Abstract
A set of schizophrenic male monozygotic triplets is described. At age 20 years, within 8 months the three men independently developed acute fulminant schizophrenic disorders (DSM-III-R) with auditory hallucinations, bizarre delusions, and thought disturbances. There were also great similarities between the triplets with regard to the chronic intermittent course of the disorder, impairment of social adjustment, and loss of working ability. The psychoses responded rapidly to conventional neuroleptic treatment. neuropsychological assessment demonstrated similar marked reductions of attentional, mnestic, and executive functions. Magnetic resonance imaging (MRI) showed similar borderline ventricular enlargement and widened subarachnoid spaces over frontoparietal and basal regions as well as around the pituitary gland (empty sella). All the boys also had a right-sided hearing defect with a marked reduction of the ossicular bones on the right side. Possible clues as to etiological mechanisms were the lack of reported family history for the disorder and a possible influenza infection in the mother during the first trimester. It is suggested that a DNA aberration being present or occurring at conception initiated a precise timeprogrammed series of events that produced the very similar schizophrenic phenotypes. Such an aberration might have been induced by an external agent, occurred spontaneously, or been inherited by a recessive mechanism. It seems possible that the psychoses, the reductions of neuropsychological functions, the morphological MRI changes, and the right-sided ossicular reductions may all be related to such a DNA alteration.
Similar content being viewed by others
References
Adarns W, Kendell RE, Hare EH, Munk-Jørgensen P (1993) Epidemilogical evidence that maternal influenza contributes to the aetiology of schizophrenia. An analysis of Scottish English, and Danish data. Br J Psychiatry 163:522–534
Austin F (1985) Congenital malformation of the ear. In: J. Balinger (ed) Diseases of the Nose, Throat, Ear, Head and Neck. Lea & Febiger, pp 1217–1231
Blanchard JJ, Neale JM (1994) The neuropsychological signature of schizophrenia-generalized or differential deficit. Am J Psychiatry 151:40–48
Brismar K, Bajraktari X, Goulatia R, Efendíc S (1978) The emtysella syndrome-intrasellar herniation-in “normal” patients and in patients with communicating hydrocephalus and intracranial tumors. Neuroradiology 17:35–43
Claeson L-E, Dahl E (1971) Claeson-Dahls inlärningstest för kliniskt bruk. Psykologiförlaget, Stockholm
Greitz T, Bergström M, Boethius J, Kingsley D, Ribbe T (1980) Head fixation system for integration of radiognostic and therapeutic procedures. Neuroradiology 19:1–6
Gyldensted C (1977) Measurements of the normal ventricular system and hemispheric sulci of 100 adults with computed tomography. Neuroradiology 14:183–192
Hansson J, Levander B, Liliequist B (1975) Size of the intracerebral ventricles as measured with computer tomography, encephalography and echoventriculography. Acta Radiol (Suppl) 346:98–106
Jablensky A, Sartorius N, Ernberg G, Anker M, Korten A, Cooper JE, Day R, Bertelsen A (1992) Schizophrenia: manifestations, incidence and course in different cultures. A World Health Organization Ten-Country Study. Psychol Med 1–97
Jeffreys AJ, Wilson V, Thein SL (1985) Hypervariable “minisatelite” regions in human DNA. Nature 314:67–73
Johnstone EC, Frith CD, Crow TJ, Husband EJ, Kreel L (1976) Cerebral ventricular size and cognitive impairment in chronic schizophrenia. Lancet 30:924–926
Kendler KS (1988) The genetics of schizophrenia: an overview. In: M. T. Tsuang and J. C. Simpson (eds) Nosology, epidemiology and genetics of schizophrenia. Elsevier, Amsterdam New York Oxford, pp 437–462
Kety SS, Rosenthal D, Wender PH, Schlusinger F, Jacobsen B (1975) Mental illness in the biological and adoptive families of adopted individuals who have become schizophrenic: a preliminary report based on psychiatric interviews. In: R. Fieve, D. Rosenthal and N. Brill (eds) Genetic Research in Psychiatry. John Hopkins University Press, Baltimore, pp 174–165
Lezak MD (1983) Neuropsychological assessment (2 ed.). Oxford University Press, New York
McGuffin P, Reveley A, Holland A (1982) Identical triplets: nonidentical psychosis? Br J Psychiatry 140:1–6
Mirsky AF, Quinn OW (1988) The genain quadruplets. Schizophr Bull 14:595–612
Nielsen KB, Tommerup N (1984) Cytogenetic investigations in mentally retarded and normal males from 14 families with the fragile site at Xq28. Hum Genet 66:225–229
Onstad S, Skre I, Torgersen S, Kringlen E (1991) Twin concordance for DSM-III-R schizophrenia. Acta Psychiatr Scand 83: 395–401
Robertson EG (1957) Pneumoencephalography III. Thomas, Springfield
Spitzer RL, Williams JBW (1985) Structured Clinical Interview for DSM-III-R Personality Disorders (SCID II). Biometrics Research Department, New York State Psychiatrie-Institute, New York
Spitzer RL, Williams JBW, Gibbon M (1986) Structured Clinical Interview for DSM-III-R-Non Patient Version (SCID-NP). Biometrics Research Department, New York State Psychiatric Institute, New York
Wechsler D (1981) Wechsler Adult Intelligence Scale-Revised. The Psychological Corporation, San Antonio
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Sedvall, G., Härnryd, C., Jönsson, E. et al. A set of male monozygotic triplets with schizophrenic psychoses: nature or nurture?. Eur Arch Psychiatry Clin Nuerosci 245, 1–7 (1995). https://doi.org/10.1007/BF02191537
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF02191537