by Adam Stucke (Indiana State University Genetic Counseling Student, Class of 2018)
One topic in medical diagnostics that is certainly getting more attention is psychiatric disorders. Conditions like depression, anxiety, schizophrenia, and autism have previously received quite a stigma for falling onto the fault of the individual or parents and campaigns to raise awareness to ending these stereotypes has also gained popularity. These campaigns aim to normalize these conditions and elucidate the discrimination people have against psychiatric conditions versus physical or anatomical medical conditions. An unlikely source to help these campaigns has come in the form of research in genetics. The advent of whole-exome sequencing has allowed for the discovery of new, novel SNPs and facilitated research on several more genes associated with psychiatric disorders. Like any research in its beginning stages though, solidifying the correlations of genetic diagnosis with a condition is a far-off result with other ethical quagmires to sort.
The genetics behind psychiatric disorder lie in the body’s ability to handle stress, or resiliency. Some people may have inherited a better tolerance for stress, while others are more susceptible to their environmental stressors and develop conditions like schizophrenia or depression. However, when you start to get excited about the prospect of this technology, it is important to think of the ramifications of this technology in the context of modern medicine, study of genetics, and psychiatric disorders in general. In an article by the National Institute of Mental Health “although statistically significant, each of these genetic associations individually can account for only a small amount of risk for mental illness, making them insufficient for predictive or diagnostic usefulness by themselves” says Jordona Smoller M.D. So while technology begins to define some of these genetic correlations to psychiatric disorders, it will be the role of genetic counselors to help explain this interplay between environment and genetics and what ways that people can reduce the risk of developing these conditions.
Another article by Allen Frances M.D. takes into account the excitement of this new prospect, but accurately summarizes how it can lead to a “minefield” of intricacies that can be hard to navigate. People today are looking for yes or no answers as well as a concrete solution and the genetics of psychiatric disorder is not going to produce either outcome. Direct-to-consumer genetic tests complicate this by allowing anyone to access this type of technology without being able to understand any results. This is a prime example of how technology can move so rapidly, yet ethical and logistical guidelines not being addressed can cause even more obstacles. While this post focuses on how to unravel the genetics for psychiatric disorders, the same methodology could also be useful for how to approach other conditions like autoimmune disorders, both types of diabetes, and many more.
The future for these types of conditions is to decipher the environmental from the genetic causes. An article in “Nature” the weekly international journal of science, informs us how gene linkage studies aim to discover the evolution of the genetics of psychiatric disorders. For example, people who lived in the coldest temperatures of Europe were more prone to develop schizophrenia. The researcher hypothesized that the loci associated with tolerating cold temperatures was genetically close to the loci related to schizophrenia. Other factors studied alongside populations more likely to develop schizophrenia were the prevalence of infectious disease and amount of rainfall. Research is also going into understanding how human brains are regulated compared to Neanderthals. While the two species may contain the same genes, like FOXP2 which is associated with development of proper language, human brains may produce more of a gene product and cause a more developed language system. Advantageous in the evolution of the human species, however this system can then be tampered with to cause different types of conditions.
The future of the genetic relation to psychiatric disorders is definitely promising. The technology and research is fast-approaching the capability to deliver more specific evaluations of risks, but ultimately is also at the discretion of environmental factors. There is still much to be learned about this relationship between genetics and environment. Popular stereotypes and ethical guidelines pose threats to the implementation of this research when it does become available for use in the medical diagnostic setting. Hopefully more advocacy can be drawn to these potential obstacles in order to help other have a brighter future.