Exploration of experiences with and understanding of polygenic risk scores for bipolar disorder.

Attitudes Bipolar disorder Experiences Genetic testing Polygenic risk score Understanding

Journal

Journal of affective disorders
ISSN: 1573-2517
Titre abrégé: J Affect Disord
Pays: Netherlands
ID NLM: 7906073

Informations de publication

Date de publication:
15 03 2020
Historique:
received: 16 06 2019
revised: 27 11 2019
accepted: 11 01 2020
entrez: 25 2 2020
pubmed: 25 2 2020
medline: 16 2 2021
Statut: ppublish

Résumé

Polygenic risk scores (PRSs) summarise genetic risk in complex genetic disorders such as bipolar disorder (BD). The aim of this study was to gain in-depth, nuanced information regarding the understanding and experience of receiving a PRS for BD from individuals who already have a BD diagnosis. Participants from a previous genetics study were invited to receive their PRS in a face-to-face consultation with a genetic counsellor or psychiatrist. Four weeks later, semi-structured interviews were conducted, with 14 'acceptors' (those who chose to receive their PRS) and 4 'decliners' (those who did not wish to receive their PRS). Four themes were developed: (1) An easy decision, (2) A positive experience, (3) The grey area, and (4) The future is exciting and frightening. Despite some reported initial shock and distress, all acceptors described the experience of receiving their PRS as a positive one. It allowed them to better understand their condition and/or reduced feelings of self-blame. Decliners chose not to receive their results because of a lack of perceived usefulness or concern that PRS may hinder personal recovery. Given the qualitative design of the study, statistically valid generalisations cannot be undertaken, nor can causal relationships be established. PRS for BD were generally well accepted and understood. Knowledge regarding the impact of PRS for BD ensures that counselling frameworks are responsive to patient needs as well as informing education for psychiatrists and genetic counsellors, who will play pivotal roles in future polygenic testing provision.

Sections du résumé

BACKGROUND
Polygenic risk scores (PRSs) summarise genetic risk in complex genetic disorders such as bipolar disorder (BD). The aim of this study was to gain in-depth, nuanced information regarding the understanding and experience of receiving a PRS for BD from individuals who already have a BD diagnosis.
METHODS
Participants from a previous genetics study were invited to receive their PRS in a face-to-face consultation with a genetic counsellor or psychiatrist. Four weeks later, semi-structured interviews were conducted, with 14 'acceptors' (those who chose to receive their PRS) and 4 'decliners' (those who did not wish to receive their PRS).
RESULTS
Four themes were developed: (1) An easy decision, (2) A positive experience, (3) The grey area, and (4) The future is exciting and frightening. Despite some reported initial shock and distress, all acceptors described the experience of receiving their PRS as a positive one. It allowed them to better understand their condition and/or reduced feelings of self-blame. Decliners chose not to receive their results because of a lack of perceived usefulness or concern that PRS may hinder personal recovery.
LIMITATIONS
Given the qualitative design of the study, statistically valid generalisations cannot be undertaken, nor can causal relationships be established.
CONCLUSIONS
PRS for BD were generally well accepted and understood. Knowledge regarding the impact of PRS for BD ensures that counselling frameworks are responsive to patient needs as well as informing education for psychiatrists and genetic counsellors, who will play pivotal roles in future polygenic testing provision.

Identifiants

pubmed: 32090758
pii: S0165-0327(19)31581-2
doi: 10.1016/j.jad.2020.01.037
pii:
doi:

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

342-350

Informations de copyright

Copyright © 2020 Elsevier B.V. All rights reserved.

Déclaration de conflit d'intérêts

Declaration of Competing Interest Bettina Meiser has a remunerated consultant role with the company AstraZeneca with respect to an unrelated project. The other authors have no conflicts of interest.

Auteurs

Sophie Putt (S)

University of New South Wales Medicine, Sydney, NSW 2052, Australia. Electronic address: s.putt@student.unsw.edu.au.

Tatiane Yanes (T)

Prince of Wales Clinical School, University of New South Wales, Sydney, NSW 2052, Australia.

Bettina Meiser (B)

Prince of Wales Clinical School, University of New South Wales, Sydney, NSW 2052, Australia.

Rajneesh Kaur (R)

Prince of Wales Clinical School, University of New South Wales, Sydney, NSW 2052, Australia.

Janice M Fullerton (JM)

Neuroscience Research Australia, Randwick, Sydney, NSW 2031, Australia; School of Medical Sciences, University of New South Wales, Sydney, NSW 2052, Australia.

Kristine Barlow-Stewart (K)

Northern Clinical School, Faculty of Medicine and Health, University of Sydney, Sydney, NSW 2000, Australia.

Peter R Schofield (PR)

Neuroscience Research Australia, Randwick, Sydney, NSW 2031, Australia; School of Medical Sciences, University of New South Wales, Sydney, NSW 2052, Australia.

Claudio Toma (C)

Neuroscience Research Australia, Randwick, Sydney, NSW 2031, Australia; School of Medical Sciences, University of New South Wales, Sydney, NSW 2052, Australia.

Holly Peay (H)

National Human Genome Research Institute, Bethesda, United States.

Philip B Mitchell (PB)

School of Psychiatry, University of New South Wales, Sydney, NSW 2052, Australia; Black Dog Institute, Prince of Wales Hospital, Sydney, NSW 2052, Australia.

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