et al., 2013). ...
Cette étude s’intéresse à la situation d’emploi des personnes vivant avec un trouble bipolaire diagnostiqué et pris en charge dans le cadre d’un protocole de soins de longue durée, en mobilisant des données administratives couvrant la période de 2000 à 2015. La population d’étude est constituée de 674 personnes ayant ces troubles incluses dans le dispositif des affections de longue durée (ALD), âgées de 25 à 50 ans lors de cette inclusion. Nos résultats portent tout d’abord sur leur situation d’emploi au cours des huit années qui précèdent l’entrée en ALD. Ils mettent en évidence, parmi les personnes bipolaires, plus de situations d’emploi heurtées, marquées par des périodes de chômage, par comparaison à la population de témoins. Cela peut traduire un retentissement négatif de ces troubles sur la situation d’emploi avant l’entrée en ALD. Néanmoins, des événements de vie ou des facteurs de vulnérabilité au cours de ces années ont pu augmenter le risque de bipolarité et affecter la situation d’emploi, tandis que des parcours d’emploi marqués par le chômage et la désinsertion professionnelle ont pu également constituer des facteurs déclencheurs de l’apparition ou de l’aggravation des troubles. Ensuite, l’analyse de la situation d’emploi des personnes bipolaires après l’entrée en ALD suggère que ces troubles ont des effets négatifs importants sur les parcours d’emploi, persistants dans le temps. Cette étude souligne l’importance de mettre en œuvre et de développer des interventions dédiées à améliorer la situation d’emploi des personnes vivant avec un trouble bipolaire.
... In three of the five activities: going to a movie, going to the library, and taking a class for leisure, the SMI population deemed them more important than the non-SMI sample. As highlighted previously, much of the prior research on arts and culture with individuals with SMI has focused almost entirely on art production, such as creative professions (Kyaga et al., 2013) and art therapy (e.g., Rustin, 2008). Although the research on art production programs for individuals with SMI have reported positive outcomes, the findings of studies on the link between mental illness and heightened creativity has been inconsistent, indicating that it is an area that requires further exploration (Carson, 2019;Patra & Balhara, 2012;Waddell, 1998). ...
Objective:
Engagement in arts and cultural activities is valued and yields positive outcomes but may be understudied in populations with serious mental illness (SMI). Our aims are to evaluate the extent to which individuals with SMI deem participation areas related to arts and culture (e.g., going to a theater) to be important, and if important, how often they are being done and if it is enough in comparison to a nonSMI sample.
Methods:
We conducted analyses using a sample of 1,120 individuals with SMI from nine research studies between 2008 and 2016 and a sample of 300 individuals without SMI that were part of the Truven Health Analytics PULSE survey. All participants completed a survey containing questions related community participation. Analyses were conducted using independent samples t tests, followed by analysis of variances, and chi-square tests.
Results:
The results indicate that adults with SMI are as, or more interested in arts and cultural activities as adults in the general population, but do not participate in those areas as much as they would like in comparison. We also found that, as with the general population, participation in these areas is positively associated with quality of life and to a lesser degree, recovery.
Conclusions and implications for practice:
Engagement in arts and culture activities may be an overlooked compared to other areas of participation, such as employment. Psychiatric rehabilitation practitioners may need to pay greater attention to areas related to art appreciation, rather than just art production. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
... To explore the relationship between psychological pain, hopelessness and suicide stages for high-suicide-risk adolescents, we established a hypothesis for the suicide mechanism path: psychological pain → hopelessness → suicide stages, with hopelessness as the mediating variable. In addition, there is a high correlation between mental illness and suicidal behaviors [24,25], and in order to better clarify the effect of psychological pain and hopelessness on suicide stages, a mediating effect model of our study is proposed with mental illness as a control variable (Figure 1). We used the more ecological Weibo text analysis method in this study, and hoped to further deepen the research on adolescent suicide and to find a new theoretical basis for future suicide interventions drawing on online data. ...
Background:
Adolescent suicide can have serious consequences for individuals, families and society, so we should pay attention to it. As social media becomes a platform for adolescents to share their daily lives and express their emotions, online identification and intervention of adolescent suicide problems become possible. In order to find the suicide mechanism path of high-suicide-risk adolescents, we explore the factors that influence is, especially the relations between psychological pain, hopelessness and suicide stages.
Methods:
We identified high-suicide-risk adolescents through machine learning model identification and manual identification, and used the Weibo text analysis method to explore the suicide mechanism path of high-suicide-risk adolescents.
Results:
Qualitative analysis showed that 36.2% of high-suicide-risk adolescents suffered from mental illness, and depression accounted for 76.3% of all mental illnesses. The mediating effect analysis showed that hopelessness played a complete mediating role between psychological pain and suicide stages. In addition, hopelessness was significantly negatively correlated with suicide stages.
Conclusion:
mental illness (especially depression) in high-suicide-risk adolescents is closely related to suicide stages, the later the suicide stage, the higher the diagnosis rate of mental illness. The suicide mechanism path in high-suicide-risk adolescents is: psychological pain→ hopelessness → suicide stages, indicating that psychological pain mainly affects suicide risk through hopelessness. Adolescents who are later in the suicide stages have fewer expressions of hopelessness in the traditional sense.
... ADHD is a behavioral and neurodevelopmental disorder characterized by inattention, hyperactivity, and impulsivity, which are pervasive, impairing, and otherwise ageinappropriate [384]. ADHD is associated with SUDs, alcoholism, and other mental disorders, including MDD, GAD, and ASD [385]. ...
Nearly half a century has passed since the discovery of cytoplasmic inheritance of human chloramphenicol resistance. The inheritance was then revealed to take place maternally by mitochondrial DNA (mtDNA). Later, a number of mutations in mtDNA were identified as a cause of severe inheritable metabolic diseases with neurological manifestation, and the impairment of mitochondrial functions has been probed in the pathogenesis of a wide range of illnesses including neurodegenerative diseases. Recently, a growing number of preclinical studies have revealed that animal behaviors are influenced by the impairment of mitochondrial functions and possibly by the loss of mitochondrial stress resilience. Indeed, as high as 54% of patients with one of the most common primary mitochondrial diseases, mitochondrial encephalomyopathy with lactic acidosis and stroke-like episodes (MELAS) syndrome, present psychiatric symptoms including cognitive impairment, mood disorder, anxiety, and psychosis. Mitochondria are multifunctional organelles which produce cellular energy and play a major role in other cellular functions including homeostasis, cellular signaling, and gene expression, among others. Mitochondrial functions are observed to be compromised and to become less resilient under continuous stress. Meanwhile, stress and inflammation have been linked to the activation of the tryptophan (Trp)-kynurenine (KYN) metabolic system, which observably contributes to the development of pathological conditions including neurological and psychiatric disorders. This review discusses the functions of mitochondria and the Trp-KYN system, the interaction of the Trp-KYN system with mitochondria, and the current understanding of the involvement of mitochondria and the Trp-KYN system in preclinical and clinical studies of major neurological and psychiatric diseases.
... Attention dificit hyperactivity disorder Attention deficit hyperactivity disorder (ADHD) is a behavioral and neurodevelopmental disorder characterized by inattention, hyperactivity, and impulsivity, which are pervasive, impairing, and otherwise age inappropriate [348]. ADHD is associated with SUDs, alcoholism and other mental disorders including MDD, GAD, and ASD [349]. Furthermore, multidirectional relationships between stress, anxiety, and inflammation in the pathogenesis of ADHD are discussed recently [350]. ...
Nearly half a century has passed since the discovery of cytoplasmic inheritance of human chloramphenicol resistance. The inheritance was then revealed to take place maternally by mito-chondrial DNA (mtDNA). Later, a number of mutations in mtDNA were identified as a cause of severe inheritable metabolic diseases with neurological manifestation, and the impairment of mito-chondrial functions has been probed in the pathogenesis of a wide range of illnesses including neu-rodegenerative diseases. Recently growing number of preclinical studies has revealed that animal behaviors are influenced by the impairment of mitochondrial functions and possibly by the loss of mitochondrial stress resilience. Indeed, as high as 54% of patients with one of the most common primary mitochondrial diseases, mitochondrial encephalomyopathy with lactic acidosis and stroke-like episodes (MELAS) syndrome, present psychiatric symptoms including cognitive impairment, mood disorder, anxiety, and psychosis. Mitochondria are multifunctional organelles which produce cellular energy and play a major role in other cellular functions including homeostasis, cellular sig-naling, and gene expression, among other. Mitochondrial functions are observed to be compromised and to become less resilient under continuous stress. Meanwhile, stress and inflammation have been linked to the activation of the tryptophan (Trp)-kynurenine (KYN) metabolic system, which observably contributes to development of pathological conditions including neurological and psychiatric disorders. This narrative review discusses the functions of mitochondria and the Trp-KYN system, the interaction of the Trp-KYN system with mitochondria, and the current understanding of the involvement of mitochondria and the Trp-KYN system in preclinical and clinical studies of major neurological and psychiatric diseases.
