Psychiatrists Unprepared for Genetic Counseling. (Need for Knowledge Is Great)

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SAN FRANCISCO -- Psychiatrists performed poorly in a quiz of their genetic knowledge, and most of them said they do not feel prepared to discuss genetic information about psychiatric illness, according to a survey of 352 psychiatrists.

Although 83% of the psychiatrists said that they believe it is their role to discuss genetic information with patients and families, 77% said they don't feel prepared to do so and 85% felt unprepared for this by their medical training, Dr. Christine T. Finn reported in a poster presentation at the annual meeting of the American Psychiatric Association.

Although few genes have been identified as the actual causes of psychiatric illnesses other than Alzheimer's disease, it is likely that within 3-4 years genetic researchers will identify more causative genes or genes that affect clinical management of psychiatric disorders, said Dr. Finn, a psychiatrist and fellow in medical genetics at Harvard Medical School, Boston.

The fast pace of genetic research is creating a growing demand for physicians to use information about genetics in their practices.

The psychiatrists who were surveyed correctly answered a median of 4 out of 12 questions dealing with psychiatric genetic knowledge in the survey of physicians attending a conference on psychopharmacology Fully 85% of the psychiatrists got no more than half the answers correct, she said.

Only half the psychiatrists, for example, knew whether the probability that a child born to a mother with bipolar disorder would not develop the disorder was 90%, 50%, 25%, 10%, or 1%.

Those who want the answer to that question will have to look it up-Dr. Finn declined to give answers to the quiz questions in her poster, which drew viewers into discussions with her about their own knowledge about genetics.

She may use the same questions in future research, she added.

Out of nine other questions dealing with more general genetic knowledge, the psychiatrists correctly answered a median of four questions, and 68% of respondents got fewer than half the answers right.

In a hypothetical scenario, a significant proportion of the psychiatrists said that they would adopt a style of genetic counseling that is not favored by genetic counselors. If prenatal testing showed that a fetus had a high probability of inheriting a psychiatric disorder present in the family history of the parents, 25%-33% of the psychiatrists would give directive recommendations rather than nondirective information. …