Mandich Paola, Lamp Merit, Gotta Fabio, Gulli Rossella, Iacometti Ariela, Marchese Roberta, Bellone Emilia, Abbruzzese Giovanni, Ferrandes Giovanna
Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics and Maternal-Child SciencesUniversity of GenoaGenoaItaly.
Medical Genetics UnitIRCCS AOU San Martino-ISTGenoaItaly.
Mol Genet Genomic Med. 2017 Jun 17;5(5):473-480. doi: 10.1002/mgg3.238. eCollection 2017 Sep.
Predictive testing for Huntington's disease has been available at the Medical Genetics Unit of the University of Genoa from 1987. In 1989, an integrated counseling protocol (geneticist, psychologist, and neurologist) was developed following International Guidelines.
This is a retrospective analysis of the clinical charts and motivation questionnaires of persons seeking predictive testing through direct DNA analysis from 1993 until 2014, with the aim to evaluate their individual characteristics, motivations, and the outcomes of the counseling protocol.
A total of 299 persons (164 women, 135 men) applied for predictive testing. Most applicants' features and motivations were similar to those previously described, but surprisingly the percentage of completed protocols was higher among men, 68.5% versus 53.5% ( = 0.011). Likewise, persons over 25 years of age were more likely to take the test than younger applicants (18-25 years): 63.4% versus 48.1% ( = 0.043). In addition, relationship status, having children, and the gender of the affected parent showed different effects on the decision about testing in males and females. No catastrophic reactions were reported during the study period.
We observed that factors influencing the decision-making process might differ between males and females, and that predictive testing appears a safe procedure if framed within an integrated counseling protocol.
自1987年起,热那亚大学医学遗传学部门就提供亨廷顿舞蹈症的预测性检测。1989年,依据国际指南制定了一套综合咨询方案(由遗传学家、心理学家和神经学家共同参与)。
这是一项回顾性分析,研究对象为1993年至2014年间通过直接DNA分析寻求预测性检测的人员的临床病历和动机调查问卷,目的是评估他们的个人特征、动机以及咨询方案的效果。
共有299人(164名女性,135名男性)申请预测性检测。大多数申请者的特征和动机与先前描述的相似,但令人惊讶的是,男性完成方案的比例更高,为68.5%,而女性为53.5%(P = 0.011)。同样,25岁以上的人比年轻申请者(18 - 25岁)更有可能接受检测:分别为63.4%和48.1%(P = 0.043)。此外,恋爱状况、是否有子女以及受影响父母的性别对男性和女性的检测决定有不同影响。研究期间未报告有灾难性反应。
我们观察到,影响决策过程的因素在男性和女性之间可能存在差异,并且如果在综合咨询方案的框架内进行,预测性检测似乎是一个安全的程序。