... Numerous biographical studies of the eminently creative combined with large population-based studies of everyday creativity provide strong support for a connection between creativity and bipolar disorder (Jamison, 1993;Tremblay et al., 2010;Kyaga et al., 2011). While these studies have found a ten-fold increase in the rate of bipolar disorder among creative individuals, they have also shown that creativity and professional success are particularly enhanced among unaffected first-degree relatives and individuals expressing bipolar spectrum traits (Verdoux and Bourgeois, 1995;Richards et al., 1988;Kyaga et al., 2013;Coryell et al., 1989;Simeonova et al., 2005;Akiskal and Akiskal, 2007). These findings suggest that some bipolar spectrum traits may confer advantages for creativity. ...
Creativity has long been associated with the bipolar spectrum, particularly among unaffected first-degree relatives and those with milder expressions of bipolar traits, suggesting that some aspects of the bipolar spectrum may confer advantages for creativity. Here we took a multifaceted approach to better define the shared vulnerability between creativity and bipolar disorder. We recruited 135 individuals with bipolar disorder, 102 creative controls, and 103 non-creative controls for a total of 340 participants. All participants completed a comprehensive assessment battery that included several self-report temperament and personality questionnaires, a computerized test of cognitive function across multiple domains, and an evaluation of creative performance and achievement. Significant group differences were observed for the hypothesized shared vulnerability traits of hypomanic personality, cyclothymic temperament, impulsivity, and positive schizotypy. While both the creative and bipolar groups demonstrated superior creative ability, the creative group alone revealed enhanced cognitive performance. Accounting for intercorrelations between traits, a combination of openness, hypomanic personality, divergent thinking, and reasoning ability emerged as the strongest predictors of creativity, collectively explaining 34% of the variance in creative achievement and correctly classifying 85% of individuals with high achievement irrespective of diagnosis. These results confirm and extend earlier observations of a shared vulnerability between creativity and bipolar disorder and suggest that mild to moderate expressions of bipolar spectrum traits are associated with enhanced cognitive functioning and creative expression. Further investigation of these traits is needed to clarify the nature of this shared vulnerability and suggest individualized treatment strategies to improve clinical outcomes in bipolar disorder.
... Aalberg et al. (2019) separately found that these characteristics predicted levels of psychological distress in musicians. Another long-standing proposal is that higher levels of psychopathology are intrinsically linked to creativity (Kyaga et al., 2013), which might suggest that as "creative types," musicians are inherently more prone to higher levels of anxiety and depression. However, direct evidence for this is limited and the relationship has often been hotly debated (see Kyaga, 2018, for a full review). ...
People working in the music industry report significantly higher levels of anxiety and depression than the general population, but to date, studies have not explored the differences between professional musicians and those who perform music primarily for recreation. In this study, 254 musicians from 13 countries completed measures of anxiety, depression, and wellbeing as well as answering questions about their professional status, level of success, and income. Across the whole sample, we found that over half had high levels of anxiety, and a third were experiencing depression. We showed that musicians who viewed music as their main career were more likely to have poor mental wellbeing and had significantly higher levels of clinical depression. Status as a solo or lead artist and perceived level of success also significantly predicted higher levels of anxiety and depression, and lower levels of positive wellbeing. We conclude that low mental wellbeing in musicians is the result of working as a professional musician, as opposed to being an inherent trait. Future work should explore underlying beliefs and perceptions of career musicians alongside other key factors, such as health behaviors and social support, with the aim of making specific recommendations to the music industries and educators.
Introduction
The neural mechanisms that underpin cognitive impairments in patients with schizophrenia remain unclear. Previous studies have typically treated patients as a homogeneous group, despite the existence of distinct symptom presentations between deficit and non-deficit subtypes. This approach has been found to be inadequate, necessitating separate investigation.
Methods
This study was conducted at Daizhuang Hospital in Jining City, China, from January 2022 to October 2023. The study sample comprised 30 healthy controls, 19 patients with deficit schizophrenia, and 19 patients with non-deficit schizophrenia, all aged between 18 and 45 years. Cognitive abilities were evaluated using a change detection task. The NeuroScan EEG/ERP System, comprising 64 channels and utilising standard 10-20 electrode placements, was employed to record EEG signals. The multiscale entropy and sample entropy of the EEG signals were calculated.
Results
The healthy controls demonstrated superior task performance compared to both the non-deficit (p < 0.001) and deficit groups(p < 0.001). Significant differences in multiscale entropy between the three groups were observed at multiple electrode sites. In the task state, there are significant differences in the sample entropy of the β frequency band among the three groups of subjects. Under simple conditions of difficulty, the performance of the healthy controls exhibited a positive correlation with alpha band sample entropy(r = 0.372) and a negative correlation with beta band sample entropy (r = -0.411). Deficit patients demonstrated positive correlations with alpha band sample entropy (r = 0.370), whereas non-deficit patients exhibited negative correlations with both alpha and beta band sample entropy (r = -0.451, r = -0.362). Under difficult conditions of difficulty, the performance of healthy controls demonstrated a positive correlation with beta band sample entropy (r = 0.486). Deficit patients exhibited a positive correlation with alpha band sample entropy (r = 0.351), while non-deficit patients demonstrated a negative correlation with beta band sample entropy (r = -0.331).
Conclusion
The results of this study indicate that cognitive impairment in specific subtypes of schizophrenia may have distinct physiological underpinnings, underscoring the need for further investigation.
Edvard Munch, a founder of Expressionism was pre-occupied with depicting his subjective experience and the most prolific painter of self-portraits since Rembrandt. Based on evidence that faces and self-related images are more salient than other objects it is plausible that self-portraits, in which the subject and object are the same, reflect the artist’s state of mind. Although he suffered from a variety of physical and psychological illness Munch was not diagnosed with any specificity in his lifetime. Posthumous diagnoses include schizophrenia, anxiety, bipolar and other disorders. Recent research has revealed altered visual perception in such patients. The present study empirically analysed three stylistic elements of Munch’s painted self-portraits and portraits: contrast, colour and fractal dimension and his painted productivity, to determine if variations correlate with critical life events and if so whether they indicate states of mind. It found significant increases in contrast and colour brightness and persistent high complexity during critical periods supporting the conclusion that Munch is diagnostically best described as suffering from early onset schizophrenia and comorbid social anxiety disorder.
In this opening chapter, the neurodiversity paradigm is defined and explained in the context of the macro-social and political changes that have taken place since the industrial revolution, and from its roots within disability rights activism in the late twentieth century. Key terms such as ‘neurodivergent’ are explained, as well as the definitions of the typically included neurodevelopmental conditions such as ADHD, autism, dyslexia and dyspraxia. The inclusion of less well-known and more mental health-based conditions is discussed. The strengths associated with different conditions are signposted. Diagnostic disparities are discussed in some detail, referring to fluctuating identification pathways geographically and over time, but as well as demographically. The bias towards the white, western, male, middle-class and heterosexual ‘norm’ within diagnostic protocols is highlighted, which leads to significant under diagnosis and lack of early support for many neurodivergent employees. The chapter closes with the implications for consulting and applied psychologists, including the need for reflecting on our own biases, working respectfully with communities of lived experience and understanding the ambiguities related to the extent to which neurodivergence is included in disability legislation.
Vengono esaminati i problemi posti dalle patografie di Leonardo scritte da Freud. Si ricostruisce il percorso storico del problema del rapporto fra genio e patologie mentale, mostrando che la psi-coanalisi si inserisce in un filone molto attivo in quel tempo esprimendo diversi approcci teorici con cui si rapporta Freud. L'interesse per il problema è poi proseguito, con alterne risposte, fino ai giorni attuali. Vengono prese in esame le distorsioni operate da Freud nella descrizione patogra-fica di Leonardo, un aspetto ampiamente esaminato da diversi autori, che peraltro non si distanzia né da quanto Freud attua in altre sue opere, né da quanto facevano gli altri patografi del tempo. Si tratta inoltre di un comportamento usuale nell'ambito della storia della scienza e ben conosciuto nella epistemologia moderna che individua nello sviluppo delle teorie la importanza anche degli strumenti retorici con cui gli scienziati le sostengono. Si sottolinea come non si possa leggere in questi comportamenti di Freud degli aspetti psicologici particolari, facendo di fatto una patografia dell'autore di patografie, ma solo ricondurre il suo operare alla coerenza dei contesti storici in cui opera.
Introduction
Alterations of verbalized thought occur frequently in psychotic disorders. We characterize linguistic findings in individuals with schizophrenia based on the current literature, including findings relevant for differential and early diagnosis.
Methods
Review of literature published via PubMed search between January 2010 and May 2022.
Results
A total of 143 articles were included. In persons with schizophrenia, language-related alterations can occur at all linguistic levels. Differentiating from findings in persons with affective disorders, typical symptoms in those with schizophrenia mainly include so-called “poverty of speech,” reduced word and sentence production, impaired processing of complex syntax, pragmatic language deficits as well as reduced semantic verbal fluency. At the at-risk state, “poverty of content,” pragmatic difficulties and reduced verbal fluency could be of predictive value.
Discussion
The current results support multilevel alterations of the language system in persons with schizophrenia. Creative expressions of psychotic experiences are frequently found but are not in the focus of this review. Clinical examinations of linguistic alterations can support differential diagnostics and early detection. Computational methods (Natural Language Processing) may improve the precision of corresponding diagnostics. The relations between language-related and other symptoms can improve diagnostics.
