A new University of British Columbia study shows that genetic counselling helps patients with schizophrenia, bipolar disorder and similar conditions understand and cope with their illness.
The paper is published today in the Journal of Clinical Psychiatry.
The study is among the first to show the value of genetic counselling for psychiatric illnesses, demonstrating that it can help patients understand the cause of their illness, the genetic component and how they can protect their mental health going forward.
“Traditionally genetic counselling is applied to conditions that are caused entirely by genes like Huntington’s disease,” said Jehannine Austin, a Canada Research Chair in Translational Psychiatric genomics and associate professor at UBC. “Psychiatric disorders arise because of a combination of genes and experience and our study shows that genetic counselling is just as valuable for these patients.”
This study involved patients with schizophrenia, bipolar disorder or schizoaffective disorders, which are conditions with similar symptoms to schizophrenia and mood disorders. In a randomized control trial, some patients were offered counselling while others were not.
“People with mental health problems often feel guilty, ashamed or stigmatized about where the illness came from and this has a profound effect on how they feel,” said Austin, a member of UBC’s Institute of Mental Health and Djavad Mowafaghian Centre for Brain Health.
Austin’s previous work showed that individuals with psychiatric illness will come up with their own explanation of the cause of their illness if they aren’t provided with an explanation that makes sense to them. These explanations are usually not grounded in evidence, and often lead people to over-estimate the risk that someone else in their family may develop psychiatric illness. In some cases, people choose not to have children or to have fewer children than they would like.
This new study showed that genetic counselling helped to clarify misconceptions. The study also showed that genetic counselling holds promise for reducing stigma and increasing the patient’s perceived control over their illness.
“People often blame themselves for the illness they are living with,” Austin said. “We helped people better understand the cause of their illness and helped them uncover issues like guilt and distress.”
These results point to the benefits of a burgeoning field of genetic counselling that focuses on psychiatric disorders. The world’s first psychiatric genetic counselling clinic is led by Austin and based out of BC Women’s Hospital + Health Centre. Clinicians from Europe and the United States have trained at the clinic and are now setting up clinics in their own parts of the world.
Source: University of British Columbia
Image Source: The image is in the public domain.
Original Research: Abstract for “A Pilot Randomized Clinical Trial Evaluating the Impact of Genetic Counseling for Serious Mental Illnesses” by Catriona Hippman, Andrea Ringrose, Angela Inglis, Joanna Cheek, Arianne Y. K. Albert, Ronald Remick, William G. Honer, and Jehannine C. Austin in Journal of Clinical Psychiatry. Published online February 2016 doi:10.4088/JCP.14m09710
Abstract
A Pilot Randomized Clinical Trial Evaluating the Impact of Genetic Counseling for Serious Mental Illnesses
Objective: The serious mental illnesses schizophrenia, schizoaffective disorder, and bipolar disorder are complex conditions affecting 1% to 4% of the population. Individuals with serious mental illnesses express interest in genetic counseling, an intervention showing promise for increasing patient knowledge and adaptation. This trial aimed to evaluate the effects of genetic counseling for people with serious mental illnesses as compared to an educational intervention or wait list.
Method: A pilot 3-arm (each n = 40; genetic counseling, a control intervention involving an educational booklet, or wait list), parallel-group, randomized clinical trial was conducted from September 2008 through November 2011 in Vancouver, Canada. Participants with schizophrenia, bipolar disorder, or schizoaffective disorder (DSM-IV) completed outcome measures assessing knowledge, risk perception, internalized stigma, and perceived control over illness at baseline and 1-month follow-up. The Brief Symptom Inventory was administered to control for current symptoms. Analyses included linear mixed-effects models and χ2 tests.
Results: Knowledge increased for genetic counseling/educational booklet compared to wait list at follow-up (LRT1 = 19.33, Holm-adjusted P = .0003, R2LMM(m) = 0.17). Risk perception accuracy increased at follow-up for genetic counseling compared to wait list (Yates continuity corrected χ21 = 9.1, Bonferroni P = .003) and educational booklet (Yates continuity corrected χ21 = 8.2, Bonferroni P = .004). There were no significant differences between groups for stigma or perceived control scores.
Conclusions: Genetic counseling and the educational booklet improved knowledge, and genetic counseling, but not the educational booklet, improved risk perception accuracy for this population. The impact of genetic counseling on internalized stigma and perceived control is worth further investigation. Genetic counseling should be considered for patients with serious mental illnesses.
Trial Registration: ClinicalTrials.gov identifier: NCT00713804
“A Pilot Randomized Clinical Trial Evaluating the Impact of Genetic Counseling for Serious Mental Illnesses” by Catriona Hippman, Andrea Ringrose, Angela Inglis, Joanna Cheek, Arianne Y. K. Albert, Ronald Remick, William G. Honer, and Jehannine C. Austin in Journal of Clinical Psychiatry. Published online February 2016 doi:10.4088/JCP.14m09710
