Interest, rationale, and potential clinical applications of genetic testing for mood disorders: A survey of stakeholders

摘要

Bipolar disorder (BP) and major depressive disorder (MDD) are among the most severe, persistent, and debilitating illnesses occurring in young people, with an estimated lifetime prevalence of approximately 1-1.5% for BP (Kessler et al., 2005; Kato, 2007; Merikangas et al. 2007; Braff and Freedman, 2008) and 9.2-19.6% for MDD (Kessler et al., 2005). Although genetic testing for psychiatric disorders has been the goal of psychiatrists and geneticists for years (Braff and Freedman, 2008) this goal has been difficult to attain since the impact of individual genes on risk for psychiatric illness is small, often nonspecific and embedded in intricate causal pathways (Kendler, 2005). In contrast to Mende-lian disorders, tests for complex conditions such as MDD and BP may yield only weak estimates of risk, as such conditions appear to be caused by a complicated interplay of multiple genetic and environmental factors, and the associated genetic variants may be common and confer only a small increment of increased or decreased risk (Wright and Kroese, 2010).