The relationship of the nervous system and mental illness with musical creativity can be found in the production of eminent composers of the Romantic Age (1800–1910). Research published in recent decades specifies that in the history of music, mental disorders are not only present as a plot element in many operas, but are a condition experienced by many authors during the creative phase of their career. The cliché ‘genius and madness’ is reflected in the biographies of Gaetano Donizetti and Bedřich Smetana who were both suffering from neurosyphilis and confined in an asylum. Niccolò Paganini contracted syphilis, but he also suffered from a rare genetic anomaly. Robert Alexander Schumann was affected by bipolarity and, in addition to the symptoms of syphilis, he also suffered from annoying hearing alterations. Giuseppe Verdi fell into a severe depression, while Maurice Ravel suffered from aphasia and apraxia related to an unclear form of neurological deterioration. However, the production of these composers does not appear influenced by their pathological status. Indeed, their mental condition seems to have boosted their genius to the maximum degree. In this review, the association between the neuropsychological pathology and the creativity of well-known Romantic composers was investigated through the analysis of both the clinical histories and the musical production. However, it is difficult to establish where personal innovation stops and the effect of the medical condition takes over, especially for musicians of the Romantic Age accustomed to research expressive freedom and unusual intensity. Indeed, the cases examined do not have a univocal answer. In some cases, the pathological phenomenon has appeared to enrich the talent of the musicians with imagination. In other authors the serious neurological damage and the consequent invalidity seem to have represented an obstacle to the compositional work.
Depression is one of the most common and debilitating health problems, however, its heterogeneity makes a diagnosis challenging. Thus far the restriction of depression variables explored within groups, the lack of comparability between groups, and the heterogeneity of depression as a concept limit a meaningful interpretation, especially in terms of predictability. Research established students in late adolescence to be particularly vulnerable, especially those with a natural science or musical study main subject. This study used a predictive design, observing the change in variables between groups as well as predicting which combinations of variables would likely determine depression prevalence. 102 under- and postgraduate students from various higher education institutions participated in an online survey. Students were allocated into three groups according to their main study subject and type of institution: natural science students, music college students and a mix of music and natural science students at university with comparable levels of musical training and professional musical identity. Natural science students showed significantly higher levels of anxiety prevalence and pain catastrophizing prevalence, while music college students showed significantly higher depression prevalence compared to the other groups. A hierarchical regression and a tree analysis found that depression for all groups was best predicted with a combination of variables: high anxiety prevalence and low burnout of students with academic staff. The use of a larger pool of depression variables and the comparison of at-risk groups provide insight into how these groups experience depression and thus allow initial steps towards personalized support structures.
The Cambridge Handbook of Creativity and Emotions provides a state-of-the-art review of research on the role of emotions in creativity. This volume presents the insights and perspectives of sixty creativity scholars from thirteen countries who span multiple disciplines, including developmental, social, and personality psychology; industrial and organizational psychology; neuroscience; education; art therapy, and sociology. It discusses affective processes – emotion states, traits, and emotion abilities – in relation to the creative process, person, and product, as well as two major contexts for expression of creativity: school, and work. It is a go-to source for scholars who need to enhance their understanding of a specific topic relating to creativity and emotion, and it provides students and researchers with a comprehensive introduction to creativity and emotion broadly.
The hypothesis of a relationship between madness and creativity is most common in science and art. But science needs evidence, and it is in the ideas taken for granted that prejudices exist and are difficult to change. And this hypothesis, based on common sense ideas, has been supported by studies and observations. Furthermore, over time, this issue has been reinforced by anecdotes and examples, as well as plausible mechanisms that previous studies seem to confirm. But since correlation does not guarantee causality, we also need to understand the mechanisms involved. Lateral thinking, obsessive activity, among other aspects, are sometimes evoked to explain what is already thought to be known, and the proposed mechanisms end up reinforcing prejudice instead of explaining it. However, more recent studies and meta-analysis studies suggest that the relationship is too vague or negative.
The words of the well-known North American writer Ernest Hemingway, when in a letter he said that his main capital was health and he needed time to rest to be back to work, will be the guide for the research of this chapter, where the main objective is to identify the effect of stress on creativity and how creativity can help to reduce stress. The relationship between stress and creativity has generated controversy as some authors express that stress is a well-known creativity killer, while others express small doses of stress are likely to produce the best ideas. Based on the idea that there's not really any evidence that one person is inherently more creative than another, the authors analyse how stress, the illness of the 21st century, affects creativity development and how certain therapies help to reduce it through art, literature, and some leisure activities. The investigation will find the effects of stress on creativity, not only in problem-solving but also in its relationship with health.
The current article advances the hypothesis that creative culture evolved, in part, to allay the costs of the overgrown human brain and the cognitive integration limit that it imposes. Specific features can be expected among cultural elements best suited to allaying the integration limit and also among the neurocognitive mechanisms that might undergird these cultural effects. Music, visual art, and meditation are used as examples to illustrate how culture helps to bridge or sidestep the integration limit. Tiered religious, philosophical, and psychological concepts are considered in light of their reflection of the tiered process of cognitive integration. The link between creativity and mental illness is offered as additional support for the role of cognitive disconnection as a wellspring of cultural creativity, and I propose that this link can be harnessed in defense of neurodiversity. Developmental and evolutionary implications of the integration limit are discussed.
Background
Despite a large descriptive literature linking creativity and risk for psychiatric illness, the magnitude and specificity of this relationship remain controversial.
Methods
We examined, in 1 137 354 native Swedes with one of 59 3-digit official and objective occupational codes in managerial and educated classes, their familial genetic risk score (FGRS) for ten major disorders, calculated from 1 st through 5 th degree relatives. Mean FGRS across disorders were calculated, in 3- and 4-digit occupational groups, and then controlled for those whose disorder onset preceded occupational choice. Using sequential analyses, p values were evaluated using Bonferroni correction.
Results
3-digit professions considered to reflect creativity (e.g. ‘artists’ and ‘authors’) were among those with statistically significant elevations of FGRS. Among more specific 4-digit codes, visual artists, actors, and authors stood out with elevated genetic risks, highest for major depression (MD), anxiety disorders (AD) and OCD, more modest for bipolar disorders (BD) and schizophrenia and, for authors, for drug and alcohol use disorders. However, equal or greater elevations in FGRS across disorders were seen for religious (e.g. ministers), helping (e.g. psychologists, social workers), and teaching/academic occupations (e.g. professors). The potential pathway from FGRS → Disorder → Occupation accounts for a modest proportion of the signal, largely for MD and AD risk.
Conclusions
While traditional creative occupations were associated with elevated genetic risk for a range of psychiatric disorders, this association was not unique, as similar, or greater elevations were seen for religious, helping and teaching professions and was stronger for internalizing than psychotic disorders.
The idea of a connection between creativity and psychopathology has been attributed to our earliest human ancestors. It is also a notion that has, historically, been expressed across cultures. Contemporary research exploring the link between creativity and psychopathology, however, is equivocal. More recently, it has been hypothesized that this is only a subset of mental health problems that are linked with creativity; specifically, approach-based psychopathologies, such as mania and hypomania. This study explored the relationship between creativity (divergent thinking) and approach-based psychopathology (hypomanic traits) among Arab college women (n= 218) in the United Arab Emirates. The study used a Web-based version of the Alternative Uses Task to assess creativity. The study also administered the Hypomanic Personality Scale to assess hypomanic traits/bipolar risk. As predicted, there was a positive correlation between hypomanic traits and creativity. These findings broaden support for the idea of a link between approach-based psychopathologies and creativity. By extension, they lend further tentative support to archaeological hypotheses about the co-emergence of theology, creativity and mental illness.
Researchers have recently turned their focus to a specific area: the links between altered states of consciousness and creativity. A spectrum of attentional states of consciousness exists, from hypnagogia and mind wandering to mindfulness and flow. These attentional states of consciousness are present during a variety of activities (e.g., sports, music, painting, writing, video games, theater, and meditation) as well as in situations characterized by boredom. They are also present in many professional fields and practices (e.g., education and teaching). Moreover, researchers and educators focus sometimes on only one state of consciousness (such as mind wandering) or only on attention, and do not question relationships with others (such as mindfulness or flow) or the links with intention, the different levels of consciousness involved and the changes in perception of time, self and space. Additionally, as we know that a state of consciousness rarely occurs alone or that it can have two forms (such as spontaneous and deliberate mind wandering), we propose a global approach allowing to grasp the stakes and perspectives of what we call attentional states of consciousness. Thus, to our knowledge, this is the first theoretical review highlighting the historical, empirical, theorical and conceptual relationships between creativity, attention, mind wandering, mindfulness and flow by offering concrete and empirical avenues and bases for reflection about educating for creativity and developing creative potential.
Artistic creativity has long been associated with physical and psychological suffering. This phenomenon has also been the subject of empirical research. The anguished “artistic genius” stereotype is ubiquitous, and there is evidence to suggest that artists may have heightened susceptibility to psychopathology. The present qualitative study utilized in‐depth semi‐structured interviews, in accordance with the methodology of Interpretive Phenomenological Analysis to explore inter‐relationships between artistic creativity, and physical and mental health among 10 eminent Australian female visual artists. Results revealed complex, reciprocal interactions whereby physical and mental health impacted creativity and vice versa. Physical and psychological illnesses were found to either diminish or stimulate creativity due to the interplay of biological predispositions, personal vulnerabilities, and environmental factors. It was also revealed that immersive creative engagement could have therapeutic, cathartic effects and facilitate post‐traumatic growth. The stressors and demands of professional creative practice could, however, also have a detrimental impact upon artists physically and psychologically. These findings contribute to existing understandings regarding the intricacy of the relationship between creativity, physical and psychological health. They highlight the need to challenge romantic societal mythologies regarding the impact of suffering on creativity in the visual arts and explore these issues in a nuanced manner to best support those in creative industries.
