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Journal of Genetic Counseling

, Volume 23, Issue 5, pp 785–795 | Cite as

Preferences Regarding Targeted Education and Risk Assessment in People with a Family History of Major Depressive Disorder

  • Veronica Quinn
  • Bettina Meiser
  • Alex Wilde
  • Zoe Cousins
  • Kristine Barlow-Stewart
  • Philip B. Mitchell
  • Peter R. Schofield
Original Research

Abstract

Genetic testing for susceptibility to major depressive disorder (MDD) is not available for clinical use at present. Given this, family history remains the best predictor for development of MDD, and family-history-based risk assessment and information about familial aspects of MDD may be useful to clients at increased risk for MDD attending for genetic counseling. This study uses a mixed-methods design to assess the information needs and preferences of people at increased familial risk for MDD. Telephone interviews were conducted with 23 individuals, who had at least one first-degree relative with MDD and were recruited through advertisements placed on depression education websites. The most preferred way to access depression information was via the internet (87 % of participants), although this preference may have been due to the internet-based recruitment method. The second most preferred dissemination strategy (56 %) was face-to-face delivery through a health professional, including genetic counselors. Individuals reported a need for information about etiology and development of MDD, reproductive decision-making, early detection of symptoms and risk-reducing strategies. Nearly all participants expressed an interest in risk assessment. The present study found evidence of a high level of interest for information targeted to people at increased familial risk for MDD. Genetic counselors are likely to be called upon increasingly to provide supportive counseling to assist clients at increased familial risk in interpreting and contextualizing such information once it becomes available.

Keywords

Major depression Family history Attitudes Education Genetic counseling Risk assessment 

Notes

Acknowledgments

We are very grateful to the people who participated in this study and so generously shared their views. This study was supported by National Health and Medical Research Council (NHMRC) Program Grant and the Fellowship Enhancement Scheme, Faculty of Medicine, University of New South Wales. Associate Professor Bettina Meiser is supported by a Career Development Award Level 2 from the National Health and Medical Research Council of Australia.

Informed consent

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2000. Informed consent was obtained from all patients for being included in the study.

Conflict of interest

Authors Veronica Quinn, Author Bettina Meiser, Author Alex Wilde, Author Zoe Cousins, Author Kristine Barlow-Stewart, Author Philip B. Mitchell and Author Peter R. Schofield declare they have no conflict of interest.

