Interestingly, individuals with excellent school performance had an increased risk of later bipolar disorder compared with those with average performance
Individuals with the poorest grades also had a moderately increased risk of bipolar disorder
A study of Tiihonen et al. [4] examined healthy male subjects and suggested that a high score for arithmetic reasoning was associated with a more than 12-fold greater risk of later bipolar disorder.
In addition, poor performance on the visuospatial reasoning test was associated with higher risk for schizophrenia, bipolar disorder, and other psychosis, respectively.
Although bipolar disorder may etiologically share a subtle neurodevelopmental deviation with schizophrenia, enhanced cognitive function can be a risk marker only for bipolar disorder.