Thesis (doctoral)--Københavns universitet, 2007.
With few exceptions, scholarship on creativity has focused on its positive aspects while largely ignoring its dark side. This includes not only creativity deliberately aimed at hurting others, such as crime or terrorism, or at gaining unfair advantages, but also the accidental negative side effects of well-intentioned acts. This book brings together essays written by experts from various fields (psychology, criminal justice, sociology, engineering, education, history, and design) and with different interests (personality development, mental health, deviant behavior, law enforcement, and counter-terrorism) to illustrate the nature of negative creativity, examine its variants, call attention to its dangers, and draw conclusions about how to prevent it or protect society from its effects.
Previous studies (Heston & Denney, 1968; Karlsson, 1970; Kauffman, Grunebaum, Cohler, & Gamer, 1979) have reported that psychologically healthier biological relatives of persons with schizophrenia had unusually creative jobs and hobbies. These studies, however, examined only eminent levels of creativity in a few professions, involved serendipitous post hoc findings, assessed creativity, or both, while aware of diagnosis. We studied 36 index adult adoptees of biological parents with schizophrenia and 36 demographically matched control adoptees with no biological family history of psychiatric hospitalization. Adoptees were diagnosed with the Diagnostic and Statistical Manual of Mental Disorders (3rd ed.; American Psychiatric Association, 1980) criteria by investigators blind to creativity assessments. Adoptees' real-life creativity was rated by other investigators blind to personal and family psychopathology with scales of demonstrated reliability and validity applied to descriptions of vocational and avocational activities obtained from interviews. It was hypothesized that adoptees with genetic liability for schizophrenia (and thus potentially unconventional modes of thinking and perceiving)-although not schizophrenia itself-would be more creative. In fact, nonschizophrenics with either schizotypal or schizoid personality disorder or multiple schizotypal signs (which other research has linked with genetic liability for schizophrenia) had significantly higher creativity than other participants. Interestingly, some control adoptees also fit these criteria and were included in analyses. Results have implications for relations of creativity to personal symptoms and familial risk for schizophrenia.
"Creativity… is a process extended in time and characterized by originality, adaptiveness, and realization." Except for mathematicians "where there is a low positive correlation between intelligence and the level of creativeness, we have found within our creative samples essentially zero relationship between the two variables." A research study of the characteristics and background of creative architects is extensively discussed. Implications of the nature of creative talent for the nurturing of it in school and college through the processes of education are considered. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Studies of creativity and affective illness typically focus on eminent individuals in specific fields. This is the first study to select subjects solely by diagnosis, and then evaluate their overall creative accomplishments. Seventeen manic-depressives, 16 cyclothymes, and 11 normal first-degree relatives were compared with 33 controls with no personal or family history of major affective disorder, cyclothymia, or schizophrenia; 15 controls were normal and 18 carried another diagnosis. Peak creativity was assessed by raters blind to subjects' diagnosis with the use of the Lifetime Creativity Scales. Orthogonal contrasts showed (a) creativity to be significantly higher among the combined index subjects (manic-depressives, cyclothymes, and normal relatives) than among controls (
p
Giftedness researchers have long debated whether there is empirical evidence to support a distinction between giftedness and attained level of achievement. In this paper we propose a general theoretical framework that establishes scientific criteria for acceptable evidence of superior reproducible performance, which any theory of exceptional performance must explain. We review evidence for superior reproducible performance, generally emerging only after extended periods of deliberate practice that result in subsequent physiological adaptations and complex cognitive mechanisms. We also apply this framework to examine proposed evidence for innate talents. With the exception of fixed genetic factors determining body size and height, we were unable to find evidence for innate constraints to the attainment of elite achievement for healthy individuals.
Most investigations of creativity tend to take one of two directions: everyday creativity (also called "little-c"), which can be found in nearly all people, and eminent creativity (also called "Big-C"), which is reserved for the great. In this paper, the authors propose a Four C model of creativity that expands this dichotomy. Specifically, the authors add the idea of "mini-c," creativity inherent in the learning process, and Pro-c, the developmental and effortful progression beyond little-c that represents professional-level expertise in any creative area. The authors include different transitions and gradations of these four dimensions of creativity, and then discuss advantages and examples of the Four C Model.
Hospital discharge registers (HDRs) are frequently used in epidemiological research. However, the validity of several important psychiatric diagnostic entities, including bipolar disorder, remains uncertain. Hence, we aimed to develop an optimal algorithm for register-based identification of DSM-IV-TR bipolar disorder.
We identified potential cases in the Swedish national HDR using two separate discharge diagnoses of bipolar disorder according to ICD versions 8-10 during January 1, 1973 to December 31, 2004. In a randomly selected subsample of 135 cases from the county of Sörmland, two senior psychiatrists reassessed the diagnostic status based on patients' medical records. We scrutinized false-positive cases and modified the initial algorithm to improve positive predictive value while minimizing false negatives. Finally, we externally validated resulting caseness algorithms by linking HDR diagnostic data with best-estimate clinical diagnoses from the National Quality Assurance Register for Bipolar Disorder (BipoläR), dispensed lithium prescriptions from the National Prescribed Drug Register, and the ICD-10 diagnoses from the National Outpatient Register respectively.
The algorithm with two discharge diagnoses of bipolar disorder yielded a positive predictive value of 0.81. Modification by excluding individuals diagnosed with ICD-8 296.20 (manic-depressive psychosis, depressed type), and/or ICD-9 296.B (unipolar affective psychosis, melancholic form), gave a positive positive predictive value of 0.92. The modified algorithm also had statistically superior external validity compared with the original algorithm.
Our findings suggest that DSM-IV-TR bipolar disorder caseness based on two inpatient episodes with a bipolar disorder diagnosis is sufficiently sensitive and specific to be used in further epidemiological study of bipolar disorder.
The Swedish National Inpatient Register (IPR), also called the Hospital Discharge Register, is a principal source of data for numerous research projects. The IPR is part of the National Patient Register. The Swedish IPR was launched in 1964 (psychiatric diagnoses from 1973) but complete coverage did not begin until 1987. Currently, more than 99% of all somatic (including surgery) and psychiatric hospital discharges are registered in the IPR. A previous validation of the IPR by the National Board of Health and Welfare showed that 85-95% of all diagnoses in the IPR are valid. The current paper describes the history, structure, coverage and quality of the Swedish IPR.
In January 2010, we searched the medical databases, Medline and HighWire, using the search algorithm "validat* (inpatient or hospital discharge) Sweden". We also contacted 218 members of the Swedish Society of Epidemiology and an additional 201 medical researchers to identify papers that had validated the IPR. In total, 132 papers were reviewed. The positive predictive value (PPV) was found to differ between diagnoses in the IPR, but is generally 85-95%.
In conclusion, the validity of the Swedish IPR is high for many but not all diagnoses. The long follow-up makes the register particularly suitable for large-scale population-based research, but for certain research areas the use of other health registers, such as the Swedish Cancer Register, may be more suitable.
There is a long-standing belief that creativity is coupled with psychopathology.
To test this alleged association and to investigate whether any such association is the result of environmental or genetic factors.
We performed a nested case-control study based on Swedish registries. The likelihood of holding a creative occupation in individuals who had received in-patient treatment for schizophrenia, bipolar disorder or unipolar depression between 1973 and 2003 and their relatives without such a diagnosis was compared with that of controls.
Individuals with bipolar disorder and healthy siblings of people with schizophrenia or bipolar disorder were overrepresented in creative professions. People with schizophrenia had no increased rate of overall creative professions compared with controls, but an increased rate in the subgroup of artistic occupations. Neither individuals with unipolar depression nor their siblings differed from controls regarding creative professions.
A familial cosegregation of both schizophrenia and bipolar disorder with creativity is suggested.
We argue that hyper-systemizing predisposes individuals to show talent, and review evidence that hyper-systemizing is part of the cognitive style of people with autism spectrum conditions (ASC). We then clarify the hyper-systemizing theory, contrasting it to the weak central coherence (WCC) and executive dysfunction (ED) theories. The ED theory has difficulty explaining the existence of talent in ASC. While both hyper-systemizing and WCC theories postulate excellent attention to detail, by itself excellent attention to detail will not produce talent. By contrast, the hyper-systemizing theory argues that the excellent attention to detail is directed towards detecting 'if p, then q' rules (or [input-operation-output] reasoning). Such law-based pattern recognition systems can produce talent in systemizable domains. Finally, we argue that the excellent attention to detail in ASC is itself a consequence of sensory hypersensitivity. We review an experiment from our laboratory demonstrating sensory hypersensitivity detection thresholds in vision. We conclude that the origins of the association between autism and talent begin at the sensory level, include excellent attention to detail and end with hyper-systemizing.