References

  1. American Psychiatric Association (2000). Diagnostic and statistical manual of mental disorders (Vol. 4th Edition). Washington DC: Author.Google Scholar
  2. Austin, J. (2010). Re-conceptualizing risk in genetic counseling: implications for clinical practice. Journal of Genetic Counseling, 19(3), 228–234.PubMedCentralPubMedCrossRefGoogle Scholar
  3. Austin, J. C., Smith, G. N., & Honer, W. G. (2006). The genomic era and perceptions of psychotic disorders: genetic risk estimation, associations with reproductive decisions and views about predictive testing. American Journal of Medical Genetics Part B: Neuropsychiatric Genetics, 141, 926–928.CrossRefGoogle Scholar
  4. Barney, L. J., Griffiths, K. M., & Banfield, M. A. (2011). Explicit and implicit information needs of people with depression: a qualitative investigation of problems reported on an online depression support forum. BMC Psychiatry, 11, 88–95.Google Scholar
  5. Barrera, A. Z., Torres, L. D., & Munoz, R. F. (2007). Prevention of depression: the state of the science at the beginning of the 21st century. International Review of Psychiatry, 19, 655–670.PubMedCrossRefGoogle Scholar
  6. Bienvenu, O. J., Davydow, D. S., & Kendler, K. S. (2011). Psychiatric ‘diseases’ versus behavioral disorders and degree of genetic influence. Psychological Medicine, 41(01), 33–40.PubMedCrossRefGoogle Scholar
  7. Collins, V. R., Meiser, B., Ukoumunne, O. C., Gaff, C., St John, D. B. J., Halliday, J. L. (2007). The impact of predictive genetic testing for hereditary nonpolyposis colorectal cancer (HNPCC) – Three years after testing. Genetics in Medicine, 9(5), 290–297.Google Scholar
  8. Cross-Disorder Group of the Psychiatric Genomics Consortium, Smoller, J., Craddock, N., Kendler, K., Lee, P., Neale, B., et al. (2013). Identification of risk loci with shared effects on five major psychiatric disorders: a genome-wide analysis. The Lancet, 381(9875), 1371–1379.CrossRefGoogle Scholar
  9. Feret, H., Conway, L., & Austin, J. (2011). Genetic counselors’ attitudes towards individuals with schizophrenia: Desire for social distance and endorsement of stereotypes. Patient Education and Counesling, 82, 69–73.CrossRefGoogle Scholar
  10. Form, A. F., Christensen, H., Griffiths, K. M., & Rodgers, B. (2002). Effectiveness of complementary and self-help treatments for depression. Medical Journal of Australia, 176, s84–s96.Google Scholar
  11. Frets, P. G., Duivenvoorden, H. J., Verhage, F., Niermeijer, M. F., Van de Berge, S. M., & Galjaard, H. (1990). Factors influencing the reproductive decision after genetic counseling. American Journal of Medical Genetics, 35, 496–502.PubMedCrossRefGoogle Scholar
  12. Gottesman, I., Laursen, T., Bertelsen, A., & Bo Mortensen, P. (2010). Severe mental disorders in offspring with two psychiatrically ill parents. Archives of General Psychiatry, 67, 252–257.PubMedCrossRefGoogle Scholar
  13. International Schizophrenia Consortium. (2008). Rare chromosomal deletions and duplications increase risk of schizophrenia. Nature, 455(7210), 237–241.CrossRefGoogle Scholar
  14. Jacob, K. S., Bhugra, D., & Mann, A. H. (2002). A randomised controlled trial of an educational intervention for depression among Asian women in primary care in the United Kingdom. International Journal of Social Psychiatry, 48(2), 139–148.PubMedCrossRefGoogle Scholar
  15. Jorm, A. F., Christensen, H., & Griffiths, K. M. (2005). The impact of beyondblue: the national depression initiative on the Australian public’s recognition of depression and beliefs about treatments. Australian and New Zealand Journal of Psychiatry, 39(4), 248–254.PubMedCrossRefGoogle Scholar
  16. Judd, L. L., Akiskal, H. S., Schettler, P. J., Endicott, J., Leon, A. C., Solomon, D. A., et al. (2005). Psychosocial disability in the course of Bipolar I and II disorders. Archives of General Psychiatry, 62, 1322–1330.PubMedCrossRefGoogle Scholar
  17. Kendler, K. S., & Prescott, C. A. (1999). A population-based twin study of lifetime major depression in men and women. Archives of General Psychiatry, 56(1), 39–44.Google Scholar
  18. Kieseppa, T., Partonen, T., Haukka, J., Kaprio, J., & Lönnqvist, J. (2004). High concordance of bipolar I disorder in a nationwide sample of twins. The American Journal of Psychiatry, 161, 1814–1821.PubMedCrossRefGoogle Scholar
