Preferences Regarding Targeted Education and Risk Assessment in People with a Family History of Major Depressive Disorder
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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.
KeywordsMajor depression Family history Attitudes Education Genetic counseling Risk assessment
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.
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.
- American Psychiatric Association (2000). Diagnostic and statistical manual of mental disorders (Vol. 4th Edition). Washington DC: Author.Google Scholar
- 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
- 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
- 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
- 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
- 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
- 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
- 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
- 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
- Miles, M. B., & Huberman, A. M. (1994). Qualitative data analysis: An expanded sourcebook (2nd ed.). London: Sage.Google Scholar
- Powell, J., & Clarke, A. (2006). Internet information-seeking in mentalh health. The British Journal of Psychiatry, 189, 273–279.Google Scholar
- 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
- 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
- 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
- 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
- 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
- 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
- World Health Organisation (2008). Global burden of disease: 2004 update. Geneva.Google Scholar
- 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
- 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
- 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