9番染色体のpericentric inversionがみられた精神分裂病の3例

Three Cases of Schizophrenia with Pericentric Inversion on Chromosome 9

　【抄録】　Gバンド法により9番染色体の腕間逆位（pericentric inversion）が見い出された精神分裂病（DSM-Ⅲ-R）の3例（女2例，男1例）を報告した。いずれも染色体の切断部位は（p11；q13）であった。第1例（女）は28歳で発症し，幻聴，幻視などの症状を呈し抗精神病薬によく反応した。第2例（女）は15歳で発症し，病初期はうつ状態が前景に立つパーソナリティ障害と診断されて入院したが，後に急激に精神病症状を呈した。第3例（男）は19歳で発症し，幻聴，被害妄想，緊張病症状などにより入院した。

　3症例に共通した身体的異常は見い出されず，分裂病の経過や病型も異なっていた。また3例の家族歴において分裂病者は存在しなかった。しかし，この染色体異常は，分裂病と病因的関連を持つ可能性があり，連鎖研究の手がかりを与えるものであると考えられ，さらに，今後同様の染色体異常を持つ症例を集積していくことの重要性を示唆している。

　Three cases of schizophrenia according to the DSM-Ⅲ-R criteria with pericentric inversion on chromosome 9 [inv. (9) (p11; q13)] were reported. Case 1 was a divorced housewife and herillness began at the age of 28 years. She presented auditory and visual hallucination which were well controlled by neuroleptics. Case 2 was a female student. She was referred to our psychiatric clinic at the age of 15 when she appeared to be in a depressive state based on personality disorder. She was admitted to our hospital, and later she developed an acute psychotic state presenting delusion of persecution, auditory hallucination, and psychomotor excitement. The diagnosis of her illness changed to schizophrenia. Her symptoms were so irresponsive to neuroleptics that it took 3 years of hospitalization until she remitted. Brain computerized tomography scan revealed no abnormalities in case 1 and 2. Case 3 was a male college student who presented auditory hallucination, delusion of persecution, and catatonic symptoms. His age at the onset was 19 years old. He was admitted to the hospital.

　No specific physical abnormalities were found in the three cases. The courses and subtypes of the cases varied from one another. They had no family members with schizophrenia among their first degree relatives. However, it can not be denied that there is a possibility that inv. (9) was one of the genetic etiological factors making these subjects vulnerable to schizophrenia. Accumulation of cases with the same chromosomal abnormality, and linkage studies between DNA markers on chromosome 9 and schizophrenia are indicated.