  19. Laegsgaard, M. M., Kristensen, A. S., Mors, O. (2009). Potential consumers' attitudes toward psychiatric genetic research and testing and factors influencing their intentions to test. Genetic Testing & Molecular Biomarkers, 13(1), 57–65.Google Scholar
  20. Lewis, C. M., Ng, M. Y., Butler, A. W., Cohen-Woods, S., Uher, R., Pirlo, K., et al. (2010). Genome-wide association study of major recurrent depression in the U.K. population. The American Journal of Psychiatry, 167, 949–957.PubMedCrossRefGoogle Scholar
  21. Lieb, R., Isensee, B., Hofler, M., Pfister, H., & Wittchen, H. U. (2002). Parental major depression and the risk of depression and other mental disorders in offspring: a prospective-longitudinal community study. Archives of General Psychiatry, 59(4), 365–374.PubMedCrossRefGoogle Scholar
  22. Lo, C. S. L., Ho, S. M. Y., & Hollon, S. D. (2008). The effects of rumination and negative cognitive styles on depression: a mediation analysis. Behaviour Research and Therapy, 46(4), 487–495.PubMedCrossRefGoogle Scholar
  23. McGuffin, P., Rijsdijk, F., Andrew, M., Sham, P., Katz, R., & Cardno, A. (2003). The heritability of bipolar disorder and the genetic relationship to unipolar despression. Archives of General Psychiatry, 60, 497–502.PubMedCrossRefGoogle Scholar
  24. Meiser, B., Mitchell, P. B., McGirr, H., Van Herten, M., & Schofield, P. R. (2005). Implications of genetic risk information in families with a high density of bipolar disorder: an exploratory study. Social Science & Medicine, 60, 109–118.CrossRefGoogle Scholar
  25. Meiser, B., Mitchell, P. B., Kasparian, N. A., Strong, K., Simpson, J. M., Mireskandari, S., & Schofeild, P. (2007). Attitudes towards childbearing, causal attributions for bipolar disorder and psychological distress: a study of families with multiple cases of bipolar disorder. Psychological Medicine, 37, 1601–1611.PubMedCrossRefGoogle Scholar
  26. Meiser, B., Kasparian, N. A., Mitchell, P. B., Strong, K., Simpson, J. M., Tabassum, L., & Schofield, P. R. (2008). Attitudes to genetic testing in families with multiple cases of bipolar disorder. Genetic Testing, 12(2), 233–243.PubMedCrossRefGoogle Scholar
  27. Merikangas, K., Chakravarti, A., Moldin, S., Araj, H., Blangero, J., Burmeister, M., et al. (2002). Future of genetics in mood research. Biological psychiatry, 52(6), 457–477.PubMedCrossRefGoogle Scholar
  28. Miles, M. B., & Huberman, A. M. (1994). Qualitative data analysis: An expanded sourcebook (2nd ed.). London: Sage.Google Scholar
  29. 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, 33(1), 225–243.PubMedCrossRefGoogle Scholar
  30. Powell, J., & Clarke, A. (2006). Internet information-seeking in mentalh health. The British Journal of Psychiatry, 189, 273–279.Google Scholar
  31. Roter, D., Ellington, L., Erby, L., Larson, S., & Dudley, W. (2006). The Genetic Counseling Video Project (GCVP): models of practice. American Journal of Medical Genetics, Seminars in Medical Genetics, 142(4), 209–220.CrossRefGoogle Scholar
  32. Scheuner, M. T., Wang, S., Raffel, L. J., Larabell, S. K., & Rotter, J. I. (1997). Family history: a comprehensive genetic risk assessment method for the chronic conditions of adulthood. American Journal of Medical Genetics, 71, 315–324.PubMedCrossRefGoogle Scholar
  33. Seeley, J. R., Stice, E., & Rohde, P. (2009). Screening for depression prevention: identifying adolescent girls at high risk for future depression. Journal of Abnormal Psychology, 118(1), 161–170.PubMedCentralPubMedCrossRefGoogle Scholar
  34. Sheehan, D. V., Lecrubier, Y., Sheehan, K. H., Amorim, P., Janavs, J., Weiller, E., et al. (1998). The Mini-International Neuropsychiatric Interview (M.I.N.I.): the development and validation of a structured diagnostic psychiatric interview for DSM-IV and ICD-10. Journal of Clinical Psychiatry, 59(Suppl 20), 22–33. quiz 34–57.PubMedGoogle Scholar
  35. Shyn, S. I., Shi, J., Kraft, J. B., Potash, J. B., Knowles, J. A., Weissman, M. M., & Hamilton, S. P. (2011). Novel loci for major depression identified by genome-wide association study of sequenced treatment alternatives to relieve depression and meta-analysis of three studies. Molecular Psychiatry, 16(2), 202–215.PubMedCentralPubMedCrossRefGoogle Scholar
  36. Sniehotta, F. F. (2009). Towards a theory of intentional behavior change: plans, planning, and self-regulation. British Journal of Health Psychology, 14, 261–273.PubMedCrossRefGoogle Scholar
