SU47 - BEHAVIOURAL CHANGES AFTER PSYCHIATRIC GENETIC COUNSELING: AN EXPLORATORY STUDY

Abstract

Background Though often thought of as an intervention exclusively concerned with delivering information about genetic testing/recurrence risk, Genetic Counseling (GC) is actually “a process of helping people to understand and adapt to the medical, psychological, and familial implications of genetic contributions to disease.” There is currently limited data relating to the effect of genetic counseling (rather than information) on patients’ health behaviors. With its focus on strategies to protect mental health, Psychiatric Genetic Counseling (PGC) is conceptually positioned to produce health behavior changes. Indeed, research shows that PGC leads to increased patient empowerment and self-efficacy – both of which are necessary for patients to engage in behavior change. No studies have yet examined if PGC can evoke patient health behavior changes. Methods We conducted semi-structured interviews with eight patients with a personal history of psychiatric illness who had received PGC in Vancouver, Canada within the previous year, to explore its effect on health behaviors. Interviews focused on (i) experience with PGC services, (ii) perception of the etiology of mental illness and risk of developing symptoms, (iii) views on their past and current behavior and ability to change, and (iv) changes in their behavior since their PGC session. Guided by grounded theory, we used a constant comparative approach to data analysis. Results Participants reported increases in use of protective behaviors such as exercise, improving sleep habits, adhering to prescribed medication, seeking professional help and engaging in self-care. Participants reported increased sense of control, confidence and acceptance of their psychiatric disorder after PGC. This arose from having their feelings of guilt, shame, fear and hopelessness, and misconceptions and/or uncertainties about the etiology of psychiatric disorders and recommended risk-reducing behaviors addressed. PGC reframed participants’ initial perception of mental illness by separating cause into controllable and uncontrollable factors, discussing strategies to address the controllable factors and reiterating that everyone has a varying degree of susceptibility –some may be higher than others- but symptoms of mental illness are not predetermined. Discussion Overall, participants reported health behavior changes and improved mental health outcome after PGC. Future studies could explore these changes quantitatively.