Use of Genetic Tests among Neurologists and Psychiatrists: Knowledge, Attitudes, Behaviors, and Needs for Training
This study explores neurologists’ and psychiatrists’ knowledge, attitudes, and practices concerning genetic tests. Psychiatrists (n = 5,316) and neurologists (n = 2,167) on the American Medical Association master list who had agreed to receive surveys were sent an email link to a survey about their attitudes and practices regarding genetic testing; 372 psychiatrists and 163 neurologists responded. A higher proportion of neurologists (74 %) than psychiatrists (14 %) who responded to the survey had ordered genetic testing in the past 6 months. Overall, most respondents thought that genetic tests should be performed more frequently, but almost half believed genetic tests could harm patients psychologically and considered legal protections inadequate. Almost half of neurologists (49 %) and over 75 % of psychiatrists did not have a genetics professional to whom to refer patients; those who had ordered genetic tests were more likely than those who did not do so to have access to a genetic counselor. Of respondents, 10 % had received patient requests not to document genetic information and 15 % had received inquiries about direct-to-consumer genetic testing. Neurologists reported themselves to be relatively more experienced and knowledgeable about genetics than psychiatrists. These data, the first to examine several important issues concerning knowledge, attitudes and behaviors of neurologists and psychiatrists regarding genetic tests, have important implications for future practice, research, and education.
KeywordsDecision making Insurance Discrimination Ethics Medical education Genetic testing Genetic counseling
The authors would like to thank Matthew Wynia, MD, Abby Fyer, MD, and Patricia Contino, MFA for their assistance with this manuscript.
From the Center for Research on Ethical, Legal and Social Implications of Psychiatric, Neurologic, and Behavioral Genetics, Columbia University Medical Center. This work was supported by NHGRI grant #1P20HG005535-01 (Paul Appelbaum, PI).
- DeLisi, L., & Bertisch, H. (2006). A preliminary comparison of the hopes of researchers, clinicians, and families for the future ethical use of genetic findings on schizophrenia. Am J Human Genetics, 141B(1), 110–115.Google Scholar
- Genetics in Primary Care Institute. Time Out for Genetics Webinar Series. [Internet]; 2013[cited May 31, 2013]. Available from: http://www.medicalhomeinfo.org/gpci.aspx#webinar.
- Genomind website. 2013[cited June 4, 2013]. Available from: https://www.genomind.com/.
- Klitzman, R., Chung, W., Marder, K., Shanmugham, A., Chin, L., Stark, M., Leu, C., & Appelbaum, P. (2012). Attitudes and practices among internists concerning genetic testing. Journal of Genetic Counseling, 1059(7700), 1–11.Google Scholar
- Mitchell, P. B., Meiser, B., Wilde, A., Fullerton, J., Donald, J., Wilhelm, K., & Schofield, P. R. (2010). Predictive and diagnostic genetic testing in psychiatry. The Psychiatric Clinics of North America, 30, 829.Google Scholar