Psychosomatic Medicine 19:221-227 (1957)
© 1957 American Psychosomatic Society

Duodenal Ulcer in One of Identical Twins

¹ Departments of Psychiatry and Medicine, Yale University School of Medicine, New Haven, Connecticut
² Departments of Psychiatry and Medicine, Yale University School of Medicine, New Haven, Connecticut; Department of Psychiatry, Western Reserve University School of Medicine, Cleveland, Ohio

A case of peptic ulcer in one 46-year-old male identical twin has been presented. Both subjects have strikingly similar backgrounds and character structure; passive, shy, dependent, anxious, semiskilled workers. The twin with the ulcer 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 woman who dependably manages the family affairs. Both patients have high blood pepsin levels, but show on interview and psychological testing, modest but real differences in their responses to stressful circumstances.

This paper serves as a demonstration of the use of identical twins in the study of psychosomatic disorders, and illustrates techniques of examining hypotheses concerning these disorders in this unusual setting.