Genes, Depression, and Policy

Healthcare professionals helping patients with mental health problems have an increasing array of treatment and prevention tools at their disposal. But on the horizon is a preventative tool that poses challenging public policy questions about ethics and privacy: personal genomic sequencing.

Exactly what should the public make of genetic tests indicating a predisposition to depression? How can we ensure that medical information about depression does not lead to employer discrimination? Experts tackled these and other issues at a Monday symposium, “DNA and Depression: Tests, Trust, and Treatment,” part of a Johns Hopkins University series of Genetic Perspective on Policy Seminars hosted by the University’s Genetics and Public Policy Center.

Dr. Francis McMahon of the NIMH discussed the research that his team carried out on the genes that predispose patients to having suicidal thoughts while taking Selective Seratonin Reuptake Inhibitors such as Prozac. This research came in the wake of FDA research indicating that SSRIs can can cause a rise in suicidal thinking and behavior in adolescents; the Agency subsequently mandated “black-box” warnings on the medications. Dr. McMahon also noted that these types of drug side effects can be minimized as personalized medicine, which is based on a patient’s personal genome information, becomes standard practice. In the near future, doctors may be able to recommend preventative treatments based not just on family history, but on indicators found in a patient’s own genome.

“Everyone has predicted that the complete genome will be part of your medical record in five years or so,” McMahon said. However, as private companies offer to decode and interpret the genomes of consumers, doctors will no longer be the sole gatekeepers of genetic information. “We don’t have a monopoly on the information anymore,” McMahon affirmed.

While genome sequencing is not currently a part of regular mental health diagnoses, Kim Bechthold, CEO of Neuromark, which develops diagnostic tools to help doctors determine if SSRIs pose a risk for their patients based on their genomes, explained that surveys show that “patients and consumers trust genetic tests,” which means that “we have a very exciting and very challenging task” in trying to accurately convey genetic information to doctors and patients. She explained that the public trusts genetic diagnosis more than they trust diagnoses based on lifestyle, environmental factors, and socioeconomic status.

Bechthold also stressed the need to protect patient privacy with regard to genetic information and added that Congress must pass the Genetic Information Nondiscrimination Act in order to prevent employer discrimination against employees at risk for ailments—mental health or otherwise. “Without GINA…preventative medicine is simply not going to get off the ground,” she said.

Tags: CDC, genetics, genome, pharmaceuticals

Comments on this article

You can skip to the end and leave a response. Pinging is currently not allowed.