Blind Men and Elephants

Genetic and Other Perspectives on Schizophrenia
  • Irving I. Gottesman


I must apologize for invoking the timeworn but apt Indian legend of probing blind men and an elephant, each persuaded of his superior grasp of the pachyderm and the others’ conceptual errors; they cannot imagine that each one of them is wrong while at the same time each one is right from their own very limited perspective. The tail is like a rope, the side is like a wall, and the leg is like a tree, but the elephant, like schizophrenia, is all of these, none of these, and much, much more. Indeed, schizophrenia may comprise more than one elephant.


Twin Study Identical Twin Subacute Sclerosing Panencephalitis Discordant Pair Psychiatric Genetic 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. Andreasen, N. C. (1989). Brain imaging: Applications in psychiatry. (Washington, DC: American Psychiatric Press.Google Scholar
  2. Barnard, E. A. (1992). GABA receptor genes: Applications to neuropsychiatric disorders. In J. Mendlewicz & H. Hippius (Eds.), Genetic research in psychiatry. Berlin: Springer-Verlag.Google Scholar
  3. Berg, K. (1990). Level genes and variability genes in the etiology of hyperlipidemia and atherosclerosis. In K. Berg, N. Retterstol, & S. Refsum (Eds.), From phenotype to gene in common disorders. Copenhagen: Munksgaard.Google Scholar
  4. Bertelsen, A., & Gottesman, I. I. (1990). Offspring of twins with schizophrenia: In reply. Archives of General Psychiatry, 47, 977–978.CrossRefGoogle Scholar
  5. Brown, Z. A., Benedetti, J., Ashley, R., et al. (1991). Neonatal herpes simplex virus infection in relation to asymptomatic maternal infection at the time of labor. New England Journal of Medicine, 324, 1247–1252.PubMedCrossRefGoogle Scholar
  6. Burke, W., & Motulsky, A. G. (1992). Hypertension. In R. A. King, J. I. Rotter, & A. G. Motulsky (Eds.), The genetic basis of common diseases. London: Oxford University Press.Google Scholar
  7. Cadoret, R. J. (1973). Toward a definition of the schizoid state: Evidence from studies of twins and their families. British Journal of Psychiatry, 122, 679–685.PubMedCrossRefGoogle Scholar
  8. Claridge, G. (1994). A single indicator of risk for schizophrenia: Probable fact or likely myth? Schizophrenia Bulletin, 20, 151–168.PubMedCrossRefGoogle Scholar
  9. Coon, H., Byerley, W., Holik, J., et al. (1993). Linkage analysis of schizophrenia with five dopamine receptor genes in nine pedigrees. American Journal of Human Genetics, 52, 327–334.PubMedGoogle Scholar
  10. Coon, H., Jensen, S., Holik, J., et al. (1994). Genomic scan for genes predisposing to schizophrenia. American Journal of Medical Genetics (Neuropsychiatrie Genetics), 54, 59–71.CrossRefGoogle Scholar
  11. Crow, T. J. (1990). Nature of the genetic contribution to psychotic illness—A continuum viewpoint. Acta Psychiatrica Scandinavica, 81, 401–408.PubMedCrossRefGoogle Scholar
  12. Crow, T. J. (1994). Prenatal exposure to influenza as a cause of schizophrenia. British Journal of Psychiatry, 164, 588–592.PubMedCrossRefGoogle Scholar
  13. Davison, K. (1992). Organic schizophrenia-like psychoses. Neurological Psychiatry and Brain Research, 1, 90–94.Google Scholar
  14. Day, R. (1986). Social stress and schizophrenia: From the concept of recent life events to the notion of toxic environments. In G. D. Burrows & T. R. Norman (Eds.), Handbook of studies on schizophrenia. Amsterdam: Elsevier.Google Scholar
  15. Devereux, R. B., & Brown, W. T. (1992). Structural heart disease. In R. A. King, J. I. Rotter, & A. G. Motulsky, (Eds.), The genetic basis of common diseases. London: Oxford University Press.Google Scholar
  16. Ehrnst, A., Lindgren, S., Dictor, M., et al. (1991). HIV in pregnant women and their offspring: Evidence for late transmission. Lancet, 338, 203–207.PubMedCrossRefGoogle Scholar
