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High intelligence and the risk of ADHD and other psychopathology

  • Nanda Rommelse (a1), Kevin Antshel (a2), Stijn Smeets (a3), Corina Greven (a4), Lianne Hoogeveen (a5), Stephen V. Faraone (a6) and Catharina A. Hartman (a7)...

High intelligence may be associated with positive (adaptive, desired) outcomes, but may also come with disadvantages.


To contribute empirically to the debate concerning whether a trade-off in IQ scores exists in relation to attention-deficit hyperactivity disorder (ADHD) and related problems, suggesting that high intelligence – like low intelligence –increases the risk of ADHD.


Curves of the relation between IQ score and ADHD problems were fitted to questionnaire data (parent, teacher, self-report) in a population-based study of 2221 children and adolescents aged 10–12 years. Externalising and internalising problems were included for comparison purposes.


Higher IQ score was most strongly related to fewer attention problems, with more rater discrepancy in the high v. average IQ range. Attention problems – but only minimally hyperactivity/impulsivity problems – predicted functional impairment at school, also in the higher IQ range.


Attention problems in highly intelligent children are exceptional and affect school performance; they are therefore a reason for clinical concern.

Corresponding author
Dr N. Rommelse, Radboud University Medical Centre, Department of Psychiatry, Reinier Postlaan 10, 6525 GC Nijmegen, The Netherlands. Email:
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Declaration of interest

S.F has received income, potential income, travel expenses and/or research support from Rhodes, Arbor, Pfizer, Ironshore, Shire, Akili Interactive Labs, CogCubed, Alcobra, VAYA Pharma and NeuroLifeSciences. With his institution he has US patent US20130217707 A1 for the use of sodium-hydrogen exchange inhibitors in the treatment of ADHD.

