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

Objective: Poor scholastic performance is known to pre-date adult schizophr enia. We studied the 1966 North Finland general population birth cohort (n = 11017) in order to determine whether excellent school performance was a r isk or protective factor. Method: Data on school marks at the age of 16 years were linked to data on psychiatric morbidity. Tn total, 89 subjects (58 boys) developed DSM-III-R schizophrenia between the ages of 16 and 28 years. Results: Six (115) of the pre-schizophrenic boys (6/54) had excellent mean school marks, compared to only 3% (166/5245) of the comparison group (OR 3. 8. 95% CI 1.6-9.3, adjusted for parental social class, place of residence a nd birth order). Conclusion: These results may be a chance phenomenon and require replicatio n. However, adult schizophrenia may be linked to excellent school performan ce. This result may be relevant both to the preservation of schizophrenia i n the population, and to mechanisms of developing schizophrenia.