A Survey in Austria Supports the Significance of Genetic Counseling and Pharmacogenetic Testing for Mental Illness

Overview

Journal Front Psychiatry

Specialty Psychiatry

Date 2024 Oct 18

PMID 39421071

Authors

Elena Aschauer

Shahriar Izadi Yazdi

Harald Aschauer

Affiliations

Soon will be listed here.

Abstract

Introduction: Genetic counseling and testing in psychiatry warrant attention, but research results on attitude, knowledge, personal experience and interest are limited. There are only a few studies that have compared the opinions of the general population and experts regarding genetic counseling and genetic testing in mental illness.

Methods: This study aimed to investigate these gaps through a cross-sectional survey conducted in Austria, involving a sample of the web-active population, representative according to gender, age and geographical location (n=1,000, 24.5% of them had a psychiatric diagnosis), and experts (n=145, 83.4% of them psychiatrists). Two questionnaires were developed. Pearson chi-square statistics were used to compare responses, and regression analyses were employed to measure the strength of psycho-sociodemographic influences on answers.

Results: The findings revealed that public considered genetic counseling to be more important than experts did (68.8% versus 54.2%; Pearson chi-square 12.183; df=1; p<0.001). The general population believed that genetic testing is useful for diagnosing mental disorders, which contrasted with experts' opinions (67.9% versus 17.2%; Pearson chi-square 137.236; df=1; p<0.001). Both groups agreed on the potential benefits of pharmacogenetic testing (79% versus 80%). A small number of individuals from the public had sought genetic counseling (8%), and only a minority of experts had specific training and experience in this field (28%).

Discussion: This is the first survey study on the topic conducted in Austria, with limited international studies available. Austrian experts place less value on genetic counseling compared to their counterparts in other countries. Despite recognized importance placed on genetic counseling and testing, utilization rates remain low. The value of pharmacogenetics is predicted to increase in the future. Consequently, it is crucial for medical training programs to emphasize the significance of genetic counseling and enhance the understanding of genetic aspects related to mental illnesses to enable experts to provide adequate psychoeducation and personalized care to the extent possible to patients and their families.

References

Ormond K, Laurino M, Barlow-Stewart K, Wessels T, Macaulay S, Austin J . Genetic counseling globally: Where are we now?. Am J Med Genet C Semin Med Genet. 2018; 178(1):98-107. PMC: 5947883. DOI: 10.1002/ajmg.c.31607. View

Solomon H, Cates K, Li K . Does obtaining CYP2D6 and CYP2C19 pharmacogenetic testing predict antidepressant response or adverse drug reactions?. Psychiatry Res. 2018; 271:604-613. DOI: 10.1016/j.psychres.2018.12.053. View

Sundby A, Marcheco-Teruel B, Monzon-Benitez G, Fuentes-Smith E, Laegsgaard Madsen M, Mors O . Attitudes Toward Psychiatric Genetic Testing and Research: A Comparative Study Between Denmark and Cuba. Genet Test Mol Biomarkers. 2019; 23(12):857-864. DOI: 10.1089/gtmb.2019.0163. View

Andreassen O, Hindley G, Frei O, Smeland O . New insights from the last decade of research in psychiatric genetics: discoveries, challenges and clinical implications. World Psychiatry. 2023; 22(1):4-24. PMC: 9840515. DOI: 10.1002/wps.21034. View

Morris E, ODonovan M, Virani A, Austin J . An ethical analysis of divergent clinical approaches to the application of genetic testing for autism and schizophrenia. Hum Genet. 2021; 141(5):1069-1084. DOI: 10.1007/s00439-021-02349-1. View

Soda T, Merner A, Small B, Torgerson L, Munoz K, Austin J . Child and adolescent psychiatrists' use, attitudes, and understanding of genetic testing and pharmacogenetics in clinical practice. Psychiatry Res. 2023; 325:115246. PMC: 10365566. DOI: 10.1016/j.psychres.2023.115246. View

van Westrhenen R, van Schaik R, van Gelder T, Birkenhager T, Bakker P, Houwink E . Policy and Practice Review: A First Guideline on the Use of Pharmacogenetics in Clinical Psychiatric Practice. Front Pharmacol. 2021; 12:640032. PMC: 8117336. DOI: 10.3389/fphar.2021.640032. View

