O'Reilly Richard, Torrey E Fuller, Rao Jay, Singh Shiva
Department of Psychiatry, University of Western Ontario, St, Joseph's Regional Mental Health Care, 850 Highbury Avenue North, London, ON, N6A 4H1, Canada.
J Med Case Rep. 2013 May 28;7:134. doi: 10.1186/1752-1947-7-134.
Schizophrenia and bipolar disorder are generally considered to be distinct illnesses. One piece of evidence supporting their distinctness is the rarity of schizophrenia and bipolar disorder occurring in monozygotic co‒twins.
We describe a well-characterized pair of African American, female, monozygotic twins assessed at 53 years of age.Case 1: Twin A developed psychotic symptoms at age 23. She was hospitalized and diagnosed with schizophrenia. Twin A was subsequently hospitalized several more times and was consistently diagnosed as suffering from schizophrenia. At the time of assessment, Twin A was single, lived with her parents and attended a day program. Case 2: In contrast, Twin B worked in a professional career, married and raised a family. She remained well until age 48 when she developed a depressive disorder requiring medication treatment. Four years later, Twin B abruptly developed grandiose delusions and mood-congruent auditory hallucinations. She was hospitalized and diagnosed with a manic episode. Since then Twin B has remained symptom-free on the mood stabilizer sodium valproate.
Schizophrenia and bipolar disorder can occur in identical co-twins. We speculate on what it tells us about the meaning of discordance and the putative role of de novo mutations.
精神分裂症和双相情感障碍通常被认为是不同的疾病。支持它们具有差异性的一条证据是，同卵双胞胎中同时患精神分裂症和双相情感障碍的情况很罕见。
我们描述了一对特征明显的非裔美国女性同卵双胞胎，她们在53岁时接受了评估。病例1：双胞胎A在23岁时出现精神病症状。她住院并被诊断为精神分裂症。双胞胎A随后又多次住院，并一直被诊断患有精神分裂症。在评估时，双胞胎A单身，与父母同住，并参加日间项目。病例2：相比之下，双胞胎B从事专业工作，已婚并育有家庭。她一直很健康，直到48岁时患上需要药物治疗的抑郁症。四年后，双胞胎B突然出现夸大妄想和与心境相符的幻听。她住院并被诊断为躁狂发作。从那时起，双胞胎B在服用心境稳定剂丙戊酸钠后一直没有症状。
精神分裂症和双相情感障碍可发生在同卵双胞胎中。我们推测这能告诉我们关于不一致性的意义以及新发突变的假定作用。
