Genetic counseling benefits relatives of schizophrenia patients

By Mark Cowen, Senior medwireNews Reporter

Genetic counseling is generally welcomed by the family members of patients with schizophrenia and can provide lasting benefits, say researchers.

The team found that genetic counseling led to increased knowledge about schizophrenia among family members and a significant reduction in levels of concern about familial recurrence, as well as a decreased sense of stigma.

"To our knowledge, this is the first study that formally demonstrates the feasibility and worth of genetic counseling for schizophrenia in community mental health practice," write Anne Bassett (Centre for Addiction and Mental Health, Toronto, Ontario, Canada) and colleagues in Schizophrenia Bulletin.

The team approached 122 immediate family members of 92 patients with schizophrenia about participating in a study of genetic counseling for the disorder.

In total, 78 family members actively expressed an interest in participating, with 52 assigned to genetic counseling based on tested protocols for other complex diseases and the existing schizophrenia literature. Counseling was undertaken by mental healthcare providers in a community setting.

The researchers found that the number of participants who significantly overestimated the personal and familial risk for schizophrenia decreased significantly from 35 at baseline to 20 after counseling.

Furthermore, the mean familial recurrence risk estimate decreased by nearly half, and there was a concomitant decrease in mean recurrence-related concern of a third.

At baseline, participants had a significantly lower mean schizophrenia knowledge quiz percentage score than 22 selected junior psychiatric residents, at 18.7% versus 21.8%. After counseling, however, there was no significant difference in scores between the groups, at 21.0% and 21.8%, respectively.

Participants also showed lower levels of stigma after counseling compared with beforehand, as assessed using the Experience of Caregiving Inventory stigma subscale.

Overall, 96.1% of participants endorsed the need for genetic counseling.

Bassett et al conclude: "The results support the integration of contemporary genetic counseling for families into the general management of schizophrenia."

They add: "Such informed discussions may ultimately help in 'priming' individuals, families, and clinicians for further advances anticipated in the emerging 'molecular age' in psychiatry and the potential for return of individually relevant molecular genetic findings in the future."

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