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Published Online:https://doi.org/10.1176/ajp.120.6.528

We report a case of schizophrenia in triplets in which 2 monozygotic sisters are affected and a fraternal brother is not. Prolonged clinical investigation of the family has revealed major differences in the form, symptomatology, and depth or regression exhibited by the 2 sisters. A genetic hypothesis by itself is felt not to account for the differences in the manifestations of the illness. Various psychogenetic hypotheses including such areas as confusion of identity, disturbances in primary object relations, social isolation, pathological communications and psychopathology of role models for identification all derive some support from the family study. The identification of one girl (Janet) with mother and the other (Jeanine) with father is felt to account for behavior differences before and during the psychosis.

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