  17. Essen-Moller, E., Larsson, H., Uddenberg, C. E., et al. (1956). Individual traits and morbidity in a Swedish rural population. Acta Psychiatrica et Neurologica Scandinavica (Suppl. 100).Google Scholar
  18. Farmer, A. E., McGuffin, P., & Gottesman, I. I. (1987). Twin concordance for DSM-III schizophrenia: Scrutinizing the validity of the definition. Archives of General Psychiatry, 44, 634–641.PubMedCrossRefGoogle Scholar
  19. Fischer, M. (1971). Psychoses in the offspring of schizophrenic monozygotic twins and their normal co-twins. British Journal of Psychiatry, 118, 43–52.PubMedCrossRefGoogle Scholar
  20. Gershon, E. S., & Cloninger, C. R. (1994). Genetic approaches to mental disorders. Washington, DC: American Psychiatric Press.Google Scholar
  21. Gottesman, I. I. (1987). The psychotic hinterlands or the fringes of lunacy. British Medical Bulletin, 43, 557–569.PubMedGoogle Scholar
  22. Gottesman, I. I. (1991). Schizophrenia genesisThe origins of madness. San Francisco: Freeman.Google Scholar
  23. Gottesman, I.I. (1994a). Complications to the complex inheritance of schizophrenia. Clinical Genetics, 46, 116–123.PubMedCrossRefGoogle Scholar
  24. Gottesman, I.I. (1994b). Schizophrenia epigenesis: Past, present, and future. Acta Psychiatrica Scandinavica, 90(Suppl. 384), 26–33.CrossRefGoogle Scholar
  25. Gottesman, I.I., & Bertelsen, A. (1989). Confirming unexpressed genotypes for schizophrenia. Risks in the offspring of Fischer’s Danish identical and fraternal discordant twins. Archives of General Psychiatry, 46, 867–872.PubMedCrossRefGoogle Scholar
  26. Gottesman, I. I., & McGue, P. M. (1991). Mixed and mixed-up models for the transmission of schizophrenia. In W. Grove & D. Cicchetti (Eds.), Thinking clearly about psychology: Personality and psychopathology (Vol. 2). Minneapolis: University of Minnesota Press.Google Scholar
  27. Gottesman, I. I., & Shields, J. (1967). A polygenic theory of schizophrenia. Proceedings of the National Academy of Sciences USA, 58, 199–205.CrossRefGoogle Scholar
  28. Gottesman, I.I., & Shields, J. (1972). Schizophrenia and genetics: A twin study vantage point. New York: Academic Press.Google Scholar
  29. Heston, L. L. (1966). Psychiatric disorders in the foster home reared children of schizophrenic mothers. British Journal of Psychiatry, 112, 819–825.PubMedCrossRefGoogle Scholar
  30. Huntington’s Disease Collaborative Research Group. (1993). A novel gene containing a trinucleotide repeat that is expanded and unstable on the Huntington’s disease chromosome. Cell, 72, 971–983.CrossRefGoogle Scholar
  31. Iacono, W. G., & Clementz, B. A. (1993). A strategy for elucidating genetic influences on complex psychopathological syndromes (with special reference to ocular motor functioning and schizophrenia). Progress in Experimental Personality and Psychopathology Research, 16, 11–65.PubMedGoogle Scholar
  32. Jablensky, A. (1993). The epidemiology of schizophrenia. Current Opinion in Psychiatry, 6, 43–52.CrossRefGoogle Scholar
  33. Kendler, K. S., & Diehl, S. R. (1993). The genetics of schizophrenia: A current, genetic-epidemiologic perspective. Schizophrenic Bulletin, 19, 261–285.CrossRefGoogle Scholar
  34. Kendler, K. S., Gruenberg, A. M., & Kinney, D. K. (1994). Independent diagnoses of adoptees and relatives, using DSM-III criteria in the provincial and national samples of the Danish Adoption Study of Schizophrenia. Archives of General Psychiatry, 51, 456–468.PubMedCrossRefGoogle Scholar
  35. Kendler, K. S., McGuire, M., Gruenberg, A. M., et al. (1993). The Roscommon family study: I. Methods, diagnosis of probands and risk of schizophrenia in relatives. Archives of General Psychiatry, 50, 527–540.PubMedCrossRefGoogle Scholar
  36. Kety, S. S., Wender, P. H., Jacobsen, B., et al. (1994). Mental illness in the biological and adoptive relatives of schizophrenic adoptees: Replication of the Copenhagen study in the rest of Denmark. Archives of General Psychiatry, 51, 442–455.PubMedCrossRefGoogle Scholar
