Opportunities for psychiatry from genetic findings

Abstract

Background: The opportunities for psychiatry deriving from available or likely genetic advances are reviewed.

Method: Clinical implications are considered in the context of both the misconceptions and benefits associated with relevant genetic findings.

Results: Misconceptions include that: heritability estimates have a 'true' fixed value; a high heritability means that environmental interventions will be ineffective; a high heritability within groups means that differences between groups will also be due to genes; genetic effects are determinative; 'genetic' means single abnormal genes; genes associated with disease must be bad and justify eugenic measures; gene therapy will be widely applicable; and genetic screening of the general population will be useful. The benefits include demonstrations that: both genes and environment have an ubiquitous influence; some prevailing diagnostic assumptions are mistaken; genes influence development; the effects of nature and nurture are not separate; and environmental effects tend to be person-specific. The potential value of molecular genetics lies in elucidation of causal processes as they apply to both brain systems and nature-nurture interplay; improving diagnosis and genetic counselling; and the development of improved pharmacological interventions.

Conclusion: Advances in genetics will make a major impact on clinical psychiatry, and should bring practical benefits for both prevention and treatment.