TITLE

Monozygotic twins with early-onset schizophrenia and late-onset bipolar disorder: a case report

AUTHOR(S)
O'Reilly, Richard; Torrey, E. Fuller; Rao, Jay; Singh, Shiva
PUB. DATE
June 2013
SOURCE
Journal of Medical Case Reports;2013, Vol. 7 Issue 1, p1
SOURCE TYPE
Academic Journal
DOC. TYPE
Case Study
ABSTRACT
Introduction: 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. Case presentation: 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. Conclusion: 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.
ACCESSION #
88014138

 

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