  37. King, R. A., Rotter, J. I., & Motulsky, A. G. (Eds.). (1992). The genetic basis of common diseases. London: Oxford University Press.Google Scholar
  38. Kringlen, E., & Cramer, G. (1989). Offspring of monozygotic twins discordant for schizophrenia. Archives of General Psychiatry, 46, 873–877.PubMedCrossRefGoogle Scholar
  39. Lenzenweger, M. F. (1993). Explorations in schizotypy and the psychometric high-risk paradigm. Progress in Experimental Personality and Psychopathology Research, 16, 66–116.PubMedGoogle Scholar
  40. Lipska, B. K., Jaskiw, G. E., & Weinberger, D. R. (1993). Postpubertal emergence of hyper-responsiveness to stress and to amphetamine after neonatal excitotoxic hippocampal damage: A potential animal model of schizophrenia. Neuropsychopharmacology, 9, 67–75.PubMedCrossRefGoogle Scholar
  41. McGue, M. (1992). When assessing twin concordance, use the probandwise not the pairwise rate. Schizophrenia Bulletin, 18, 171–176.PubMedCrossRefGoogle Scholar
  42. McGuffin, P., Katz, R., Rutherford, J., et al. (1993). Twin studies as vital indicators of pheno-types in molecular genetic research. In T. J. Bouchard & P. Propping (Eds.), Twins as a tool of behavioral genetics. New York: Wiley.Google Scholar
  43. McGuffin, P., Owen, M. J., O’Donovan, M. C., et al., (1994). Seminars in psychiatric genetics. London: Gaskell Press.Google Scholar
  44. Maier, W., Lichtermann, D., Hallmayer, J., et al. (1993). Continuity and discontinuity of affective disorders and schizophrenia: Results of a controlled family study. Archives of General Psychiatry, 50, 871–883.PubMedCrossRefGoogle Scholar
  45. Mednick, S. (Ed.). (1995). Neural development in schizophrenia: Theory and research. New York: Plenum Press.Google Scholar
  46. Mendlewicz, J., & Hippius, H. (Eds.). (1992). Genetic research in psychiatry. Berlin: Springer-Verlag.Google Scholar
  47. Moldin, S. O., & Gottesman, I.I. (1995). Population genetics in psychiatry. In H. I. Kaplan & B. J. Sadock (Eds.), Comprehensive textbook of psychiatry (6th ed.). Baltimore: Williams & Wilkins, pp. 144–155.Google Scholar
  48. Moldin, S. O., Gottesman, I.I., Erlenmeyer-Kimling, L., et al. (1990). Psychometric deviance in offspring at risk for schizophrenia: I. Initial delineation of a distinct subgroup. Psychiatry Research, 32, 297–310.PubMedCrossRefGoogle Scholar
  49. Motulsky, A. G., & Brunzell, J. D. (1992). The genetics of coronary atherosclerosis. In R. A. King, J. I. Rotter, & A. G. Motulsky (Eds.), The genetic basis of common diseases. London: Oxford University Press.Google Scholar
  50. Nowakowski, R. S. (1987). Basic concepts of CNS development. Child Development, 58, 568–595.PubMedCrossRefGoogle Scholar
  51. Odegaard, O. (1952). La Genetique Dans la Psychiatric. Proceedings of the First World Congress in Psychiatry, VI, 84–90.Google Scholar
  52. Odegaard, O. (1972). The multifactorial theory of inheritance in predisposition to schizophrenia. In A. R. Kaplan (Ed.), Genetic factors in schizophrenia. Springfield, IL: CC Thomas.Google Scholar
  53. Oldstone, M. B. A., Sinha, Y. N., Blount, P., et al. (1982). Virus-induced alterations in homeostasis: Alterations in differentiated functions of infected cells in vivo. Science, 218, 1125–1127.PubMedCrossRefGoogle Scholar
  54. Onstad, S., Skre, I., Torgersen, S., et al. (1991). Twin concordance for DSM-III-R schizophrenia. Acta Psychiatrica Scandinavica, 83, 395–401.PubMedCrossRefGoogle Scholar
  55. Owen, M. J. (1992). Will schizophrenia become a graveyard for molecular geneticists? Psychological Medicine, 22, 289–293.PubMedCrossRefGoogle Scholar
  56. Peters, C. J., Reeves, W. C., & Purcell, R. H. (1977). Disparate response of monozygotic twins to hepatitis B virus infection. Journal of Pediatrics, 91, 265–266.PubMedCrossRefGoogle Scholar
  57. Prescott, C. A., & Gottesman, I.I. (1993). Genetically mediated vulnerability to schizophrenia. Psychiatric Clinics of North America, 16, 245–267.PubMedGoogle Scholar
