Psychosocial consequences of DNA analysis for MEN type 2.
Multiple endocrine neoplasia type 2 (MEN-2) is characterized by medullary thyroid carcinoma in combination with pheochromocytomas and, sometimes, parathyroid adenomas. Since 1993, the psychosocial implications of DNA analysis for MEN-2 have been studied in the Netherlands. This article summarizes the first results of that study. Individuals who applied for DNA analysis cited the need to reduce uncertainty as the major reason for wanting the test. An unfavorable test outcome resulted in anxiety and depression but also relief. Immediate preventive treatment was preferred to continued periodic screening. Carriers were preoccupied with disease-related complaints, and identified with other carriers and MEN-2 patients. A favorable test led, in most applicants and partners, to both relief and worry. Some noncarriers felt guilty and isolated from their families. One year after counseling, participants reported fewer psychosomatic complaints.
Grosfeld
F J
FJ
Department of Internal Medicine, Utrecht University Hospital, Netherlands.
Lips
C J
CJ
Ten Kroode
H F
HF
Beemer
F A
FA
Van Spijker
H G
HG
Brouwers-Smalbraak
G J
GJ
D000236:Adenoma / Q000235:genetics / Q000523:psychology; D000293:Adolescent; D000310:Adrenal Gland Neoplasms / Q000235:genetics / Q000523:psychology; D000328:Adult; D001007:Anxiety; D004273:DNA, Neoplasm / Q000032:analysis*; D003674:Defense Mechanisms; D003863:Depression / Q000209:etiology; D005817:Genetic Counseling / Q000523:psychology*; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D009042:Motivation; D018813:Multiple Endocrine Neoplasia Type 2a / Q000235:genetics / Q000523:psychology*; D010282:Parathyroid Neoplasms / Q000235:genetics / Q000523:psychology; D010673:Pheochromocytoma / Q000235:genetics / Q000523:psychology; D012917:Social Adjustment; D013964:Thyroid Neoplasms / Q000235:genetics / Q000523:psychology; D014342:Truth Disclosure
D004273:DNA, Neoplasm