Premorbid intelligence quotient and school failure as risk markers for bipolar disorder and major depressive disorder.

Mood disorders significantly impact global health, with MDD ranking as the second leading cause of disability in the United States and BD ranking 18th. Despite their prevalence and impact, the relationship between premorbid intelligence and the subsequent development of BD and MDD remains inconclusive. This study investigates the potential of premorbid Intelligence Quotient (IQ) and school failure frequency as risk factors for Bipolar Disorder (BD) and Major Depressive Disorder (MDD) in a birth cohort setting. We analyze data from the Pelotas population-based birth cohort study, comprising 3580 participants aged 22, who had no prior mood disorder diagnoses. Utilizing regression models and accounting for potential confounders, we assess the impact of IQ and school failure, measured at age 18, on the emergence of BD and MDD diagnoses at age 22, using individuals without mood disorders as comparators. Results reveal that lower IQ (below 70) at 18 is associated with an increased risk of BD (Adjusted Odds Ratio [AOR] 1.75, 95%CI: 1.00-3.09, p < 0.05), while higher IQ (above 120) is linked to MDD (AOR 2.16, 95%CI: 1.24-3.75, p < 0.001). Moreover, an elevated number of school failures is associated with increased BD risk (AOR 1.23, 95%CI: 1.11-1.41, p < 0.001), particularly for BD type 1 (AOR 1.36, 95% CI: 1.17-1.58, p < 0.001). These findings offer insights into the distinct premorbid intellectual characteristics of BD and MDD and contribute to a deeper understanding of their developmental trajectories, potentially informing the development of risk assessment tools for mood disorders.
Competing Interests: Declaration of competing interest Flávio Kapczinski reports personal fees from Daiichi Sankyo and Janssen-Cilag, grants from Stanley Medical Research Institute (07TGF/1148), grants from National Institute for Science and Technology (INCT - CNPq 465458/2014–9), and from the Canada Foundation for Innovation - CFI. Ives Cavalcante Passos has received research support from or served as consultant, adviser or speaker for Lundbeck, EMS, Libbs, and receives authorship royalties from Springer Nature and ArtMed. Furthermore, Ives Cavalcante Passos’ research is supported by National Council for Scientific and Technological Development (CNPq) and by Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES), Brazil Mauricio Kunz reports personal fees from Daiichi Sankyo. Francisco Diego Rabelo-da-Ponte receives authorship royalties from Springer Nature. Silvia Amoretti has been supported by a Sara Borrell contract (CD20/00177), funded by Instituto de Salud Carlos III (ISCIII) and co-funded by European Social Fund “Investing in your future”. The remaining authors do not have competing interests to declare.
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