To validate the ICD-10 diagnosis of a single depressive episode as used in daily clinical psychiatric practice and as recorded in the Danish Psychiatric Central Research Register.
Patients discharged with a diagnosis of a single depressive episode were consecutively sampled from the register and diagnosed according to an interview using the Schedules for Clinical Assessment in Neuropsychiatry (SCAN).
A total of 75.4% of 399 patients with a register diagnosis of a single depressive episode also got this diagnosis according to the SCAN interview (82.8% for severe type of a single depression, 76.0% for moderate type of a single depression and 65.2% for mild type of a single depression).
The ICD-10 diagnosis of a single depressive episode can be used in daily clinical practice with sufficient precision. The validity of the diagnosis is highest for severe and moderate type of depression and decreases for mild depression.
To investigate the impact of coexistent psychiatric morbidity on risk of suicide after a suicide attempt.
Cohort study with follow-up for 21-31 years.
Swedish national register based study.
39 685 people (53% women) admitted to hospital for attempted suicide during 1973-82.
Completed suicide during 1973-2003.
A high proportion of suicides in all diagnostic categories took place within the first year of follow-up (14-64% in men, 14-54% in women); the highest short term risk was associated with bipolar and unipolar disorder (64% in men, 42% in women) and schizophrenia (56% in men, 54% in women). The strongest psychiatric predictors of completed suicide throughout the entire follow-up were schizophrenia (adjusted hazard ratio 4.1, 95% confidence interval 3.5 to 4.8 in men, 3.5, 2.8 to 4.4 in women) and bipolar and unipolar disorder (3.5, 3.0 to 4.2 in men, 2.5, 2.1 to 3.0 in women). Increased risks were also found for other depressive disorder, anxiety disorder, alcohol misuse (women), drug misuse, and personality disorder. The highest population attributable fractions for suicide among people who had previously attempted suicide were found for other depression in women (population attributable fraction 9.3), followed by schizophrenia in men (4.6), and bipolar and unipolar disorder in women and men (4.1 and 4.0, respectively).
Type of psychiatric disorder coexistent with a suicide attempt substantially influences overall risk and temporality for completed suicide. To reduce this risk, high risk patients need aftercare, especially during the first two years after attempted suicide among patients with schizophrenia or bipolar and unipolar disorder.
We investigated effects of occupational physical activity on relative risk for prostate cancer. From Swedish nationwide censuses in 1960 and 1970, we defined two cohorts of men whose occupational titles allowed classification of physical activity levels at work in 1960 (n=1 348 971) and in 1970 (n=1 377 629). A third cohort included only men whose jobs required a similar level of physical activity in both 1960 and 1970 (n=673 443). The incidence of prostate cancer between 1971 and 1989 was ascertained through record linkage to the Swedish Cancer Register. A total of 43 836, 28 702, and 19 670 prostate cancers, respectively, occurred in the three cohorts. In all three cohorts, the relative risk for prostate cancer increased with decreasing level of occupational physical activity (P<0.001), using Poisson regression. Among men with the same physical activity levels in 1960 and 1970, the rate ratio was 1.11 for men with sedentary jobs as compared with those whose jobs had very high/high activity levels after adjustment for age at follow-up, calendar year of follow-up and place of residence (95% CI 1.05–1.17; P for trend <0.001). There was no association between occupational activity and prostate cancer mortality. Since we had no data on other potential risk factors the observed associations for both incidence and mortality might have been confounded. Further studies are needed to better understand the potential role of physical activity for prostate cancer.
British Journal of Cancer (2002) 86, 70–75. DOI: 10.1038/sj/bjc/6600023 www.bjcancer.com
© 2002 The Cancer Research Campaign
Theory and research in both personality psychology and creativity share an essential commonality: emphasis on the uniqueness of the individual. Both disciplines also share an emphasis on temporal consistency and have a 50-year history, and yet no quantitative review of the literature on the creative personality has been conducted. The 3 major goals of this article are to present the results of the first meta-analytic review of the literature on personality and creative achievement, to present a conceptual integration of underlying potential psychological mechanisms that personality and creativity have in common, and to show how the topic of creativity has been important to personality psychologists and can be to social psychologists. A common system of personality description was obtained by classifying trait terms or scales onto one of the Five-Factor Model (or Big Five) dimensions: neuroticism, extraversion, openness, agreeableness, and conscientiousness. Effect size was measured using Cohen's d (Cohen, 1988). Comparisons on personality traits were made on 3 sets of samples: scientists versus nonscientists, more creative versus less creative scientists, and artists versus nonartists. In general, creative people are more open to new experiences, less conventional and less conscientious, more self-confident, self-accepting, driven, ambitious, dominant, hostile, and impulsive. Out of these, the largest effect sizes were on openness, conscientiousness, self-acceptance, hostility, and impulsivity. Further, there appears to be temporal stability of these distinguishing personality dimensions of creative people. Dispositions important to creative behavior are parsed into social, cognitive, motivational, and affective dimensions. Creativity like most complex behaviors requires an intra- as well as interdisciplinary view and thereby mitigates the historically disciplinocentric attitudes of personality and social psychologists.
The suicide rates in Denmark have been declining during the last two decades. The decline was relatively larger among women than among men. All age groups experienced a decline except the very young with stable rates and the very old with increasing rates. The Universal, Selective, Indicated (USI) model recommended by Institute of Medicine was used as a framework for the thesis. Universal preventive interventions are directed toward the entire population; selective interventions are directed toward individuals who are at greater risk for suicidal behaviour; and indicated preventions are targeted at individuals who have already begun self-destructive behaviour. At the universal level, a review was carried out to highlight the association between availability of methods for suicide and suicide rate. There were mostly studies of firearms, and the conclusion of the review was that there was clear indication of restricted access to lethal means was associated with decline in suicide with that specific method, and in many cases also with overall suicide mortality. Restricting access is especially important for methods with high case fatality rate. Our own study indicated a beneficial effect on suicide rates of restrictions in access to barbiturates, dextropropoxyphen, domestic gas and car exhaust with high content of carbon monoxide. Although a range of other factors in the society might also be of importance, it was concluded that restrictions in access to dangerous means for suicide were likely to play an important role in reducing suicide rates in Denmark, especially for women. At the selective level, there are several important risk groups such as psychiatric patients, persons with alcohol and drug abuse, persons with newly diagnosed severe physical illness, all who previously attempted suicide, and groups of homeless, institutionalized, prisoners and other socially excluded persons. The thesis focused on homeless persons and psychiatric patients, especially patients with schizophrenia and related disorders. The thesis contains a review of the risk of suicide in homeless. In all the studies included, increased suicide mortality was found, and in the studies that evaluated suicide risk in different age groups, the excess suicide mortality was most dominant in younger age groups. Our own study revealed an increased risk of suicide, and in univariate analysis, significant predictors for suicide were found to be associated with shortest stay in hostel less than 11 days and more than one stay during one year. The thesis also contains a review of the risk of suicide in first-episode patients with schizophrenia, and it was concluded on the basis of the identified studies that long-term risk of suicide was not 10 percent as previously accepted, but lower. Risk factors for suicide among patients with schizophrenia were evaluated in case control studies, in nested case control studies, and in prospective studies. The following risk factors were the most important and frequently observed predictors: male gender, young age, short duration of illness, many admissions during last year, current inpatient, short time since discharge, previous and recent suicide attempt, co-morbid depression, drug abuse, poor compliance with medication, poor adherence to treatment, high IQ, and suicidal ideations. The results of analyses of psychotic symptoms as risk factor for suicide were contradictory, but a recent meta-analysis concluded that both hallucinations and delusions seemed to be protective; however, there was a non-significant tendency that command hallucinations were associated with higher suicide risk. Prevention of suicide in schizophrenia must especially focus on improving assessment of risk of suicide during inpatient treatment and the first week after discharge, and special attention must be paid to patients with one or more of the identified risk factors. There is a need for large randomised clinical trials evaluating the effect on suicide and suicide attempt of psychosocial and pharmacological treatment in schizophrenia. In our own study, we did not find any effect of integrated treatment on attempted suicide, but there was an effect on hopelessness and a trend toward lower prevalence of depression among patients in the integrated treatment. There were four suicides and one probable suicide (drowning) in standard treatment and one suicide in integrated treatment at two-year follow-up, but the study did not have sufficient power to detect these differences in proportion to who committed suicide; more than one thousand patients should have been in each treatment condition in order for these differences in proportion to be significant. At the indicated prevention level, a literature review was carried out regarding risk of suicide attempt and suicide in short-term, medium-term and long-term follow-up of persons who attempted suicide. It was concluded that the risk of repetition in short- and medium-term follow-up studies was approximately 16 percent, with lower risk among "first-evers" compared to repeaters. There was a large variation in repetition rate. The proportion who committed suicide in medium-term follow-up studies was 2.8 percent and in long-term follow-up studies was 3.5 percent (weighted mean) with clearly higher proportions in the Nordic studies than in the studies from UK. Risk factors for attempted suicide were previous suicide attempt, alcohol and drug abuse, depression, schizophrenia, previous inpatient treatment, self-discharge before evaluation, sociopathy, unemployment, frequent change of address, hostility, and living alone. Several of the predictors are overlapping and most of them were already identified in early studies of factors predictive of repetition of suicide attempt. Predictors of suicide were male gender, increasing age, previous suicide attempt, serious suicide attempt, alcohol and substance abuse, somatic disease, mental illness, and planning of suicide attempt, high suicidal intent score, violent suicide attempt or suicide attempt with severe lethality, and