Mental Health Service, VA San Diego Healthcare System, San Diego, California.
Department of Psychiatry, University of California San Diego, La Jolla, California.
Depress Anxiety. 2020 Sep;37(9):842-850. doi: 10.1002/da.23074. Epub 2020 Jul 15.
Novel technologies make it possible to incorporate pharmacogenetic testing into the medical management of depression. However, previous studies indicate that there may be a subset of subjects who have concerns about genetic testing and may be psychologically vulnerable. If so, pharmacogenetic testing in depressed subjects could negatively impact their mental health and undermine treatment goals.
In this study, we developed a standardized instrument to assess motivations and attitudes around pharmacogenetic testing in a cohort of 170 depressed Veterans participating in a multi-center clinic trial.
Testing reveals that subjects were largely positive about the use of genetic testing to guide pharmacological treatment and help plan their future. Most subjects showed only modest concerns about the impact on family, inability to cope with the results, and fear of discrimination. The severity of depression did not predict the concern expressed about negative outcomes. However, non-Caucasian subjects were more likely on average to endorse concerns about poor coping and fear of discrimination.
These data indicate that while the overall risk is modest, some patients with depression may face psychosocial challenges in the context of pharmacogenetic testing. Future work should identify factors that predict distress and aim to tailor test results to different populations.
新的技术使得将药物遗传学检测纳入抑郁症的医学管理成为可能。然而，先前的研究表明，可能有一部分对基因检测有顾虑并可能在心理上较为脆弱的人群。如果是这样，对抑郁患者进行药物遗传学检测可能会对他们的心理健康产生负面影响，并破坏治疗目标。
在这项研究中，我们开发了一种标准化的工具，用于评估 170 名参与多中心临床研究的退伍军人抑郁患者对药物遗传学检测的动机和态度。
检测表明，受试者对使用基因检测来指导药物治疗和帮助规划未来的态度基本上是积极的。大多数受试者只对检测结果对家庭的影响、无法应对检测结果和担心歧视表示适度的关注。抑郁的严重程度并不能预测对负面结果的担忧程度。然而，非白种人受试者平均更有可能认同对应对能力差和担心歧视的担忧。
这些数据表明，尽管总体风险较小，但一些抑郁症患者在药物遗传学检测方面可能会面临心理社会挑战。未来的研究应该确定哪些因素可以预测痛苦，并努力根据不同的人群调整检测结果。
