Psychiatric Time June 2013 Genetic testing to diagnose psychiatric disorders. Given our present knowledge, in general there is essentially no meaningful role for genetic testing in establishing, confirming, or refining a psychiatric diagnosis in routine psychiatric practice. Genetic testing to predict psychiatric disorders. Conditions such as 22q11.2 deletion syndrome that are known to be associated with a greater chance of psychiatric illness are relatively rare in the general population (the syndrome occurs at a rate of approximately 1 in 4000 births). But there will be rare situations in which it may make sense to test for a genetic syndrome in a young person who currently has no psychiatric problems—if he or she has a parent in whom the syndrome has been diagnosed. In this scenario, identifying the presence of the syndrome provides the information that there is an approximately 30% chance that psychotic symptoms will develop in the young person. It also indicates that regular psychiatric monitoring can allow early intervention strategies to be implemented if psychiatric issues do emerge. Aside from these rare situations, the best strategy for predicting risk for psychiatric disorders is based on analysis of a detailed 3-generation psychiatric family history. While data provide empirical information about the chance for similar conditions to develop in relatives of individuals with psychiatric disorders, direct application of these figures to individuals in clinical practice can be misleading and inaccurate. However, a genetic counselor can provide accurate, individualized information about risk in the context of supportive counseling. So, for individuals with a personal or family history of psychiatric disorders who are interested in understanding the chances for other family members to be similarly affected, referral to a genetic counselor for documentation and interpretation of detailed psychiatric family history information is appropriate (see Part A: Additional Resources). Direct-to-consumer genetic testing. Some companies are providing information about risk for psychiatric disorders, such as schizophrenia and bipolar disorder, directly to the consumer that is based on testing of a small selection of genetic variants that have been implicated in these conditions (eg, 23andme). Physicians of all specialties will increasingly be confronted with patients who need help in understanding the personal meaning and implications of these types of genetic test result. The discussion presented above (and in Part B: Additional Resources) may help physicians in this task; however, referral to genetic counseling services for patients who present with questions in this regard is also appropriate. - See more at: psychiatrictimes/neuropsychiatry/genetic-testing-psychiatric-disorders-its-current-role-clinical-psychiatric-practice/page/0/3?GUID=FA71BB76-62A0-4608-B9DC-E980453A8C76&rememberme=1&ts=29082013#sthash.ZyLfcbdm.dpuf
Posted on: Sun, 08 Sep 2013 14:01:57 +0000
Trending Topics
Recently Viewed Topics
© 2015