Le conseil génétique en psychiatrie

Abstract

There are several lines of evidence supporting the role of genetic factors in major psychiatric disorders. The evidence is mainly provided by family and twin studies. These have documented the familiality of disorders such as autism, schizophrenia, bipolar disorder or major depression. These data are relevant in providing information about familial risk of illness. Nevertheless, the available information is still limited and this probably justifies the little attention paid to genetic counselling for psychiatric disorders. However, probably related to the recent high profile of genetics, clinicians are now confronted with questions from patients and their families regarding risks of disorders for themselves and/or their relatives. Despite the difficulty to precise the risk of recurrence for psychiatric disorders and since having a family history of the disorder is currently the best predictor for the development of these disorders, it is noteworthy that the American Psychiatric Association guidelines for the treatment of bipolar disorder suggest that genetic counselling is helpful for patients who are considering having children. In the coming years the expected identification of susceptibility genes for psychiatric disorders may bring new opportunities and expectations from patients and families for the clinical translation of research findings in psychiatric genetics. We review evidence for possible increasing demand for genetic counselling, particularly if specific genes related to psychiatric disorders are identified. We also explore both the potential role of genetic counselling for psychiatric disorders and the issues involved in conveying genetic information in the clinical setting. The psychiatry genetics is currently in its infancy, but with accelerating advances in understanding the genetic basis of psychiatric disorders, psychiatrists will certainly be called upon to incorporate genetic information into clinical practice.