ongoing or previous psychiatric treatment. In our follow-up study from Bispebjerg Hospital, we found that the risk of suicide during a ten-year follow-up period among patients admitted in 1980 after self-poisoning was 30 times greater than in the general population. We also found increased mortality by all other causes of death. Predictors of suicide were several previous suicide attempts, living alone and increasing age. There are not many randomised clinical trials of psychosocial interventions aiming to reduce risk of repetition among suicide attempters. A Cochrane review concluded that evidence was lacking to indicate the most effective forms of treatment for deliberate self-harm patients. A recent randomised controlled trial showed a positive influence of cognitive behavioural therapy on repetition rate. Our own quasi-experimental study of effectiveness of two weeks' inpatient treatment in a special unit of young persons who had severe suicidal thoughts or who had attempted suicide showed that risk of repetition was reduced in the intervention group, and that the intervention group obtained a significantly greater improvement in Beck's Depression Inventory, Hopelessness Scale, Rosenberg Self-Esteem Scale and CAGE-score. The study of emergency outreach indicates that there are many persons in the community that experience a suicidal crisis, and that this group is an important target group for psychiatric emergency outreach. In our study of registration and referral practice in Copenhagen Hospital Cooperation, we conclude that not all suicide attempts were registered as such in the National Patient Register - in fact, only 37 percent. It must be concluded that the quality of the Danish Patient Register must be improved with regard to registration of suicide attempt. We found that psychiatric evaluation was planned in relation to almost all suicide attempts, but that it must be recommended to pay attention to escorting patients to psychiatric emergency in order to ensure that the patient actually attends the planned consultation. We found that patients who were referred after psychiatric evaluation to psychiatric treatment at outpatient facilities only received the planned treatment in approximately two-thirds of the cases; therefore, like Hawton et al. [Hawton et al., 1998; Hawton et al., 1999], we recommend that outpatient facilities adopt an assertive approach to patients who have attempted suicide. Danish suicide research is strong, primarily due to the possibilities for linking complete national registers providing detailed data and large sample sizes for suicide research, which is so far unique for the Nordic countries. This, combined with skilful use of epidemiological methods, had resulted in a remarkable series of papers highlighting risk of suicide in different risk groups, risk factors and protective factors. This activity must continue. In this work it is important to be aware of limitations in naturalistic studies such as the risk of interchanging cause and effect and the necessity to carry out control for confounders. Meta-analysis is a strong tool for summing up results of previous research. Meta-analyses can be used in reporting the evidence for effectiveness of interventions, but also for determining risk or identifying risk factors. A meta-analysis of risk factors of repetition of suicide attempt has not been carried out, and the quality of the identified studies did not allow a formal meta-analysis. Large randomised clinical trials examining the effectiveness of interventions on reducing rate of suicide attempt and suicide should have high priority. Suicide is a major public health problem and should be given high priority with regard to prevention and research. (ABSTRACT TRUNCATED)
This comparative study of Icelanders, born during the period 1881–1910, indicates that close relatives of psychotic individuals have a significantly increased probability of being considered persons of eminence. Their rate of listing in Who Is Who is doubled, both in regard to general listings and those based on artistic or scholastic endeavors. Review of relevant literature supports the view that the dominant principal gene proposed for schizophrenia may in a heterozygous state lead to cerebral stimulation, with improved performance in areas of giftedness and creativity.
All four facets of creativity – Person, Product, Process, and Press – have long been seen in a positive light. Creativity is strongly linked to favorable psychological development, beneficial outcomes, and aesthetic achievement. It is increasingly clear, however, that creativity also has a dark side that can manifest itself equally strongly in the four facets of creativity. Whether these manifestations take the form of mental problems, destructive outcomes, or harmful, criminal behavior, it is clear that the generation of effective, useful novelty is not limited to that which is inherently good. Terrorists, for example, are often fiendishly creative.
In order to assess the quality of the Stockholm county inpatient register for use in epidemiological studies on schizophrenia, a retrospective validity study was performed on a 10% sample of all patients discharged with the diagnosis schizophrenia from hospitals in Stockholm county during 1971. In order to assess fulfillment of the DSM-III criteria for schizophrenia, 102 medical records with an ICD-8 diagnosis of schizophrenia were scrutinized. Seventy-eight patients (76%) were classified as positively fulfilling the DSM-III criteria. In a global assessment, taking into account a lack of documentation on some criteria, 85 patients (83%) were judged as fulfilling the DSM-III criteria for schizophrenia. Excluding the ICD-8 schizo-affective subgroup, 88% of the patients fulfilled the DSM-III criteria for schizophrenia. The DSM-III schizophrenia criteria seem to fit the Swedish diagnostic tradition, except for the age limit of 45 years which excluded 36% of the paranoid group. The study confirms that the ICD diagnosis schizophrenia has been applied with great restriction in Sweden. The validity of the Stockholm county inpatient register as regards the diagnosis schizophrenia is thus quite satisfactory for epidemiological studies on schizophrenia.
This article assesses and extends Campbell's (1960) classic theory that creativity and discovery depend on blind variation and selective retention (BVSR), with special attention given to blind variations (BVs). The treatment begins by defining creativity and discovery, variant blindness versus sightedness, variant utility and selection, and ideational variants versus creative products. These definitions lead to BV identification criteria: (a) intended BV, which entails both systematic and stochastic combinatorial procedures; and (b) implied BV, which involves both variations with properties of blindness (variation superfluity and backtracking) and processes that should yield variant blindness (associative richness, defocused attention, behavioral tinkering, and heuristic search). These conceptual definitions and identification criteria then have implications for four persistent issues, namely, domain expertise, ideational randomness, analogical equivalence, and personal volition. Once BV is suitably conceptualized, Camp-bell's theory continues to provide a fruitful approach to the understanding of both creativity and discovery.
My main goal is simply to reinterpret schizophrenia and certain closely related forms of pathology (the so-called schizophrenia spectrum of illnesses, which also includes schizoid and schizotypal, and some forms of schizophreniform and schizoaffective, disorders); to show, using the affinities with modernism, that much of what has been passed off as primitive or deteriorated is far more complex and interesting—and self-aware—than is usually acknowledged.
In this book I will be concerned almost exclusively with phenomenological issues, the forms of consciousness and the texture of the lived world characteristics of many schizophrenics. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Modern computer technology permits efficient evaluation of test scores in terms of basic orthogonal factors of ability. A three-level hierarchical model of cognitive abilities was used as the theoretical basis of the computerized Swedish Enlistment Battery (CAT-SEB). Structural analysis of ten ability tests on a sample of 1,436 conscripts by confirmatory factor analysis (tested by the LISREL system) revealed a general, a verbal and a spatial factor -- although the determinacy of the latter was weak. A nested factor model was used, with direct influences of the latent variables on the tests. This result is a construct validity evaluation of the testing system. Unrelated factor scores of the three latent variables comprise the output of the testing system. Future research should evaluate the efficiency of the prediction from the latent variables.
The aim of the study was to explore the validity of registry-based diagnoses of autism in Finland using the Autism Diagnostic Interview - Revised (ADI-R). This study was designed for the Finnish Prenatal Study of Autism and Autism Spectrum Disorders (FIPS-A), an ongoing research project where registry-based diagnoses will be used for epidemiological studies.
In this small pilot study, a clinical sample of 95 subjects diagnosed with childhood autism or pervasive developmental disorder/pervasive developmental disorder - not otherwise specified (PDD/PDD-NOS) or Asperger's syndrome according to the Finnish Hospital Discharge Register (FHDR) was gathered nationwide. A small control group consisting of siblings without any registered diagnoses of those being examined was also included in the study. Diagnoses were further re-evaluated by interviewing parents with the ADI-R.
The mean scores of autistic subjects clearly exceeded cut-off limits for autism on all three ADI-R domains and 96% of the subjects with registered diagnosis of childhood autism fulfilled the criteria based on the instrument as well.
These results suggest that the validity of Finnish registry-based diagnoses of childhood autism can be considered good. Our findings lay important groundwork for further population- based studies of the aetiology of autism.
The apparently large genetic contribution to the aetiology of mental illness presents a formidable puzzle. Unlike common physical disorders, mental illness usually has an onset early in the reproductive age and is associated with substantial reproductive disadvantage. Therefore, genetic variants associated with vulnerability to mental illness should be under strong negative selection pressure and be eliminated from the genetic pool through natural selection. Still, mental disorders are common and twin studies indicate a strong genetic contribution to their aetiology. Several theories have been advanced to explain the paradox of high heritability and reproductive disadvantage associated with the same common phenotype, but none provides a satisfactory explanation for all types of mental illness. At the same time, identification of the molecular substrate underlying the large genetic contribution to the aetiology of mental illness is proving more difficult than expected. The quest for genetic variants associated with vulnerability to mental illness is predicated upon the common disease/common variant (CDCV) hypothesis. On the basis of a summary of evidence, it is concluded that the CDCV hypothesis is untenable for most types of mental illness. An alternative evolution-informed framework is proposed, which suggests that gene-environment interactions and rare genetic variants constitute most of the genetic contribution to mental illness. Common mental illness with mild reproductive disadvantage is likely to have a large contribution from interactions between common genetic variants and environmental exposures. Severe mental illness that confers strong reproductive disadvantage is likely to have a large and pleiotropic contribution from rare variants of recent origin. This framework points to a need for a paradigm change in genetic research to enable major progress in elucidating the aetiology of mental illness.
