ISSN 2585-2795 Dialogues in Clinical Neuroscience & Mental Health | 139 | Dialogues in Clinical Neuroscience & Mental Health, 2019, Volume 2, Issue 3, p. 139-145 Α Case of Triplets Concordant for Schizophrenia: Psychopathological Considerations Dimitris G. Dikeos¹, George B. Mitropoulos², Ersi Tsopanaki², Maria Typaldou¹, Dimitra Gorgoli 3 , Ioannis Papoulidis 4 , Christos Garnetas², George N. Papadimitriou¹ 1 First Department of Psychiatry, Athens University Medical School, Athens, Greece 2 Fourth Inpatient Department, Psychiatric Hospital of Attica, Athens, Greece 3 Psychiatric Psychiatric Department, General Hospital of Nea Ionia, Athens, Greece 4 Eurogenetica SA, Thessaloniki, Greece Abstract A case of monozygotic triplets sufering from schizophrenia is presented. The three brothers had grown in a strikingly common environment and they developed an almost identical psychotic symptomatology at the age of 19. We thor- oughly assessed their symptomatology using the structured interview Schedules for Clinical Assessment in Neuropsychi- atry, blindly to results of zygosity testing. Brain MRI scans were also performed. The patients’ psychopathology included trichotillomania in the context of an elaborate pseudo-philosophical world view, which led them to grandiose self-per- ception; withdrawal and social isolation; decline in every aspect of functioning; fnally, physical aggressiveness. The vast majority of symptoms were practically identical and the MRI fndings did not difer substantially among the three sib- lings. This case, by showing that the clinical presentation of the disease was similar in three men having in common both genes and environment, provides support for the hypothesis that, once the disease develops, the type of schizophrenic symptoms is almost exclusively infuenced by genetic and environmental factors. Key words: triplets, monozygotic, schizophrenia, hoarding, trichotillomania Corresponding author: George B. Mitropoulos, Psychiatric Hospital of Attica, Athens, Greece, e-mail: geobmitro@yahoo.gr Dimitris G. Dikeos et al DOI: 10.26386/obrela.v2i3.124 Α Case of Triplets Concordant for Schizophrenia: Psychopathological Considerations