Duodenal Ulcer in One of Identical Twins

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Abstract
The study of illness in identical twins has been used as a method of identifying genetic factors in the pathogenesis of disease. Twin methods may also be used to shed light on the differential effect of environment in the development of personality and illness. The study of a 46 year old, white, male patient with peptic ulcer and his identical twin affords an opportunity to clarify some concepts concerning the etiology of this condition. Both subjects have strikingly similar backgrounds and character structure; passive, shy, dependent, anxious, semi-skilled workers. The ulcer twin began to have symptoms during a near-psychotic breakdown in his wife when she was having an affair with another man and threatened to kill their children. The patient''s difficulty with his wife, though somewhat diminished, has persisted since the onset of illness and so have the ulcer symptoms. In contrast, is his brother''s marriage to a motherly women who dependably manages family affairs. Both patients have high blood pepsin levels, but show no interview and psychological testing, modest but real differences in their responses to stressful circumstances. Blind analysis of protective test results highlighted certain personality differences and correctly identified the ulcer twin.

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