Tuesday, 7 December 2010

Psychiatric Genomics in good mental health

Blog post by Kristrun Gunnarsdottir, Cesagen: (on Session 4A - Personalised Medicine: Debating the Promise of Psychiatric Genomics)

The chair, Adam Hedgecoe of Ceasgen opened with an apology for the absence of Nick Craddock, Cardiff Medical School - another victim of the wintry weather.

What can we make of personalised psychiatric genetics in 2010?
  • Mike Arribas-Ayllon, Ceasagen talked about managing promise and complexity: gene networks, unpredictable environmental factors, hard-to-classify patients and psychiatrists who are already very cautious about promising a cure.
  • Maria Arranz, Institute of Psychiatry, London argued that great achievements are reached if genomics can help, even if only minimally, predicting reaction to psychiatric medication. Managing doses and types of medication has always been notoriously difficult.
  • Barbara Prainsack, Austrian Bioethics Commission, argued that direct-to-consumer testing does not lead to more genetic determinism. Consumers/patients/individuals are more sophisticated than that. 
Speakers were brilliant, 50 people in the audience all looked genuinely interested. However, the chair, had to open the Q&A session with a question about speaking to policy.
  • Maria talked about regulation of tests which are not validated, for example, schizophrenia susceptibility.
  • Barbara mentioned inequalities in access to health services as a policy-issue, but risks in relation to genetic information which is medically critical should be at the top of the agenda.
The audience asked if we should be more experimental about policy.
  • Michael mentioned direct-to-consumer testing, and argued that the data showed how sophisticated people's understanding is of risk factors, they have family histories which play a role here, and so on...  common paternalistic tendencies are subject to doubt
  • Barbara suggested that most of the issues facing policy-makers are within conventional stratifications of risk and protection.
Good session!

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