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Psychiatry

Your Psychiatric DNA Determination

Does genetic testing dictate psychiatric diagnosis and treatment?

The mapping of the human DNA code has opened up many exciting possibilities. Several private companies have formed, offering genetic explorations of health vulnerabilities and ancestry analyses. Medical research has uncovered areas that are beginning to identify tendencies for illness and specific treatment approaches.

One example of an area of research has involved recognition of BRCA gene mutations and their connection with breast cancer. Most women with the disease, however, do not have a mutation, and only a limited of number of women with a mutation develop cancer. Nevertheless, the enthusiasm about this association may overwhelm the currently available information that encourages screening and is devising treatment approaches. Other areas in medicine are progressing, however gradually, in similar directions.

In psychiatry there is comparable excitement. Small studies have identified areas of interest. Changes in particular gene structure have been associated with diagnosis of some disorders (including borderline personality disorder), and even severity of symptoms. Some studies have examined the probability of response to particular classes of antidepressants. Some research focuses on how chromosomes metabolize different medicines, suggesting when higher or lower than usual doses may be optimal.

However, it is also clear that we are far from ultimate goals, especially in research of the brain, probably our most complex organ. Heritable contributions to psychiatric illnesses are probably determined by complex interactions of many genes. Current knowledge is limited. Many experts believe that the cost of routine genetic testing is not justified. They feel that the sparse information gleaned is not robust enough to guide or contradict usual treatment approaches. Although many seek the latest medical information, we must temper enthusiasm with recognition of the limits of our knowledge.

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More from Jerold J. Kreisman M.D.
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