Genetic testing for cancer in children. Short-term psychological effect.

OBJECTIVE

To study the psychological effect of genetic testing in children.

DESIGN

We evaluated the psychological effect of predictive genetic testing through surveys of children at risk for familial adenomatous polyposis. Their psychological state was assessed before testing and 3 months later.

SETTING

A research clinic.

PARTICIPANTS

A volunteer sample of 41 children, aged 6 to 16 years, and their parents.

MAIN OUTCOME MEASURES

Self-report inventories of depression, anxiety, behavior problems, and competence.

RESULTS

Nineteen children were found to have a gene mutation (mutation-positive) and 22 did not (mutation-negative). Their depression, anxiety, and behavior problem and competence scores remained in the normal range after testing. Also, parents' depression scores remained within normal limits at follow-up. There were subclinical changes, however. Mutation-positive children with affected mothers had significantly higher depression scores at follow-up. Also, regardless of test results, children with affected mothers had significantly increased anxiety scores after testing. In families with mutation-positive and mutation-negative children, familial adenomatous polyposis-unaffected parents experienced significantly increased depressive symptoms at follow-up.

CONCLUSIONS

Predictive testing of children at risk for familial adenomatous polyposis did not lead to clinically significant psychological symptoms in tested children or their parents. However, it is premature to conclude that long-term follow-up will be equally favorable. Additional study will be needed to determine the families' understanding of the genetic information and the effect of the information on familial relationships.