Posted by Tomatheus on November 27, 2005, at 1:48:09
In reply to Re: where to get Serotonin Transporter gene testing?, posted by jamestheyonger on November 27, 2005, at 1:11:56
jamestheyounger,
See below...
> I do not think genetic testing is useful, yet, for mental illness. Having a gene for something does not mean you will get it; only existing diagnostic methods will indicate you have depression, ect.
I did not say in my post that I think people should be scanned for the genes related to mental illness from birth. I agree that such a test would not be useful yet. What I said was that genetic testing should be incorporated into psychiatric practice, which by definition, begins when patients go in to see a psychiatrist, usually complaining of the symptoms of a particular psychiatric illness. I also did not state that genetic testing should completely replace the DSM; I said that it would be helpful to have some way of understanding the underlying genetics behind mentally illness so we wouldn't have to rely *exclusively* on the DSM. If a patient is diagnosed with a particular illness, shouldn't that patient's doctor know as much as possible about the underlying cause of the patient's illness so he/she can make as informed of a treatment decision as possible?
> Knowing you have a gene for a disease can allow you to take preventive steps but prevention for mental illness is non-specific (reduce stress, nutrition, exercise). Things everyone should do.
I agree. But as I said, I don't think it would be a good idea to test people for the genes related to psychiatric illnesses from birth, in part, because there is such much about the relationship between genes and psychiatric illnesses (and physical illnesses) that is not known. What I've been saying is that psychiatrists should be able to use data from genetic tests as one tool to help them decide how to treat a patient (but only if the patient first decides to go to a psychiatrist complaining of psychiatric symptoms).
> It is a fallacy that there are genes for mental illness, cancer, ect. Genes only control proteins. There is not always a high correlation between having or lacking a protein and a specific disease. Getting from a protein to a disease is often a multi-step process.
Yes, getting from a protein to a disease is often a multi-step process. But wouldn't it be better if psychiatrists at least had some idea as to how this process begins (the presence or absence of a protein), as opposed to knowing nothing about it whatsoever?
And about the correlations between genes and diseases, particular genetic variants *have* shown statistically significant correlations with many diseases, including psychiatric illnesses. If you were to read research reports of genetic association studies, that is what you would find. On what basis do you dispute these research findings?
> For genetic testing to be effective one must be counseled by a geneticist. Other doctors are not qualified to provide interpretation of genetic testing.
Psychiatrists are not geneticists. I'll give you that. If somebody wants genetic counseling, then, yes, they should see a geneticist. But there is no reason why doctors of all types shouldn't be able to use the results of a genetic test (as they would with any other type of lab test) to help them make more informed treatment decisions. As I've said in other posts, there is far too much guesswork in psychiatry. Just because psychiatrists aren't experts in genetics doesn't mean that they shouldn't incorporate genetic testing into their practice so they can understand *something* about their patients' pathologies before prescribing them drugs could potentially make their patients' illnesses worse.
Tomatheus
poster:Tomatheus
thread:582481
URL: http://www.dr-bob.org/babble/20051126/msgs/582628.html