Public interest in predictive genetic testing, including direct-to-consumer testing, for susceptibility to major depression: preliminary findings.
The past decade has seen rapid advances in the identification of associations between candidate genes and a range of common multifactorial disorders. This paper evaluates public attitudes towards the complexity of genetic risk prediction in psychiatry involving susceptibility genes, uncertain penetrance and gene-environment interactions on which successful molecular-based mental health interventions will depend. A qualitative approach was taken to enable the exploration of the views of the public. Four structured focus groups were conducted with a total of 36 participants. The majority of participants indicated interest in having a genetic test for susceptibility to major depression, if it was available. Having a family history of mental illness was cited as a major reason. After discussion of perceived positive and negative implications of predictive genetic testing, nine of 24 participants initially interested in having such a test changed their mind. Fear of genetic discrimination and privacy issues predominantly influenced change of attitude. All participants still interested in having a predictive genetic test for risk for depression reported they would only do so through trusted medical professionals. Participants were unanimously against direct-to-consumer genetic testing marketed through the Internet, although some would consider it if there was suitable protection against discrimination. The study highlights the importance of general practitioner and public education about psychiatric genetics, and the availability of appropriate treatment and support services prior to implementation of future predictive genetic testing services.
Wilde
Alex
A
School of Psychiatry, University of New South Wales, Sydney, Black Dog Institute Building, Prince of Wales Hospital, Hospital Road, Randwick, NSW 2031, Australia.
Meiser
Bettina
B
Mitchell
Philip B
PB
Schofield
Peter R
PR
D000293:Adolescent; D000328:Adult; D000368:Aged; D003710:Demography; D003866:Depressive Disorder / Q000235:genetics*; D005260:Female; D020022:Genetic Predisposition to Disease; D005820:Genetic Testing / Q000379:methods* / Q000523:psychology*; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D020407:Internet; D008297:Male; D040541:Marketing; D008875:Middle Aged; D011639:Public Opinion; D050486:Serotonin Plasma Membrane Transport Proteins / Q000235:genetics; D055815:Young Adult
C493230:SLC6A4 protein, human; D050486:Serotonin Plasma Membrane Transport Proteins
Schizophr Bull. 2004;30(3):511-41
15631243
Am J Med Genet B Neuropsychiatr Genet. 2006 Dec 5;141B(8):926-8
16958030
JAMA. 2009 Jun 17;301(23):2462-71
19531786
Int J Soc Psychiatry. 2006 Mar;52(2):166-74
16615248
Soc Sci Med. 2005 Jan;60(1):109-18
15482871
J Health Soc Behav. 2005 Dec;46(4):307-22
16433278
Genet Test. 2008 Jun;12(2):233-43
18554164
Med J Aust. 2008 Feb 18;188(4):243-6
18279135
Aust N Z J Psychiatry. 2009 Nov;43(11):1070-6
20001402
Am J Med Genet B Neuropsychiatr Genet. 2006 Jan 5;141B(1):110-5
16287043
Nature. 2008 Nov 6;456(7218):34-5
18987720
Obstet Gynecol. 2007 Dec;110(6):1392-5
18055737
Am J Psychiatry. 1998 Jul;155(7):899-904
9659854
J Consult Clin Psychol. 2002 Jun;70(3):784-97
12090383
Trends Neurosci. 2002 Aug;25(8):430-1
12127761
Proc Natl Acad Sci U S A. 2004 Dec 7;101(49):17316-21
15563601
N Engl J Med. 2009 Apr 23;360(17):1701-3
19369656
J Affect Disord. 2002 Sep;71(1-3):189-93
12167515
Arch Gen Psychiatry. 2008 Jan;65(1):28-37
18180426
Psychol Med. 2007 Nov;37(11):1601-11
17537283
Aust N Z J Psychiatry. 2004 Jan-Feb;38(1-2):73-80
14731197
Science. 2003 Jul 18;301(5631):386-9
12869766
Biol Psychiatry. 2006 Oct 1;60(7):671-6
16934775
Clin Genet. 2005 Feb;67(2):134-42
15679823
Br J Psychiatry. 2006 Mar;188:210-5
16507960
J Med Genet. 1996 Jul;33(7):544-9
8818938
Mol Psychiatry. 2004 Oct;9(10):908-15
15241435
Arch Gen Psychiatry. 2005 May;62(5):529-35
15867106