  58. Roos, R. P. (1985). Genetically controlled resistance to viral infections of the central nervous system. Progress in Medical Genetics, 6, 242–276.Google Scholar
  59. Saugstad, L., & Odegaard, O. (1986). Huntington’s chorea in Norway. Psychological Medicine, 16, 39–48.PubMedCrossRefGoogle Scholar
  60. Sierra-Honigmann, A. M., Carbone, K. M., & Yolken, R. H. (1995). Polymerase chain reaction (PCR) search for the viral nucleic acid sequences in schizophrenia. British Journal of Psychiatry, 166, 55–60.PubMedCrossRefGoogle Scholar
  61. Sing, C. F., & Moll, P. P. (1990). Strategies for unravelling the genetic basis of coronary artery disease. In K. Berg, N. Retterstol, & S. Refsum (Eds.), From phenotype to gene in common disorders. Copenhagen: Munksgaard.Google Scholar
  62. Sobell, J. L., Heston, L. L., & Sommer, S. S. (1993). Novel association approach for determining the genetic predisposition to schizophrenia: Case-control resource and resting of a candidate gene. American Journal of Medical Genetics (Neuropsychiatric Genetics), 48, 28–35.CrossRefGoogle Scholar
  63. Stromgren, E. (1987). Changes in the incidence of schizophrenia. British Journal of Psychiatry, 150, 1–7.PubMedCrossRefGoogle Scholar
  64. Stromgren, E. (1994). The unitary psychosis (Einheitspsychose) concept: Past and present. Neurology, Psychiatry, & Brain Research, 2, 201–205.Google Scholar
  65. Thaler, M. M., Park, C. K., Landers, D. V., et al. (1991). Vertical transmission of hepatitis C virus. Lancet, 338, 17–18.PubMedCrossRefGoogle Scholar
  66. Tienari, P. J., Wikstrom, J., Sajantila, A., et al. (1992). Genetic susceptibility to multiple sclerosis linked to myelin basic protein gene. Lancet, 340, 987–991.PubMedCrossRefGoogle Scholar
  67. Tienari, P., Wynne, L., Moring, J., et al. (1994). The Finnish Adoptive Family Study of Schizophrenia: A longitudinal study exploring joint effects of genetics and environment. Acta Psychiatrica Scandinavica (Suppl.).Google Scholar
  68. Torrey, E. F. (1989). Schizophrenia: Fixed incidence or fixed thinking? Psychological Medicine, 19, 285–287.PubMedCrossRefGoogle Scholar
  69. Torrey, E. F. (1991). A viral-anatomical explanation of schizophrenia. Schizophrenia Bulletin, 17(1), 15–18.PubMedCrossRefGoogle Scholar
  70. Torrey, E. F. (1992). Are we overestimating the genetic contribution to schizophrenia? Schizophrenia Bulletin, 18, 159–170.PubMedCrossRefGoogle Scholar
  71. Torrey, E. F. (1995). Surviving schizophrenia: A manual for families, consumers, and providers (3rd ed.). New York: Harper & Row.Google Scholar
  72. Torrey, E. F., Bowler, A. E., Taylor, E. H., & Gottesman, I. I. (1994). Schizophrenia and manic-depressive disorder: The biological roots of mental illness as revealed by the landmark study of identical twins. New York: Basic Books.Google Scholar
  73. Tsujita, T., Okazaki, Y., Fujimara, K., et al. (1992). Twin concordance rate of DSM-III schizophrenia in a new Japanese sample. Unpublished manuscript.Google Scholar
  74. Walker, E. (1994). Developmentally moderated expressions of the neuropathology underlying schizophrenia. Schizophrenia Bulletin, 20, 453–480.PubMedCrossRefGoogle Scholar
  75. Warner, R. (1994). Recovery from schizophreniaPsychiatry and political economy. New York: Routledge.Google Scholar
  76. Weinberger, D. R. (1987). Implications of normal brain development for the pathogenesis of schizophrenia. Archives of General Psychiatry, 44, 660–669.PubMedCrossRefGoogle Scholar
  77. Whitaker, J. N., Sever, J. L., & Engel, W. K. (1972). Subacute sclerosing panencephalitis in only one of identical twins. New England Journal of Medicine, 287, 864–866.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 1996

Authors and Affiliations

  • Irving I. Gottesman
    • 1
  1. 1.Department of PsychologyUniversity of VirginiaCharlottesvilleUSA

Personalised recommendations