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1 Gale, CR, Batty, GD, Mcintosh, AM, Porteous, DJ, Deary, IJ, Rasmussen, F. Is bipolar disorder more common in highly intelligent people? A cohort study of a million men. Mol Psychiatry 2013; 18: 190–4.
2 Karlsson, JL. Relation of mathematical ability to psychosis in Iceland. Clin Genet 1999; 56: 447–9.
3 Holahan, CK, Holahan, CJ. Being labeled as gifted, self-appraisal, and psychological well-being: a life span developmental perspective. Int J Aging Hum Dev 1999; 48: 161–73.
4 MacCabe, JH, Lambe, MP, Cnattingius, S, Sham, PC, David, AS, Reichenberg, A, et al. Excellent school performance at age 16 and risk of adult bipolar disorder: national cohort study. Br J Psychiatry 2010; 196: 109–15.
5 Plomin, R, Deary, IJ. Genetics and intelligence differences: five special findings. Mol Psychiatry 2015; 20: 98108.
6 Vreeker, A, Boks, MP, Abramovic, L, Verkooijen, S, van Bergen, AH, Hillegers, MH, et al. High educational performance is a distinctive feature of bipolar disorder: a study on cognition in bipolar disorder, schizophrenia patients, relatives and controls. Psychol Med 2016; 46: 807–18.
7 Tiihonen, J, Haukka, J, Henriksson, M, cannon, M, Kieseppa, T, Laaksonen, I, et al. Premorbid intellectual functioning in bipolar disorder and schizophrenia: results from a cohort study of male conscripts. Am J Psychiatry 2005; 162: 1904–10.
8 Sternberg, RJ, Grigorenko, EL, Bundy, DA. The predictive value of IQ. Merrill Palmer Q 2001; 47: 141.
9 Nettle, D. The evolution of personality variation in humans and other animals. Am Psychol 2006; 61: 622–31.
10 Budding, D, Chidekel, D. ADHD and giftedness: a neurocognitive consideration of twice exceptionality. Appl Neuropsychol Child 2012; 1: 145–51.
11 Lee, KM, Olenchak, FR. Individuals with a gifted/attention deficit/ hyperactivity disorder diagnosis: identification, performance, outcomes, and interventions. Gifted Education International 2014; 31: 185–99.
12 Webb, JT, Amend, ER, Webb, NE, Goerss, J, Beljan, P, Olenchak, FR. Misdiagnosis and Dual Diagnoses of Gifted Children and Adults. Great Potential Press, 2005.
13 Milioni, ALV, Chaim, TM, Cavallet, M, de Oliveira, NM, Annes, M, dos Santos, B, et al. High IQ may ‘mask’ the diagnosis of ADHD by compensating for deficits in executive functions in treatment-naïve adults with ADHD. J Atten Disord 2017; 21: 455–64.
14 Moon, SM. Gifted children with attention-deficit/hyperactivity disorder. In The Social and Emotional Development of Gifted Children: What Do We Know? (eds Niehart, M, Reis, S, Robinson, N, Moon, S): 193201. National Association for Gifted Children, 2002.
15 Alloway, TC, Elsworth, M. An investigation of cognitive skills and behavior in high ability students. Learn Individ Differ 2012; 22: 891–5.
16 Richards, J, Encel, J, Shute, R. The emotional and behavioral adjustment of intellectually gifted adolescents: a multi-dimensional, multi-informant approach. High Ability Studies 2003; 14: 153–64.
17 Rommelse, N, van der Kruijs, M, Damhuis, J, Hoek, I, Smeets, S, Antshel, KM, et al. An evidenced-based perspective on the validity of attention-deficit/hyperactivity disorder in the context of high intelligence. Neurosci Biobehav Rev 2016; 71: 2147.
18 De Winter, AF, Oldehinkel, AJ, Veenstra, R, Brunnekreef, JA, Verhulst, FC, Ormel, J. Evaluation of non-response bias in mental health determinants and outcomes in a large sample of pre-adolescents. Eur J Epidemiol 2005; 20: 173–81.
19 Huisman, M, oldehinkel, AI, de Winter, A, Minderaa, RB, de Bildt, A, Huizink, AC, et al. Cohort Profile: The Dutch ‘TRacking Adolescents Individual Lives' Survey’. TRAILS. Int J Epidemiol 2008; 37: 1227–35.
20 Van Haasen, PP, De Bruyn, EEJ, Pijl, YL, Poortinga, YH, Lutje Spelberg, HC, vander steene, G, et al. wechsler intelligence Scale for Children – Revised (Dutch edn). Swets ' zeitlinger, 1986.
21 wechsler, D. wechsler Intelligence Scale for Children – Revised. Psychological Corporation, 1974.
22 Sattler, JM. Assessment of Children (3rd edn). Jerome M. Sattler, 1992.
23 Achenbach, TM, Rescorla, LA. Manual for the ASEBA School-Age Forms and Profiles. University of Vermont, Research Center for Children, Youth, and Families, 2001.
24 Benjamini, Y, Hochberg, Y. Controlling the false discovery rate: a practical and powerful approach to multiple testing. J Roy Stat Soc Series B 1995; 57: 289300.
25 Bracken, BA, Brown, EF. Behavioral identification and assessment of gifted and talented students. J Psychoeduc Assess 2006; 24: 112–22.
26 Gere, DR, Capps, SC, Mitchell, DW, Grubbs, W. Sensory sensitivities of gifted children. Am J Occup Ther 2009; 64: 288–95.
27 Ackerman, CM. Identifying gifted adolescents using personality characteristics: Dabrowski's overexcitabilities. Roeper Rev 1997; 19: 229–36.
28 Bouchet, N, Falk, RF. The relationship among giftedness, gender, and overexcitability. Gift Child Q 2001; 45: 260–7.
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The British Journal of Psychiatry
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High intelligence and the risk of ADHD and other psychopathology

  • Nanda Rommelse (a1), Kevin Antshel (a2), Stijn Smeets (a3), Corina Greven (a4), Lianne Hoogeveen (a5), Stephen V. Faraone (a6) and Catharina A. Hartman (a7)...
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