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Twin Studies and Genetic Models of Schizophrenia

Douglas F. Levinson, MD
Arch Gen Psychiatry. 1988;45(9):876-877. doi:10.1001/archpsyc.1988.01800330110016
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To the Editor.—  The elegant and important data reported by Farmer and colleagues1 raise several issues that deserve comment. A different interpretation of their data would be to exclude from analysis those twin pairs with one twin with an affective disorder and one schizophrenic twin, on the grounds that there is a reasonable possibility of a misdiagnosed affective psychosis in the schizophrenic twin. Reanalysis of the remainder of the sample lends support to the possibility of a single-gene dominant form of schizophrenia.The co-occurrence of schizophrenia and affective psychosis in the same identical twin pair is more likely (in any individual case) to be due to misdiagnosis of the "schizophrenic" twin than to a genetic relationship between schizophrenia and mood-incongruent affective disorders (as suggested by Farmer and associates). Patients with early-onset affective psychoses often receive schizophrenic diagnoses because they tend to have more bizarre and psychotic symptoms than patients

REFERENCES

Farmer AE, McGuffin P, Gottesman II:  Twin concordance for DSM-III schizophrenia: Scrutinizing the validity of the definition . Arch Gen Psychiatry 1987;;44:634-644.
Ballenger JC, Reus VI, Post RM:  The 'atypical' clinical picture of adolescent mania . Am J Psychiatry 1982;;139:602-606.
Joyce PR:  Age of onset in bipolar affective disorder and misdiagnosis as schizophrenia . Psychol Med 1984;;14:145-149.
Baron M, Gruen R, Asnis L, Kane J:  Schizoaffective illness, schizophrenia and affective disorders: Morbidity risk and genetic transmission . Acta Psychiatr Scand 1982;;65:253-262.
Baron M, Gruen R, Rainer JD, Kane J, Asnis L, Lord S:  A family study of schizophrenic and normal control probands: Implications for the spectrum concept of schizophrenia . Am J Psychiatry 1985;;142:447-455.

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Farmer AE, McGuffin P, Gottesman II:  Twin concordance for DSM-III schizophrenia: Scrutinizing the validity of the definition . Arch Gen Psychiatry 1987;;44:634-644.
Ballenger JC, Reus VI, Post RM:  The 'atypical' clinical picture of adolescent mania . Am J Psychiatry 1982;;139:602-606.
Joyce PR:  Age of onset in bipolar affective disorder and misdiagnosis as schizophrenia . Psychol Med 1984;;14:145-149.
Baron M, Gruen R, Asnis L, Kane J:  Schizoaffective illness, schizophrenia and affective disorders: Morbidity risk and genetic transmission . Acta Psychiatr Scand 1982;;65:253-262.
Baron M, Gruen R, Rainer JD, Kane J, Asnis L, Lord S:  A family study of schizophrenic and normal control probands: Implications for the spectrum concept of schizophrenia . Am J Psychiatry 1985;;142:447-455.

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