The potential impact of genetic counseling for mental illness

Abstract

Mental disorders are relatively highly heritable, yet complex with important interactions between genetic risk and environmental factors in determining illness expression. Due to the high prevalence of these complex disorders, steady increase in knowledge about genetic contributions, and increasing public awareness, this area may come to represent a significant proportion of all genetic counseling. The potential impact of genetic counseling in mental illness is broad. As well as the conventional expectations, genetic counseling may have the positive outcomes of reducing the guilt, shame, and stigma associated with mental illness, even within families. However, like many interventions in medicine, genetic counseling for mental disorders could potentially have unintended consequences resulting in increased stigma, guilt, and shame. The potential impacts of genetic education and providing recurrence risks on stigma are reviewed, as well as the role of education about the environment as a way of modifying family members' guilt. The review allows a preliminary formulation of a series of suggestions for genetic counseling in mental illness.

Public interest in predictive genetic testing, including direct-to-consumer testing, for susceptibility to major depression: preliminary findings

“…13,30,31 Conversely empirical evidence suggests a genetic model for mental illness may increase the perceived seriousness of these disorders and increase stigma. 15,30,31 These findings are further supported by a study that found endorsement of genetic explanations decreased the likelihood of social acceptance of people with schizophrenia and major depression. 32 This study supports the evidence that knowledge of genetic susceptibility could carry potential for both health promotion and harm through genetic validation versus genetic discrimination, respectively.…”

Genetic counselors’ attitudes towards individuals with schizophrenia: Desire for social distance and endorsement of stereotypes

“…When surveyed, individuals with schizophrenia and their family members have expressed strong interest in receiving genetic counseling [1][2][3], and undergoing genetic testing for the condition if and when it becomes clinically available [1]. However, we must also anticipate that even in the absence of genetic testing, as more is learned about the genetic contribution to complex disorders (like psychiatric illness), public awareness of the role of genetics will increase, and genetic counseling for these disorders may become more commonplace [4][5][6][7]. Indeed, a 2002 survey of genetic counselors showed that this group of healthcare professionals regarded referrals to discuss psychiatric illness as an area of growth [8].…”

Exploring Genetic Counselors’ Perceptions of and Attitudes towards Schizophrenia

“…While genetic counseling can certainly be applied to psychiatric illnesses like schizophrenia, it has traditionally been viewed by the broader public and healthcare system as being primarily aimed at genetic disorders with Mendelian inheritance patterns. As the public becomes more aware of the genetic contribution to schizophrenia, it has been postulated that referrals for genetic counseling and genetic services for this condition may increase [5]. Indeed, psychiatric genetic counseling was seen as an area of growth by 96% of the members of the National Society of Genetic Counselors, who responded to a 1994 survey [6].…”