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Schizophrenia Bulletin 2000 26(3):699-708;
© 2000 by Oxford University Press and the Maryland Psychiatric Research Center (MPRC)
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© Oxford University Press

A 39-Year Followup of the Genain Quadruplets

Allan F. Mirsky, Ph.D., Linas A. Bieliauskas, Ph.D., Louis M. French, M.A., Daniel P. van Kammen, M.D., Ph.D., Erik Jönsson, M.D., Ph.D. and Göran Sedvall, M.D., Ph.D.
Chief, Section on Clinical and Experimental Neuropsychology, Laboratory of Brain and Cognition NIMH, Bethesda, MD
Associate Professor, Neuropsychology Program, Department of Psychiatry, University of Michigan Medical Hospitals Ann Arbor, MI
Pre-Doctoral Fellow, Section on Clinical and Experimental Neuropsychology, Laboratory of Brain and Cognition NIMH, Bethesda, MD
Director, Global Research and Development, The RWJ Pharmaceutical Research Institute Raritan, NJ
Research Scientist, Department of Clinical Neuroscience, Psychiatry Section, Karolinska Hospital Stockholm, Sweden
Professor, Department of Clinical Neuroscience, Psychiatry Section, Karolinska Hospital Stockholm, Sweden

Send reprint requests to Dr. A.F. Mirsky, Chief, Section on Clinical and Experimental Neuropsychology, Laboratory of Brain and Cognition, NIMH, Building 15K, MSC 2668, 15 North Dr., Bethesda, MD 20892-2668; e-mail allan_mirsky{at}nih.gov

The Genains, a unique group of monozygotic female quadruplets, all developed a schizophrenic disorder by age 24. They have been studied since the 1950s, because of the rarity of this occurrence (estimated to be one in 1.5 billion) and because their illnesses varied in severity. The identical inheritance would tend to rule out genetic differences as the cause of the neuropsychological differences; however, we cannot disentangle the effects of early brain injury and harsh punitive treatment as factors accounting for the differences in the severity of their disorders. We conducted neuropsychological examinations of the Genains at age 66, compared their test profiles, and contrasted certain test scores at 66 with those at ages 27 and 51. Test results indicate generally stable (or even improved) performance over time and support the notion that cognitive decline is not a degenerative process in schizophrenia. The Genains remind us of the exquisite interaction among variables that must be understood before additional, satisfactory progress can be made in preventing the development and predicting the course of schizophrenia.

Keywords: Schizophrenia / neuropsychology / multiple births / aging


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