Artistic Education — Higher Risk of a Mental Disorder?
By Lena Meredith
I say “Vincent van Gogh” and what comes to mind? Famous painter, post-impressionist, Starry Night, yes. But maybe beyond his fantastic accomplishments, you also think “that painter that cut off his ear?” I know I do, and I know Vincent van Gogh is one of the first examples that comes to mind when I think of famous artists with mental disorders. This particular artist suffered from bipolar disorder, and one version of the story says he cut off his ear in a manic fit. Regardless of why he did it, it’s a story that stuck and somehow ties his incredible talents and creativity to being bipolar. So we have to ask — is there actually a scientific basis behind the associations between artistry and mental disorders?
In 2018, the British Journal of Psychiatry published an article called “Artistic creativity and risk for schizophrenia, bipolar disorder and unipolar depression: a Swedish population-based case-control study and sib-pair analysis,” which was a very long title to describe a study that simply looked for associations between studying an artistic topic in school and later developing schizophrenia, bipolar disorder, or depression (MacCabe et al., 2018). Sweden, if anyone wasn’t aware, often uses nation-wide census data for non-experimental studies because of the vastness and depth of information that the government has on all citizens. For this specific study, they were able to look at medical records for the development of one of the three disorders listed in the title, IQ in males, sibling pairs, and artistic classes taken in college or upper secondary school (the equivalent of high school).
The study used Sweden’s Longitudinal integrated database for health insurance and labour market studies (LISA) to collect all this information (MacCabe et al., 2018). On a side note, IQ was restricted to males because that measure was taken from a military screening test. Up until 2009, all Swedish males had mandatory conscription at the age of 18. Other than IQ scores, all information was present for both sexes. After they excluded people not within the criteria, the finalized sample had 194,039 people that studied a class within the “broad” criterion of what counts as an artistic subject (included a wider variety of art and media classes) and 50,288 people who met the “narrow” criteria (specifically visual arts, music, dance, theatre and drama, film, radio and TV production, and fashion design). After separating the groups, the study analyzed associations between the artistically educated populations and the prevalence of the disorders that developed later in these people’s lives. They also included diabetes as a negative control — a group they knew would not be positively associated (MacCabe et al., 2018). Associations just refer to statistical relationships between the two groups that are dependent on each other (a correlation, for example, is a type of association).
Here’s what they found –
This table may look confusing at first but it’s actually very straightforward. The two criteria (wide versus narrow definitions of artistic education) each contain twelve association analyses — three for each disorder/disease. The three models each control for different possible confounding variables, or outside effects that could change the results, noted at the bottom of the table (i.e. gender, age, familial factors, etc.). The statistical numbers in the table are odds ratios that indicate the probability of having one of the disorders is higher than the factor of arts education. A higher ratio number means a stronger association between these two factors. Note that the association numbers for the diabetes condition (the negative control) are all relatively low compared to the others, as expected. The article also noted similar results when they controlled for IQ in males.
So how do we interpret this? Overall, the analyses we just talked about show there were significant associations between both groups of art education and all three psychiatric disorders in this study — schizophrenia, bipolar disorder, and unipolar depression (MacCabe et al., 2018). The associations were still significant when they only analyzed sibling pairs, which means there’s more to these associations than just genetics or familial factors. There were many limitations in this study but the most important one to me was the idea of reverse causation. Because this couldn’t be an experimental study, the researchers had to make do with existing census data from the LISA. Reverse causation means it’s possible the associations are present because people who had already developed the mental disorders were then influenced in certain ways to study artistic subjects. The study was also only within the Swedish population, which makes it difficult to generalize the results to other cultures (but can you blame them for utilizing such a convenient pool of data?).
These results, while semi-understandable, are difficult to explain. Maybe creativity has a genetic basis the way psychiatric disorders do, or maybe a specific cognitive style causes both creativity and certain types of psychosis. Whatever the underlying causes, these conclusions emphasize the need for more research on genetic and environmental contributing factors to assist in identifying people who are predisposed to these disorders.
Maybe van Gogh did cut off his ear in a manic fit. But now maybe we can postulate with a little bit more information about his talents. Maybe he created his best work during his bouts of mania. Did his creativity predispose him to becoming bipolar? Or was it the disorder that brought out his creativity? Perhaps this is the next step for research in the artistic disordered world.
References -
Cheng, S. (2016, November 1). New evidence changes the story of why Vincent van Gogh cut off his ear. Retrieved from https://qz.com/823588/why-vincent-van-gogh-cut-off-his-hear/.
MacCabe, J. H., Sariaslan, A., Almqvist, C., Lichtenstein, P., Larsson, H., & Kyaga, S. (2018). Artistic creativity and risk for schizophrenia, bipolar disorder and unipolar depression: a Swedish population-based case–control study and sib-pair analysis. British Journal of Psychiatry, 212, 370–376. https://doi: 10.1192/bjp.2018.23.
