Laegsgaard Mett Marri, Mors Ole
Centre for Psychiatric Research, Aarhus University Hospital, Skovagervej 2, Risskov, Denmark.
Am J Med Genet B Neuropsychiatr Genet. 2008 Apr 5;147(3):375-84. doi: 10.1002/ajmg.b.30609.
Psychiatric genetic research may eventually render possible psychiatric genetic testing. Whereas all genetic knowledge has certain characteristics raising ethical, legal, and social issues, psychiatric genetic knowledge adds more controversial issues. Ethical principles have been proposed as a guide in this field, but the optimal utilization of genetic testing has also been recognized to depend on knowledge of the potential consumers' attitudes. To provide knowledge to inform the public debate on mental illness and genetics, and the future conducting of psychiatric genetic testing and counseling, we surveyed attitudes toward psychiatric genetic testing among 397 patients with a psychiatric diagnosis, 164 of their relatives and 100 medical and psychology students. The results showed widespread interest in psychiatric genetic testing of self and child, but less support for prenatal testing. Psychiatric and somatic genetic testing attracted the same amounts of accept. General attitudes toward access to psychiatric genetic testing and information revealed substantial support for bioethical principles of autonomy and privacy. However, questions describing more specific situations revealed contradictions mirroring the bioethical dilemmas recognized in the field and variations in attitudes between groups with different levels of knowledge of genetics, different kinds of experience with mental illness, and different motives and preconceptions regarding psychiatric genetics. The contradictions and differences in attitudes among possible future users and providers of psychiatric genetic testing and counseling indicate ambivalence, insecurity, and perceived lack of knowledge in relation to psychiatric genetics. These results should inform further research and the future integration of psychiatric genetics into practice.
精神科遗传学研究最终可能使精神科基因检测成为可能。尽管所有的基因知识都具有某些会引发伦理、法律和社会问题的特征,但精神科基因知识还增加了更多有争议的问题。已有伦理原则被提议作为该领域的指导方针,但人们也认识到基因检测的最佳利用取决于对潜在消费者态度的了解。为了提供知识以促进关于精神疾病与遗传学以及未来精神科基因检测与咨询开展情况的公开辩论,我们对397名患有精神疾病的患者、其中164名患者的亲属以及100名医科和心理学专业学生对精神科基因检测的态度进行了调查。结果显示,人们对自身及子女的精神科基因检测普遍感兴趣,但对产前检测的支持较少。精神科和躯体基因检测受到的接受程度相同。对获取精神科基因检测及信息的总体态度显示,人们对自主和隐私等生物伦理原则给予了大力支持。然而,描述更具体情况的问题揭示了一些矛盾,这些矛盾反映了该领域公认的生物伦理困境,以及不同群体之间在对遗传学知识水平、不同类型的精神疾病经历以及对精神科遗传学的不同动机和先入之见方面的态度差异。精神科基因检测及咨询未来可能的使用者和提供者之间态度的矛盾与差异表明,在精神科遗传学方面存在矛盾心理、不安全感以及认知不足。这些结果应为进一步的研究以及未来将精神科遗传学融入实践提供参考。