  37. Steinhausen, H., Foldager, L., Perto, G., & Munk-Jorgensen, P. (2009). Family aggregation of mental disorders in the nationwide Danish three generation study. European Archives of Psychiatry and Clinical Neuroscience, 259, 270–277.PubMedCrossRefGoogle Scholar
  38. Sullivan, P., Neale, M., & Kendler, K. (2000). Genetic epidemiology of major depression: review and meta-analysis. American Journal of Psychiatry, 157, 1552–1562.PubMedCrossRefGoogle Scholar
  39. Sullivan, P., De Geus, E., Gonneke, W., James, M., Smit, J., Zandbelt, T., et al. (2009). Genome-wide association for major depressive disorder: a possible role for the presynaptic protein piccolo. Molecular Psychiatry, 14, 359–375.PubMedCentralPubMedCrossRefGoogle Scholar
  40. Trippitelli, C. L., Jamison, K. R., Folstein, M. F., Bartko, J. J., & DePaulo, J. R. (1998). Pilot study on patients’ and spouses’ attitudes toward potential genetic testing for bipolar disorder. American Journal of Psychiatry, 155(7), 899–904.PubMedGoogle Scholar
  41. Wakefield, C., Meiser, B., Homewood, J., Ward, R., O’Donnell, S., Kirk, J., & the AGenDA Collaborative Group. (2008). A randomized trial of a decision aid for individuals considering genetic testing for hereditary non-polyposis colorectal cancer risk. Cancer, 113(5), 956–965.PubMedCrossRefGoogle Scholar
  42. Weissman, M., Wickramaratne, P., Adams, P., Wolk, S., Verdeli, H., & Olfson, M. (2000). Brief screening for family psychiatric history: the family history screen. Archives of General Psychiatry, 57(7), 675–682.Google Scholar
  43. Wilde, A., Meiser, B., Mitchell, P. B., & Schofield, P. R. (2010). Public interest in predictive genetic testing, including direct-to-consumer testing, for susceptibility to major depression: preliminary findings. European Journal of Human Genetics, 18(1), 47–51.Google Scholar
  44. Wilde, A., Meiser, B., Mitchell, P., Hadzi-Pavlovic, D., & Schofield, P. (2011). Community interest in predictive genetic testing for susceptibility to major depressive disorder in a large national sample. Psychological Medicine, 41(8), 1605–14.Google Scholar
  45. Wilde, A., Mitchell, P., Meiser, B., & Schofield, P. (2012). Implications of the use of genetic tests in psychiatry, with a focus on major depressive disorder: a review. Depression and Anxiety, 30(3), 267–275.PubMedCrossRefGoogle Scholar
  46. World Health Organisation (2008). Global burden of disease: 2004 update. Geneva.Google Scholar
  47. World Health Organisation (2012). Sixty-fifth world health assembly: Daily notes on proceedings. Retrieved 4th December 2012, from http://www.who.int/mediacentre/events/2012/wha65/journal/en/index4.html
  48. Yoon, P. W., Scheuner, M. T., Peterson-Oehlke, K. L., Gwinn, M., Faucett, A., & Khoury, M. J. (2002). Can family history be used as a tool for public health and preventative medicine? Genetics in Medicine, 4(4).Google Scholar
  49. Zhou, Y. Z., Wilde, A., Meiser, B., Mitchell, P. B., Barlow-Stewart, K., & Schofield, P. R. (2014). Attitudes of clinical genetics practitioners’ towards genetic risk communication for susceptibility to psychiatric illness. In press Psychiatric Genetics.Google Scholar
  50. Zubenko, G. S., Hughes, H. B., Stiffler, J. S., Zubenko, W. N., & Kaplan, B. B. (2002). Genome survey for susceptibility loci for recurrent, early-onset major depression. American Journal of Medical Genetics, 114, 413–422.PubMedCrossRefGoogle Scholar

Copyright information

© National Society of Genetic Counselors, Inc. 2014

Authors and Affiliations

  • Veronica Quinn
    • 1
  • Bettina Meiser
    • 1
  • Alex Wilde
    • 2
    • 3
  • Zoe Cousins
    • 1
  • Kristine Barlow-Stewart
    • 4
    • 5
  • Philip B. Mitchell
    • 2
    • 3
    • 6
  • Peter R. Schofield
    • 6
    • 7
    • 8
  1. 1.Psychosocial Research Group, Prince of Wales Clinical SchoolThe University of New South WalesSydneyAustralia
  2. 2.School of PsychiatryUniversity of New South WalesSydneyAustralia
  3. 3.Black Dog InstituteSydneyAustralia
  4. 4.Sydney Medical SchoolUniversity of SydneySydneyAustralia
  5. 5.Centre for Genetics Education NSW HealthRoyal North Shore HospitalSydneyAustralia
  6. 6.Brain SciencesUniversity of New South WalesSydneyAustralia
  7. 7.Neuroscience Research AustraliaSydneyAustralia
  8. 8.School of Medical SciencesUniversity of New South WalesSydneyAustralia

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