A CONTRIBUTION TO THE DIFFERENTIAL-DIAGNOSIS OF THE GROUP OF SCHIZOPHRENIAS - STRUCTURAL ABNORMALITY OF CHROMOSOME-4

A structural abnormality of chromosome 4 [inv 4 (p15.2; q21.3)] is rep orted in a male presenting with DSM-III-R schizophrenia, undifferentia ted type (295.94) and in his mother, who displayed symptoms associated with schizotypal personality disorder (DSM-III-R 301.22). The proband had a performance IQ of 91, poor motor coordination, stature in the l owest quartile and an impaired sense of time. There were no diagnostic physical or neurological abnormalities. Mild ventricular enlargement and prominent sulci were found on computed tomography. Both he and his chromosomally normal father had strabismus which required surgical co rrection. This case joins the long list of chromosomal abnormalities p reviously reported to confer an increased risk of mental illness and e mphasizes the importance of a sophisticated differential diagnosis in evaluating patients who present with symptoms of schizophrenia. The im plications for recent initiatives which attempt to localize genes conf erring susceptibility to schizophrenia and other major mental illnesse s are discussed.