The raised incidence of special abilities or 'savant skills' among individuals with autism spectrum disorders (ASD) relative to other developmental disorders suggests an association between the traits characteristic of ASD and special abilities. The purpose of this study was to investigate the association between special abilities and ASD-like traits.
This study compared the scores of 6,426 8-year-olds with and without parent-reported special abilities on a screening questionnaire for ASD-like traits in three areas: social interaction, communication, and restricted and repetitive behaviours and interests. Measures of IQ, sex, and socioeconomic status (SES) were also compared.
From parent report, children with special abilities showed significantly more ASD-like traits than those without such abilities. General intelligence did not mediate this relationship: IQ was found to be positively associated with ability, but negatively associated with ASD-like traits. Special abilities were more strongly associated with restricted/repetitive characteristics than with social or communication traits.
Results support the association between special abilities and ASD-like traits, and expand it to traits in the general population. The type of nonsocial traits most strongly associated with parental reports of special abilities suggests a link to a feature information processing style, or 'weak central coherence'.
Whether schizophrenia and bipolar disorder are the clinical outcomes of discrete or shared causative processes is much debated in psychiatry. We aimed to assess genetic and environmental contributions to liability for schizophrenia, bipolar disorder, and their comorbidity.
We linked the multi-generation register, which contains information about all children and their parents in Sweden, and the hospital discharge register, which includes all public psychiatric inpatient admissions in Sweden. We identified 9 009 202 unique individuals in more than 2 million nuclear families between 1973 and 2004. Risks for schizophrenia, bipolar disorder, and their comorbidity were assessed for biological and adoptive parents, offspring, full-siblings and half-siblings of probands with one of the diseases. We used a multivariate generalised linear mixed model for analysis of genetic and environmental contributions to liability for schizophrenia, bipolar disorder, and the comorbidity.
First-degree relatives of probands with either schizophrenia (n=35 985) or bipolar disorder (n=40 487) were at increased risk of these disorders. Half-siblings had a significantly increased risk (schizophrenia: relative risk [RR] 3.6, 95% CI 2.3-5.5 for maternal half-siblings, and 2.7, 1.9-3.8 for paternal half-siblings; bipolar disorder: 4.5, 2.7-7.4 for maternal half-siblings, and 2.4, 1.4-4.1 for paternal half-siblings), but substantially lower than that of the full-siblings (schizophrenia: 9.0, 8.5-11.6; bipolar disorder: 7.9, 7.1-8.8). When relatives of probands with bipolar disorder were analysed, increased risks for schizophrenia existed for all relationships, including adopted children to biological parents with bipolar disorder. Heritability for schizophrenia and bipolar disorder was 64% and 59%, respectively. Shared environmental effects were small but substantial (schizophrenia: 4.5%, 4.4%-7.4%; bipolar disorder: 3.4%, 2.3%-6.2%) for both disorders. The comorbidity between disorders was mainly (63%) due to additive genetic effects common to both disorders.
Similar to molecular genetic studies, we showed evidence that schizophrenia and bipolar disorder partly share a common genetic cause. These results challenge the current nosological dichotomy between schizophrenia and bipolar disorder, and are consistent with a reappraisal of these disorders as distinct diagnostic entities.
This study was designed to determine (1) whether members of the 8 "creative arts" professions (i.e., architects, artists, musicians, composers, actors/directors, essayists, fiction writers, and poets) display greater rates of psychopathology than members of other professions, and (2) whether a significant relationship exists between creative achievement and mental disturbance. The final study sample (n = 1,005), constituting 18 separate professions, consisted of all appropriate individuals whose biographies were reviewed in the New York Times Book Review over a 30-year period (1960 to 1990). The results, in their entirety, suggest (a) that different patterns of psychopathology, if any, tend to be associated with different professions and at different periods in individuals' lives, (b) that different professions are associated with different levels of creative achievement, and (c) that certain types of psychopathology are associated with creative achievement across all professions.
The main purpose of the present study was to assess the quality of information about occupational history obtained via retrospective interview questions. This assessment is achieved by linking interview data from the Swedish survey of Living Conditions (ULF) with occupational information about the same individuals obtained from a number of censuses. This has been done for the census years 1960, 1970, 1975 and 1980. In both ULF and the census, occupations have been classified according to the Nordic Occupational Classification (NYK). Both data sources contain errors. There are also differences in definitions and measurement procedures. Still, the survey question on occupational history gives results of good quality in terms of agreement with census data. This is especially the case for coarse levels of the classification scheme (NYK 1-digit level). The agreement is somewhat lower for the comparisons farthest back in time.
Extremes in mood, thought and behavior--including psychosis--have been linked with artistic creativity for as long as man has observed and written about those who write, paint, sculpt or compose. The history of this long and fascinating association, as well as speculations about its reasons for being, have been discussed by several modern authors and investigators, including Koestler (1975), Storr (1976), Andreasen (1978), Becker (1978), Rothenberg (1979), Richards (1981), Jamison (in press) and Prentky (in press). The association between extreme states of emotion and mind and creativity not only is fascinating but also has significant theoretical, clinical, literary and societal-ethical implications. These issues, more thoroughly reviewed elsewhere (Jamison et al. 1980; Richards 1981; Jamison, in press), include the understanding of cognitive, perceptual, mood and behavioral changes common to manic, depressive and creative states; the potential ability to lessen the stigma of mental illness; effects of psychiatric treatment (for example, lithium) on creativity; and concerns raised about genetic research on mood disorders. The current study was designed to ascertain rates of treatment for affective illness in a sample of eminent British writers and artists; to study differences in subgroups (poets, novelists, playwrights, biographers, artists); to examine seasonal patterns of moods and productivity; and to inquire into the perceived role of very intense moods in the writers' and artists' work. One of the major purposes of this investigation was to look at possible similarities and dissimilarities between periods of intense creative activity and hypomania. Hypothesized similarities were based on the overlapping nature of mood, cognitive and behavioral changes associated with both; the episodic nature of both; and possible links between the durational, frequency and seasonal patterns of both experiences.
Rates of mental illness were examined in 30 creative writers, 30 matched control subjects, and the first-degree relatives of both groups. The writers had a substantially higher rate of mental illness, predominantly affective disorder, with a tendency toward the bipolar subtype. There was also a higher prevalence of affective disorder and creativity in the writers' first-degree relatives, suggesting that these traits run together in families and could be genetically mediated. Both writers and control subjects had IQs in the superior range; the writers excelled only on the WAIS vocabulary subtest, confirming previous observations that intelligence and creativity are independent mental abilities.
This investigation sought to determine the prevalences of various psychopathologies in outstandingly creative individuals, and to test a hypothesis that the high prevalence of mental abnormalities reported in prominent living creative persons would not be found in those who had achieved and retained world status.
The family background, physical health, personality, psychosexuality and mental health of 291 famous men in science, thought, politics, and art were investigated. The membership of the six series of scientists and inventors, thinkers and scholars, statesmen and national leaders, painters and sculptors, composers, and of novelists and playwrights was determined by the availability of sufficiently adequate biographies. Extracted data were transformed into diagnoses in accordance with DSM-III-R criteria, when appropriate.
All excelled not only by virtue of their abilities and originality, but also of their drive, perseverance, industry, and meticulousness. With a few exceptions, these men were emotionally warm, with a gift for friendship and sociability. Most had unusual personality characteristics and, in addition, minor 'neurotic' abnormalities were probably more common than in the general population. Severe personality deviations were unduly frequent only in the case of visual artists and writers. Functional psychoses were probably less frequent than psychiatric epidemiology would suggest, and they were entirely restricted to the affective varieties. Among other functional disorders, only depressive conditions, alcoholism, and, less reliably, psychosexual problems were more prevalent than expected in some professional categories, but strikingly so in writers.
Similar findings have been reported for living artists and writers, and this suggests that certain pathological personality characteristics, as well as tendencies towards depression and alcoholism, are causally linked to some kinds of valuable creativity.
An earlier study of 291 world famous men had shown that only visual artists and creative writers were characterised, in comparison with the general population, by a much higher prevalence of pathological personality traits and alcoholism. Depressive disorders, but not any other psychiatric conditions, had afflicted writers almost twice as often as men with other high creative achievements. The present investigation was undertaken to confirm these findings in a larger and more comprehensive series of writers, and to discover causal factors for confirmed high prevalences of affective conditions and alcoholism in writers.
Data were collected from post-mortem biographies and, where applicable, translated into DSM diagnoses. The frequencies of various abnormalities and deviations were compared between poets, prose fiction writers, and playwrights.
A high prevalence in writers of affective conditions and of alcoholism was confirmed. That of bipolar affective psychoses exceeded population norms in poets, who in spite of this had a lower prevalence of all kinds of affective disorders, of alcoholism, of personality deviations, and related to this, of psychosexual and marital problems, than prose fiction and play writers.
