Grand Rounds.com

Psychiatric Genetics: A Survey of Psychiatrists' Knowledge, Opinions, and Practice Patterns

Christine T. Finn, M.D.; Marsha A. Wilcox, Sc.D., Ed.D.; Bruce R. Korf, M.D., Ph.D.; Deborah Blacker, M.D., Sc.D.; Stephanie R. Racette, M.A.; Pamela Sklar, M.D., Ph.D.; and Jordan W. Smoller, M.D., Sc.D.

Objective: Knowledge about the genetic basis of psychiatric illness is growing rapidly, and psychiatrists may be called upon to incorporate this information into clinical practice. The goal of this study was to assess psychiatrists' familiarity with and attitudes toward genetic information.

Method: We surveyed 844 participants, the majority of whom were psychiatrists, attending a continuing medical education course in the fall of 2002 and measured knowledge, opinions, and current practice patterns in regard to psychiatric genetics.

Results: Responses were received from 352 psychiatrists (54% of those surveyed). Most psychiatrists correctly answered fewer than half of survey items assessing general and psychiatric genetic knowledge. While 83% considered it their role to discuss genetic information with patients and families, fewer than 25% felt prepared or competent to do so. In response to hypothetical questions regarding genetic testing, a substantial proportion of psychiatrists indicated willingness to use such tests for diagnostic clarification, as well as presymptomatic and even prenatal risk prediction. The majority of respondents expressed interest in further genetics education.

Conclusions: Our results suggest that psychiatrists view genetic information as clinically relevant, but have limitations in knowledge that may impact the incorporation of psychiatric genetics into clinical practice.

(J Clin Psychiatry 2005;66:821-830)

Received Dec. 2, 2004; accepted Jan. 27, 2005. From the Department of Psychiatry (Drs. Finn, Blacker, Sklar, and Smoller and Ms. Racette), the Psychiatric Genetics Program in Mood and Anxiety Disorders (Drs. Finn and Smoller and Ms. Racette), and the Psychiatric and Neurodevelopmental Genetic Unit (Drs. Sklar and Smoller), Massachusetts General Hospital, Boston; Boston University Medical School Genetics Program, Boston, Mass. (Dr. Wilcox); University of Alabama at Birmingham, Birmingham (Dr. Korf); and Broad Institute, Boston, Mass. (Dr. Sklar). A portion of this study was supported by the American Psychiatric Institute for Research and Education on Severe Mental Illness-Janssen Pharmaceuticals Research Scholarship (Drs. Finn and Smoller) and by grants from the National Institute of Mental Health (K-08 MH01770-02) (Dr. Smoller) and the National Institutes of Health (ELSI grant R01 HG01831) (Dr. Blacker). The authors acknowledge the directors and staff of the Massachusetts General Hospital/Harvard Medical School psychopharmacology course for their assistance in completing this project: John B. Herman, M.D., Jerrold F. Rosenbaum, M.D., and Maurizio Fava, M.D., along with Gail Dickson, M.P.A. In addition, we thank Ming Tsuang, M.D., Ph.D., D.Sc., Stephen Faraone, Ph.D., Susan L. Santangelo, Sc.D., Robin Blatt, R.N., M.P.H., Beth Rosen-Sheidley, M.S., C.G.C., Holly Peay, M.S., C.G.C., and Catherine Bove, R.N., M.Ed., A.P.N.G., for their helpful feedback in the development of the survey. We also thank Mason Freeman, M.D., William Crowley, M.D., and Virginia Hughes, M.S., for their collaboration. Corresponding author and reprints: Christine T. Finn, M.D., 77 Avenue Louis Pasteur, Suite 250, Boston, MA 02115 (e-mail: cfinn@partners.org).

You may also view this entire article as a PDF