Bertelsen A, Harvald B, Hauge M
Br J Psychiatry. 1977 Apr;130:330-51. doi: 10.1192/bjp.130.4.330.
The existence of a nation-wide twin register and central psychiatric register has made possible a catamnestic investigation of an unselected and representative sample of twins with manic-depressive disorders. From a total population of 11,288 same-sexed twin pairs born 1870-1920 in Denmark 126 probands from 110 pairs were ascertained. Among the co-twins of 69 monozygotic probands there were found 46 with manic-depressive disorders, and a further 14 had presented other psychoses or marked affective personality disorders or had committed suicide, yielding a proband rate of strict concordance, C1 = 0-67 and of broad, partial concordance, C2 = 0-87. The corresponding direct pairwise concordance rates were 32/55 = 0-58 and 46/55 = 0-84 respectively. For the dizygotic twins the proband concordance rate of C1 was 11/54 = 0-20 and of C2 20/54 = 0-37, and the direct pairwise rates were 9/52 = 0-17 and 18/52 = 0-35 respectively. The differences between the pairwise rates for the monozygotic and dizgotic twins are significant (P less than 0-001 at X2 analysis). This finding is in accordance with previous twin studies of manic-depressive disorders and confirms the evidence of a strong genetic factor. The concordance with respect to unipolar and bipolar forms was not in contradiction to recent evidence of a genetic difference between the bipolar and unipolar form, the latter probably related to the female sex.
全国双胞胎登记册和中央精神病登记册的存在，使得对患有躁郁症的未经过挑选且具有代表性的双胞胎样本进行随访调查成为可能。在1870年至1920年出生于丹麦的11288对同性双胞胎中，确定了来自110对双胞胎的126名先证者。在69名单卵双胞胎先证者的同胞双胞胎中，发现46人患有躁郁症，另有14人患有其他精神病、明显的情感性人格障碍或自杀，得出严格一致性的先证者比率C1 = 0.67，广泛部分一致性的比率C2 = 0.87。相应的直接成对一致性比率分别为32/55 = 0.58和46/55 = 0.84。对于异卵双胞胎，C1的先证者一致性比率为11/54 = 0.20，C2为20/54 = 0.37，直接成对比率分别为9/52 = 0.17和18/52 = 0.35。单卵双胞胎和异卵双胞胎的成对比率差异具有显著性（在X2分析中P小于0.001）。这一发现与先前关于躁郁症的双胞胎研究一致，并证实了存在强大遗传因素的证据。关于单相和双相形式的一致性与双相和单相形式之间遗传差异的最新证据并不矛盾，后者可能与女性性别有关。
