Klitzman Robert, Abbate Kristopher J, Chung Wendy K, Marder Karen, Ottman Ruth, Taber Katherine Johansen, Leu Cheng-Shiun, Appelbaum Paul S
*Columbia University Medical Center, New York, NY; †American Medical Association, Chicago, IL; ‡HIV Center for Clinical and Behavioral Studies, Columbia University; and §New York State Psychiatric Institute, New York, NY.
J Nerv Ment Dis. 2014 Jul;202(7):530-8. doi: 10.1097/NMD.0000000000000154.
We examined how 372 psychiatrists view genetic aspects of mental disorders and behaviors and use genetic tests (GTs). Most thought that the genetic contribution was moderate/high for bipolar disorder, schizophrenia, depression, Alzheimer's, intelligence, creativity, anxiety, and suicidality. In the past 6 months, 14.1% ordered GTs, 18.3% discussed prenatal testing with patients, 36.0% initiated discussions about other GTs, 41.6% had patients ask about GTs, and 5.3% excluded GT results from patient records. Many thought that GTs; were available for schizophrenia (24.3%) and major depression (19.6%). Women were more likely to report that patients asked about GTs; and were less certain about the degree of genetic contribution to several disorders. Psychiatrists perceive strong genetic bases for numerous disorders and traits, and many have discussed and ordered tests for GTs, but have relatively limited knowledge about available tests. These data suggest possible sex differences in psychiatrists' beliefs about genetic contributions to disorders and have implications for future research, education, policy, and care.
我们研究了372名精神科医生如何看待精神障碍和行为的遗传因素以及他们对基因检测(GTs)的使用情况。大多数人认为,双相情感障碍、精神分裂症、抑郁症、阿尔茨海默病、智力、创造力、焦虑症和自杀倾向的遗传因素占比为中度/高度。在过去6个月中,14.1%的医生开具了基因检测,18.3%的医生与患者讨论了产前检测,36.0%的医生开始讨论其他基因检测,41.6%的医生遇到患者询问基因检测,5.3%的医生将基因检测结果排除在患者记录之外。许多人认为可进行精神分裂症(24.3%)和重度抑郁症(19.6%)的基因检测。女性更有可能报告患者询问基因检测,并且对几种疾病的遗传因素占比不太确定。精神科医生认为众多疾病和特征有很强的遗传基础,许多人已经讨论并开具了基因检测,但对现有检测的了解相对有限。这些数据表明精神科医生在对疾病遗传因素的看法上可能存在性别差异,并对未来的研究、教育、政策和护理有启示意义。