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Enhanced Neurocognitive Functioning and Positive Temperament in Twins Discordant for Bipolar Disorder
Rachel G. Higier, Ph.D.; Amy M. Jimenez, Ph.D.; Christina M. Hultman, Ph.D.; Jacqueline Borg, Ph.D.; Cristina Roman, B.A.; Isabelle Kizling, M.Sc.; Henrik Larsson, Ph.D.; Tyrone D. Cannon, Ph.D.
Am J Psychiatry 2014;:. doi:10.1176/appi.ajp.2014.13121683
View Author and Article Information

The first two authors contributed equally to this work.

The authors report no financial relationships with commercial interests.

Supported by NIH grant ROIMH052857 (to Dr. Cannon), with additional support from National Science Foundation Graduate Research Fellowships (to Dr. Higier and Dr. Jimenez).

From the Department of Psychology, University of California, Los Angeles; the Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Stockholm; and the Department of Psychology, Yale University, New Haven, Conn.

Presented at the Third Biennial Schizophrenia International Research Society Conference in Florence, Italy, April 14–18, 2012.

Address correspondence to Dr. Cannon (cannon@yale.edu).

Copyright © 2014 by the American Psychiatric Association

Received December 20, 2013; Revised April 02, 2014; Accepted May 06, 2014.

Abstract

Objective  Based on evidence linking creativity and bipolar disorder, a model has been proposed whereby factors influencing liability to bipolar disorder confer certain traits with positive effects on reproductive fitness. The authors tested this model by examining key traits known to be associated with evolutionary fitness, namely, temperament and neurocognition, in individuals carrying liability for bipolar disorder. Schizophrenia probands and their co-twins were included as psychiatric controls.

Method  Twin pairs discordant for bipolar disorder and schizophrenia and control pairs were identified through the Swedish Twin Registry. The authors administered a neuropsychological test battery and temperament questionnaires to samples of bipolar probands, bipolar co-twins, schizophrenia probands, schizophrenia co-twins, and controls. Multivariate mixed-model analyses of variance were conducted to compare groups on temperament and neurocognitive scores.

Results  Bipolar co-twins showed elevated scores on a “positivity” temperament scale compared with controls and bipolar probands, while bipolar probands scored higher on a “negativity” scale compared with their co-twins and controls, who did not differ. Additionally, bipolar co-twins showed superior performance compared with controls on tests of verbal learning and fluency, while bipolar probands showed performance decrements across all neurocognitive domains. In contrast, schizophrenia co-twins showed attenuated impairments in positivity and overall neurocognitive functioning relative to their ill proband counterparts.

Conclusions  These findings suggest that supra-normal levels of sociability and verbal functioning may be associated with liability for bipolar disorder. These effects were specific to liability for bipolar disorder and did not apply to schizophrenia. Such benefits may provide a partial explanation for the persistence of bipolar illness in the population.

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FIGURE 1. Temperament Profiles on Positivity and Negativity Scales for Probands With Bipolar Disorder or Schizophrenia, Non-Affected Co-Twins, and Control Subjectsa

a Error bars indicate standard deviation.

FIGURE 2. Neurocognitive Scores for Probands With Bipolar Disorder or Schizophrenia, Non-Affected Co-Twins, and Control Subjectsa

a Error bars indicate standard deviation.

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TABLE 1.Demographic and Clinical Characteristics of Twin Pairs Discordant for Bipolar Disorder and Schizophrenia and Control Pairsa
Table Footer Note

a Symbols indicate significant differences between groups at p≤0.01.

Table Footer Note

b Significant difference between groups, p<0.01.

+

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