A hypothesis is developed, which links the greater frequency of affective illnesses and alcoholism in playwrights and prose writers, in comparison with poets, to differences in the nature and intensity of their emotional imagination. This hypothesis could be tested by clinical psychologists collaborating with experts in literature on random samples of different kinds of writers.
To conduct a systematic review of studies investigating the validity of administrative registers for use in psychiatric research.
Studies were identified using MEDLINE (1966-2004) and EMBASE (1980-2004) databases using keywords 'validity' or 'reliability' combined with 'register' or 'database$'. Studies reviewed by two raters blind to each other and quality assessed using a data extraction form devised by the authors. A narrative description of the findings is presented.
Fourteen studies were identified, seven of which concerned Scandinavian registers. Ten studies were solely concerned with diagnostic validity and the most common single diagnosis studied was schizophrenia (five studies). Methods used and study quality varied widely.
Given the importance of the area, relatively little high-quality work exists into systematically measuring the diagnostic data validity of registers for research purposes.
We aimed to estimate the value of structured interviews, medical records and Swedish register diagnoses for assessing lifetime diagnosis of patients with schizophrenia. Psychiatric records and diagnostic interviews of 143 Swedish patients diagnosed by their treating physician with schizophrenia and related disorders were scrutinized. Based on record analysis only, or a combined record and interview analysis, DSM-IV diagnoses were obtained by the OPCRIT algorithm. Independent of the OPCRIT algorithm, a standard research DSM-IV diagnosis, based on both record and interview analysis, was given by the research psychiatrist. Concordance rates for the different psychosis diagnoses were calculated. DSM-IV diagnoses based on records only, showed a good to excellent agreement with diagnoses based on records and interviews. Swedish register diagnoses displayed generally poor agreement with the research diagnoses. Nevertheless, 94% of subjects sometimes registered with a diagnosis of schizophrenic psychoses (i.e. schizophrenia, schizoaffective psychosis or schizophreniform disorder) displayed a standard research DSM-IV diagnosis of these disorders. For patients in long-term treatment for schizophrenia in Sweden, psychiatric record reviews should be optimal, cost effective and sufficient for assessment of lifetime research diagnoses of schizophrenia. For these patients a research interview adds little new information. The results further indicate that a Swedish register diagnosis of schizophrenic psychoses has a high positive predictive power to a standard research DSM-IV diagnosis of the disorders. It is concluded that for future Swedish large-scale genetic studies focusing on a broad definition of schizophrenia, it would be sufficient to rely on the Swedish register diagnoses of schizophrenic psychosis.
To achieve a unified concept of the aetiology of psychosis.
The nuclear symptoms of "schizophrenia" occur with approximately the same age- and sex-specific incidence in all human populations. No substantive environmental precipitant has been identified, and yet these "illnesses" are associated with deviations in brain structure that are uniform across populations, are established late in development and relate to the capacity for language. No genes have been identified by linkage or association strategies. ARGUMENT: It is postulated that the variation 1. relates precisely to the genetic mechanism that distinguishes the species Homo sapiens from its precursor. 2. constitutes a class of epigenetic diversity intrinsic to the genetic control of the species characteristic (the "specific mate recognition system" according to the theory of HEH Paterson). 3. reflects the role of the cerebral torque in the neuro-developmental re-organization that enabled the faculty of language. A genetic mechanism involving both the X and the Y chromosomes is suggested by 1) evidence for anomalies of asymmetry of brain structure and function in the sex chromosome aneuploidies, 2) a same sex concordance effect for handedness, 3) sex differences in lateralization, and verbal and spatial ability, and their inter-relationships. These three facts direct attention to the Xq21.3/Yp11.2 homology block that was established by an X to Y duplication 6 million years ago, ie at the time of origin of the hominid lineage. Within this block a gene pair (Protocadherin11X and Y) expressed as two cell surface adhesion molecules at axo-dendritic synapses has been subject to change (16 amino-acid substitutions in the Y, and critically 5 in the X sequence) in the hominid lineage. The X to Y duplication and its subsequent modification (4 deletions and a paracentric inversion) on the Y may have played a central role in hominid speciation with the most recent change (at around 160,000 years) representing the transition to language and modern Homo sapiens (the 'big bang'). The expression of genes within the homologous region is influenced by the extent to which the X and Y chromosomes pair in male meiosis (referred to as MSUC "meiotic suppression of unpaired chromosomes"). This mechanism generates epigenetic diversity relating to the species capacity for language; it is proposed as the basis of the genetic predisposition to psychosis.
Language and psychosis have a common origin in the genetic event (the 'big bang') that defined the species.
Administrative registers in psychiatric research: a systematic review of validity studies:409e14. Cropley D. The dark side of creativity Crow TJ. The ‘big bang’ theory of the origin of psychosis and the faculty of language
- S Kyaga
S. Kyaga et al. / Journal of Psychiatric Research 47 (2013) 83e90 89 rByrne N, Regan C, Howard L. Administrative registers in psychiatric research: a systematic review of validity studies. Acta Psychiatrica Scandinavica 2005; 112:409e14. Cropley D. The dark side of creativity. Cambridge: Cambridge University Press; 2010. Crow TJ. The ‘big bang’ theory of the origin of psychosis and the faculty of language
Common genetic determinants of schizophrenia and bipolar disorder in Swedish fami-lies: a population-based study Creative achievement and psychopathology e comparison among professions The price of greatness: resolving the creativity and madness contro-versy
- P Lichtenstein
- Yip Bh
- C Björk
- Y Pawitan
- Cannon
- Td
- Sullivan
- Pf
Lichtenstein P, Yip BH, Björk C, Pawitan Y, Cannon TD, Sullivan PF, et al. Common genetic determinants of schizophrenia and bipolar disorder in Swedish fami-lies: a population-based study. Lancet 2009;373:234e9. Ludwig AM. Creative achievement and psychopathology e comparison among professions. American Journal of Psychotherapy 1992;46:330e56. Ludwig AM. The price of greatness: resolving the creativity and madness contro-versy. New York; London: Guilford Press; 1995.
Occupational physical activity and risk for prostate cancer in a nationwide cohort study in Sweden Creativity and psychopathology. A study of 291 world-famous men Verbal creativity, depression and alcoholism. An investigation of one hundred American and British writers
- Norman A T Moradi
- G Gridley
- Rydh M B Dosemeci
- O Nyren
Norman A, Moradi T, Gridley G, Dosemeci M, Rydh B, Nyren O, et al. Occupational physical activity and risk for prostate cancer in a nationwide cohort study in Sweden. British Journal of Cancer 2002;86:70e5. Post F. Creativity and psychopathology. A study of 291 world-famous men. British Journal of Psychiatry 1994;165:22e34. Post F. Verbal creativity, depression and alcoholism. An investigation of one hundred American and British writers. British Journal of Psychiatry 1996;168:
Accuracy of data on diagnoses, procedures and accidents in the Finnish hospital register Creativity in offspring of schizophrenic and control parents: an adoption study
- I Keskimäki
- Richards Dk R Kinney
- Pa Lowing
- D Leblanc
- Zimbalist
- Me
- Harlan
Keskimäki I, Aro S. Accuracy of data on diagnoses, procedures and accidents in the Finnish hospital register. International Journal of Health Sciences 1991;2: 15e21. Kinney DK, Richards R, Lowing PA, LeBlanc D, Zimbalist ME, Harlan P. Creativity in offspring of schizophrenic and control parents: an adoption study. Creativity Research Journal 2000;13:17e25.
Swedish Enlistment Battery (SEB): construct validity and latent variable estimation of cognitive abilities by the CAT-SEB:107e14. Nordentoft M. Prevention of suicide and attempted suicide in Denmark. Epidemi-ological studies of suicide and intervention studies in selected risk groups
- B Mårdberg
- Carlstedt
Mårdberg B, Carlstedt B. Swedish Enlistment Battery (SEB): construct validity and latent variable estimation of cognitive abilities by the CAT-SEB. International Journal of Selection and Assessment 1998;6:107e14. Nordentoft M. Prevention of suicide and attempted suicide in Denmark. Epidemi-ological studies of suicide and intervention studies in selected risk groups. Danish Medical Bulletin 2007;54:306e69.
Creativity in manic-depressives, cyclothymes, their normal relatives, and control subjects Sass LA. Madness and modernism: insanity in the light of modern art, literature and thought Validity of bipolar disorder hospital discharge diagnoses: file review and multiple register linkage in Sweden
- Richards R Dk Kinney
- I Lunde
- M Benet
- Merzel
- C Sellgren
- M Landen
- P Lichtenstein
- Hultman Cm
- Langstrom
Richards R, Kinney DK, Lunde I, Benet M, Merzel AP. Creativity in manic-depressives, cyclothymes, their normal relatives, and control subjects. Journal of Abnormal Psychology 1988;97:281e8. Sass LA. Madness and modernism: insanity in the light of modern art, literature and thought. 3rd ed. Harvard University Press; 1998. Sellgren C, Landen M, Lichtenstein P, Hultman CM, Langstrom N. Validity of bipolar disorder hospital discharge diagnoses: file review and multiple register linkage in Sweden. Acta Psychiatrica Scandinavica 2011;124:447e53. Simonton DK. Origins of genius: Darwinian perspectives on creativity. New York;