Twin Concordance for DSM-III Schizophrenia: Scrutinizing the Validity of the Definition

doi:10.1001/archpsyc.1987.01800190054009

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Vol. 44 No. 7, July 1987

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Twin Concordance for DSM-III Schizophrenia

Scrutinizing the Validity of the Definition

Anne E. Farmer, MB, MRCPsych; Peter McGuffin, MB, PhD, MRCP, MRCPsych; Irving I. Gottesman, PhD, Assoc MRCPsych

Arch Gen Psychiatry. 1987;44(7):634-641.

Abstract

• DSM-III diagnoses were applied to 26 monozygotic (MZ)and 34 dizygotic (DZ) probands and their co-twins from the MaudsleyHospital (1948 to 1965) schizophrenic series of Gottesman andShields. DSM-III criteria for schizophrenia were found to behighly reliable and valid, and to have a broad heritabilityof 0.85, which is comparable with the Research Diagnostic Criteriaand Feighner criteria from which they were derived. When thefull range of DSM-III diagnoses were considered, both affectivedisorder and schizophrenia were found in genetically identicalindividuals. The effect of DSM-III nosology on the twin serieswas also explored by adding other diagnoses to that of schizophreniaand observing the effect on the MZ/DZ concordance ratio. Theaddition of affective disorder with mood-incongruent delusionsto the schizophrenia spectrum produced the largest increasein the ratio and, by implication, a "more genetic" combinationthan schizophrenia alone. The maximum MZ/DZ concordance ratio(7.68) was produced by schizophrenia, plus affective disorderwith moodincongruent delusions, plus schizotypal personalitydisorder, plus atypical psychosis. The effect of adding paranoiddisorder (paranoia) and all other affective categories was areduction in the ratio.

Author Affiliations

From the Institute of Psychiatry, London (Dr Farmer); the University of Wales, College of Medicine, Cardiff (Dr McGuffin); and the Departments of Psychology and Pediatrics, University of Virginia, Charlottesville (Dr Gottesman).

Footnotes

Accepted for publication Jan 6, 1987.

Reprint requests to (North and South America) Department ofPsychology, University of Virginia, Charlottesville, VA 22903(Dr Gottesman); (Europe) Institute of Psychiatry, De CrespignyPark, London SE5 8AF, England (Dr Farmer).

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