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精神疾病遗传咨询的潜在影响。

The potential impact of genetic counseling for mental illness.

作者信息

Austin J C, Honer W G

机构信息

Centre for Complex Disorders, and Department of Psychiatry, University of British Columbia, 203-828 West 10th Avenue, Vancouver, British Columbia V5Z 1L8, Canada.

出版信息

Clin Genet. 2005 Feb;67(2):134-42. doi: 10.1111/j.1399-0004.2004.00330.x.

Abstract

Mental disorders are relatively highly heritable, yet complex with important interactions between genetic risk and environmental factors in determining illness expression. Due to the high prevalence of these complex disorders, steady increase in knowledge about genetic contributions, and increasing public awareness, this area may come to represent a significant proportion of all genetic counseling. The potential impact of genetic counseling in mental illness is broad. As well as the conventional expectations, genetic counseling may have the positive outcomes of reducing the guilt, shame, and stigma associated with mental illness, even within families. However, like many interventions in medicine, genetic counseling for mental disorders could potentially have unintended consequences resulting in increased stigma, guilt, and shame. The potential impacts of genetic education and providing recurrence risks on stigma are reviewed, as well as the role of education about the environment as a way of modifying family members' guilt. The review allows a preliminary formulation of a series of suggestions for genetic counseling in mental illness.

摘要

精神障碍具有较高的遗传性,但很复杂,在决定疾病表现方面,遗传风险和环境因素之间存在重要的相互作用。由于这些复杂疾病的高患病率、对遗传因素贡献的认识稳步增加以及公众意识的提高,该领域可能会在所有遗传咨询中占很大比例。遗传咨询对精神疾病的潜在影响是广泛的。除了传统的预期效果外,遗传咨询甚至在家庭内部也可能产生积极结果,即减少与精神疾病相关的内疚感、羞耻感和污名化。然而,与医学中的许多干预措施一样,针对精神障碍的遗传咨询可能会产生意想不到的后果,导致污名化、内疚感和羞耻感增加。本文回顾了遗传教育和提供复发风险对污名化的潜在影响,以及环境教育作为减轻家庭成员内疚感的一种方式所起的作用。该综述为精神疾病的遗传咨询初步提出了一系列建议。

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