Predictive and prenatal diagnosis of Huntington's disease: attitudes of Mexican neurologists, psychiatrists, and psychologists.
BACKGROUND
Huntington's disease (HD) is a hereditary disease of the central nervous system. Its molecular diagnosis has allowed predictive and prenatal diagnosis to be done, and it is now a model for the study of the ethical, legal, and social problems arising from the diagnosis of such diseases.


METHODS
This study explores the knowledge and attitudes of a group of Mexican specialists regarding the disease and its diagnosis. A self-administered, 30-item multiple-choice questionnaire was completed anonymously by neurologists, psychiatrists, and psychologists.


RESULTS
Fifty-five percent of the professionals had experience with HD patients, 59% claimed to know the hereditary risks, and 20% answered incorrectly concerning the risks. Neurologists had the most exposure to HD; 74% acknowledged the existence of predictive diagnosis, although only 10% knew the international guidelines for testing. Eighty-six percent of the participants recommended predictive diagnosis, the reasons being: 55%, if the patients considered having offspring; 41%, for the patient's professional reasons; 6%, if a treatment was available, and 12% did not answer. In cases in which the patient wanted to have offspring, 38% thought that this should be avoided. Thirty-six percent of the subjects considered prenatal diagnosis justified in a couple with a carrier, and 51% justified abortion for affected fetuses.


CONCLUSIONS
Genetic counseling and predictive diagnosis in Mexico must be the responsibility of genetics units and specialists who are aware of inheritance risks and of guidelines for HD programs. The number of patients requiring such attention is increasing rapidly.
Alonso Vilatela
M E
ME
Subdirección de Investigacion, Instituto Nacional de Neurología y Neurocirugía, México, D.F., Mexico. elisaa@fournier.facmed.unam.mx
Ochoa Morales
A
A
García de la Cadena
C
C
Ruiz López
I
I
Martínez Aranda
C
C
Villa
A
A
D000328:Adult; D000368:Aged; D001291:Attitude of Health Personnel; D005260:Female; D005817:Genetic Counseling; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D006816:Huntington Disease / Q000175:diagnosis* / Q000523:psychology; D008297:Male; D008800:Mexico; D008875:Middle Aged; D009462:Neurology; D011237:Predictive Value of Tests; D011296:Prenatal Diagnosis; D011570:Psychiatry; D011584:Psychology; D011795:Surveys and Questionnaires