Schaefer G, Mendelsohn N . Clinical genetics evaluation in identifying the etiology of autism spectrum disorders: 2013 guideline revisions. Genet Med. 2013; 15(5):399-407. DOI: 10.1038/gim.2013.32. View

Koido K, Ingvoldstad Malmgren C, Pojskic L, Almos P, Bergen S, Borg I . Lack of guidelines and translational knowledge is hindering the implementation of psychiatric genetic counseling and testing within Europe - A multi-professional survey study. Eur J Med Genet. 2023; 66(8):104805. DOI: 10.1016/j.ejmg.2023.104805. View

10.

Morosoli J, Colodro-Conde L, Barlow F, Medland S . Investigating perceived heritability of mental health disorders and attitudes toward genetic testing in the United States, United Kingdom, and Australia. Am J Med Genet B Neuropsychiatr Genet. 2021; 186(6):341-352. DOI: 10.1002/ajmg.b.32875. View

11.

Rowlatt A, McAllister M, Cuthbert A . Attitudes toward offering genetic counseling for psychiatric conditions among genetics healthcare practitioners in the United Kingdom: A qualitative study. J Genet Couns. 2021; 31(1):279-290. DOI: 10.1002/jgc4.1492. View

12.

Moldovan R, McGhee K, Coviello D, Hamang A, Inglis A, Ingvoldstad Malmgren C . Psychiatric genetic counseling: A mapping exercise. Am J Med Genet B Neuropsychiatr Genet. 2019; 180(8):523-532. DOI: 10.1002/ajmg.b.32735. View

13.

Martorell L, Sanfeliu A, Blazquez A, Lojo E, Cortes M, de Pablo J . Genetics and genetic counseling in psychiatry: Results from an opinion survey of professionals and users. Mol Genet Genomic Med. 2019; 7(8):e830. PMC: 6687663. DOI: 10.1002/mgg3.830. View

14.

Anttila V, Bulik-Sullivan B, Finucane H, Walters R, Bras J, Duncan L . Analysis of shared heritability in common disorders of the brain. Science. 2018; 360(6395). PMC: 6097237. DOI: 10.1126/science.aap8757. View

15.

Morris E, Inglis A, Austin J . Psychiatric genetic counseling for people with copy number variants associated with psychiatric conditions. Clin Genet. 2022; 102(5):369-378. DOI: 10.1111/cge.14210. View

16.

Slomp C, Morris E, Edwards L, Hoens A, Landry G, Riches L . Pharmacogenomic Testing for Major Depression: A Qualitative Study of the Perceptions of People with Lived Experience and Professional Stakeholders. Can J Psychiatry. 2022; 68(6):436-452. PMC: 10331253. DOI: 10.1177/07067437221140383. View

17.

Laegsgaard M, Mors O . Psychiatric genetic testing: attitudes and intentions among future users and providers. Am J Med Genet B Neuropsychiatr Genet. 2007; 147(3):375-84. DOI: 10.1002/ajmg.b.30609. View

18.

Muller D, Kekin I, Kao A, Brandl E . Towards the implementation of CYP2D6 and CYP2C19 genotypes in clinical practice: update and report from a pharmacogenetic service clinic. Int Rev Psychiatry. 2013; 25(5):554-71. DOI: 10.3109/09540261.2013.838944. View

19.

Bousman C, Stevenson J, Ramsey L, Sangkuhl K, Hicks J, Strawn J . Clinical Pharmacogenetics Implementation Consortium (CPIC) Guideline for CYP2D6, CYP2C19, CYP2B6, SLC6A4, and HTR2A Genotypes and Serotonin Reuptake Inhibitor Antidepressants. Clin Pharmacol Ther. 2023; 114(1):51-68. PMC: 10564324. DOI: 10.1002/cpt.2903. View

20.

Jenkins S, Arribas-Ayllon M . Genetic Counselling for Psychiatric Disorders: Accounts of Psychiatric Health Professionals in the United Kingdom. J Genet Couns. 2016; 25(6):1243-1255. PMC: 5114337. DOI: 10.1007/s10897-016-9990-5. View