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This scholarly and innovative study of the etiology of schizophrenia will interest psychoanalysts for two reasons: first, because it supplies evidence of a genetically based predisposition to schizophrenia and thus gives substance to the long felt presence of a "constitutional" factor; second, it makes very clear that schizophrenia cannot occur as a result of the genes alone and that environmental stress plays an equally significant role.
Gottesman and Shields detail the steps taken to arrive at these conclusions. Their study, commenced in 1962 and carried on over a period of seven years, uses a series of all same-sexed twins from sixteen years' consecutive admissions to outpatient and short-stay inpatient psychiatric facilities at the Maudsley Hospital. Fifty-seven twin pairs were found, twenty-four monozygotic (MZ) and thirty-three dizygotic (DZ), approximately evenly divided between the sexes. At least one member, the index case (or proband), of each pair had been registered at the hospital and diagnosed as schizophrenic. Synopses of the individual case histories are presented with all pertinent details, including verbatim excerpts from tape-recorded follow-up interviews, comments concerning the pair, and in some instances, the reasoning underlying the diagnoses.
Prerequisite for any twin-based study is the ability to make an accurate separation between MZ and DZ same-sex pairs. Here this was routinely achieved by the use of fingerprint patterns and the quantification of blood grouping.
An unusual feature of this study was the use of "consensus blind