Genetic counselling should be offered to psychiatric patients: UBC study

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A new University of British Columbia study shows that genetic counselling helps patients with schizophrenia, bipolar disorder and schizoaffective disorders understand and cope with their illness.

This is among the first studies to show the value of genetic counselling for psychiatric illnesses and researchers argue that the service should be made available to them. Genetic counselling is the process of helping people understand and adapt to the medical, psychological and familial implications of genetic contributions to disease.

“Traditionally genetic counselling is applied to conditions that are caused entirely by genes like Huntington’s disease,” said Jehannine Austin, an associate professor in the Depts. of Medical Genetics & Psychiatry. “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.”

In a randomized controlled trial, some patients were offered counselling while others were not. The focus of the counselling sessions was to help patients understand the cause of their illness, the genetic component and how they can protect their mental health going forward.
“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.

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, these beliefs lead people to 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, including inaccurate risk perception. The study also showed that genetic counselling holds promise for reducing stigma and increasing individuals’ perceived control over their illness; these represent areas of future work.
“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, in partnership with BC Mental Health and Substance Use Services. 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.

To read the abstract and article:
http://www.psychiatrist.com/jcp/article/Pages/2016/v77n02/v77n0210.aspx