Genetic Testing of Children for Predisposition to Mood Disorders: Anticipating the Clinical Issues
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NEXT GENERATION GENETIC COUNSELING
Genetic Testing of Children for Predisposition to Mood Disorders: Anticipating the Clinical Issues Jessica A. Erickson & Lili Kuzmich & Kelly E. Ormond & Erynn Gordon & Michael F. Christman & Mildred K. Cho & Douglas F. Levinson
Received: 30 June 2013 / Accepted: 5 March 2014 # The Author(s) 2014. This article is published with open access at Springerlink.com
Abstract Large-scale sequencing information may provide a basis for genetic tests for predisposition to common disorders. In this study, participants in the Coriell Personalized Medicine Collaborative (N=53) with a personal and/or family history of Major Depressive Disorder or Bipolar Disorder were interviewed based on the Health Belief Model around hypothetical intention to test one’s children for probability of developing a mood disorder. Most participants (87 %) were interested in a hypothetical test for children that had high (“90 %”) positive predictive value, while 51 % of participants remained interested in a modestly predictive test (“20 %”).
Electronic supplementary material The online version of this article (doi:10.1007/s10897-014-9710-y) contains supplementary material, which is available to authorized users. J. A. Erickson : K. E. Ormond : M. K. Cho : D. F. Levinson Center for the Integration of Research on Genetics and Ethics of the Stanford Center for Biomedical Ethics, Stanford University, Stanford, CA, USA L. Kuzmich Center for Reproductive Health, University of California San Francisco Medical Center, San Francisco, CA, USA K. E. Ormond Department of Genetics, Stanford University, Stanford, CA, USA E. Gordon : M. F. Christman Coriell Personalized Medicine Collaborative, Coriell Institute for Medical Research, Camden, NJ, USA M. K. Cho Department of Pediatrics, Stanford University, Stanford, CA, USA D. F. Levinson (*) Department of Psychiatry and Behavioral Sciences, Stanford University, 401 Quarry Rd., Rm. 3322, Stanford, CA 94305, USA e-mail: [email protected]
Interest was driven by beliefs about effects of test results on parenting behaviors and on discrimination. Most participants favored testing before adolescence (64 %), and were reluctant to share results with asymptomatic children before adulthood. Participants anticipated both positive and negative effects of testing on parental treatment and on children’s self-esteem. Further investigation will determine whether these findings will generalize to other complex disorders for which early intervention is possible but not clearly demonstrated to improve outcomes. More information is also needed about the effects of childhood genetic testing and sharing of results on parent–child relationships, and about the role of the child in the decision-making process. Keywords Genetic testing . Children . Benefits . Risks . Positive predictive value . Mood disorders . Health Belief Model . Mood disorders
Introduction The primary motivation for molecular genetic research on bipolar disorder (BPD) and major depressive disorder (MDD) is to determine how genetic
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