Evidence map›Paper›PMID 28987712›Full record

ArticleBiological psychiatry2018

Heritability of Schizophrenia and Schizophrenia Spectrum Based on the Nationwide Danish Twin Register.

Rikke Hilker, Dorte Helenius, Birgitte Fagerlund, Axel Skytthe, Kaare Christensen, Thomas M Werge, Merete Nordentoft, Birte Glenthøj

Abstract readTwin Study
PubMed Publisher
In one paragraph

Article in Biological psychiatry, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 295 papers, 6 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
295citing papers in PubMed, 6 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

295 citing papers in PubMed, 6 syntheses or guidelines pooled it.

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  7. Prefrontal cortex stimulation prevents stress-induced HPA axis reactivity in people at familial risk of schizophrenia.European psychiatry : the journal of the Association of European Psychiatrists · 2025
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  14. Polygenic risk meets early trauma: toward a neuropsychodevelopmental model of schizophrenia.Journal of neural transmission (Vienna, Austria : 1996) · 2026
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235 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

8 authors.

Rikke HilkerCINS-Lundbeck Foundation Center of Excellence for Clinical Intervention and Neuropsychiatric Schizophrenia Research, Glostrup, Denmark; CNSR-Center for Neuropsychiatric Schizophrenia Research, Mental Health Centre Glostrup, Mental Health Services, Capital Region of Denmark, Glostrup, Denmark; Faculty of Health and Medical Sciences, Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark. Electronic address: rikke.hilker@regionh.dk.
Dorte HeleniusMental Health Centre Sct Hans, Mental Health Services, Capital Region of Denmark, Roskilde, Denmark; iPSYCH-Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus, Denmark.
Birgitte FagerlundCINS-Lundbeck Foundation Center of Excellence for Clinical Intervention and Neuropsychiatric Schizophrenia Research, Glostrup, Denmark; CNSR-Center for Neuropsychiatric Schizophrenia Research, Mental Health Centre Glostrup, Mental Health Services, Capital Region of Denmark, Glostrup, Denmark.
Axel SkyttheThe Danish Twin Register, University of Southern Denmark, Odense, Denmark.
Kaare ChristensenThe Danish Twin Register, University of Southern Denmark, Odense, Denmark.
Thomas M WergeCINS-Lundbeck Foundation Center of Excellence for Clinical Intervention and Neuropsychiatric Schizophrenia Research, Glostrup, Denmark; Mental Health Centre Sct Hans, Mental Health Services, Capital Region of Denmark, Roskilde, Denmark; iPSYCH-Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus, Denmark.
Merete NordentoftCINS-Lundbeck Foundation Center of Excellence for Clinical Intervention and Neuropsychiatric Schizophrenia Research, Glostrup, Denmark; Faculty of Health and Medical Sciences, Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark; iPSYCH-Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus, Denmark; Mental Health Centre Copenhagen, Mental Health Services, Capital Region of Denmark, Copenhagen, Denmark.
Birte GlenthøjCINS-Lundbeck Foundation Center of Excellence for Clinical Intervention and Neuropsychiatric Schizophrenia Research, Glostrup, Denmark; CNSR-Center for Neuropsychiatric Schizophrenia Research, Mental Health Centre Glostrup, Mental Health Services, Capital Region of Denmark, Glostrup, Denmark; Faculty of Health and Medical Sciences, Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundTwin studies have provided evidence that both genetic and environmental factors contribute to schizophrenia (SZ) risk. Heritability estimates of SZ in twin samples have varied methodologically. This study provides updated heritability estimates based on nationwide twin data and an improved statistical methodology.

methodsCombining two nationwide registers, the Danish Twin Register and the Danish Psychiatric Research Register, we identified a sample of twins born between 1951 and 2000 (N = 31,524 twin pairs). Twins were followed until June 1, 2011. Liability threshold models adjusting for censoring with inverse probability weighting were used to estimate probandwise concordance rates and heritability of the diagnoses of SZ and SZ spectrum disorders.

resultsThe probandwise concordance rate of SZ is 33% in monozygotic twins and 7% in dizygotic twins. We estimated the heritability of SZ to be 79%. When expanding illness outcome to include SZ spectrum disorders, the heritability estimate was almost similar (73%).

conclusionsThe key strength of this study is the application of a novel statistical method accounting for censoring in the follow-up period to a nationwide twin sample. The estimated 79% heritability of SZ is congruent with previous reports and indicates a substantial genetic risk. The high genetic risk also applies to a broader phenotype of SZ spectrum disorders. The low concordance rate of 33% in monozygotic twins demonstrates that illness vulnerability is not solely indicated by genetic factors.

Indexed as

Diseases in TwinsAdultDenmarkFemaleGene-Environment InteractionGenetic Predisposition to DiseaseHumansMaleMiddle AgedRegistriesRisk FactorsSchizophreniaSurveys and QuestionnairesTwins, DizygoticTwins, MonozygoticYoung AdultCensoringConcordanceHeritabilityRegisterSchizophreniaTwin study

Identifiers

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.