Genetic testing for schizophrenia should become the norm, argue leading psychiatrists in an editorial published in the British Journal of Psychiatry.
Professor Kamaldeep Bhui, Professor David Curtis and Dr Katherine Adlington from the Centre for Psychiatry at Queen Mary University London argue that while simple genetic tests can sometimes reveal the cause of schizophrenia, the first ever publication of the National Genomic Test Directory has failed to include the illness.
This is a directory that lists every genetic test available on the NHS, often used by doctors to help them and their patients to understand a diagnosis. If an illness is not included on the list, the NHS will not fund genetic testing and patients may be left in the dark.
Recognising that genetic abnormalities can be identified in some patients suffering from schizophrenia is incredibly important for patients and families in helping them make sense of their diagnosis.
It is also expected that in time, genetic testing will lead to improved treatments.
Co-author of the editorial, Professor Kam Bhui from Centre for Psychiatry at Queen Mary University London said: “The progress in this field has been really remarkable.
“Over the last few years it’s become clear that we can do a simple genetic test on a patient and, for example, tell them that they have a small piece of chromosome 22 missing and that this is probably the reason why they’ve developed schizophrenia.
“This kind of information can be incredibly valuable in tackling the stigma that still exists around mental health.
“It can help people understand that they have an illness like any other, just like epilepsy or diabetes, and may also mean that they and their families are more comfortable with the idea of them taking medication.
“Genetic testing can also offer important information about the risk to relatives. For example, if the patient’s sister is tested and she does not have the chromosome 22 abnormality then we might think that she is not at increased risk.”
The article points out that there are potential problems in making sure that mental health patients gain the full benefits from these advances. One is that psychiatrists and mental health professionals have little knowledge of the latest genetics research so it will be important that proper training is provided.
Another challenge is to ensure that information is communicated in a way which is empowering and avoids further stigmatisation of mental illness.
Co-author of the editorial, Professor Curtis from Centre for Psychiatry at Queen Mary University London said: “Psychiatrists need to advocate for their patients to see that mental illness really is given equal value to physical illness.”
“The failure to include schizophrenia in the National Genomic Test Directory is a step backwards for psychiatric services and needs to be addressed as a matter of urgency.
“Once again we have to wonder whether psychiatric illnesses are really being given the appropriate attention they deserve.”
The editorial reports that genetics is likely to have important impacts on psychiatry. This will necessitate enhanced training for professionals and will require the introduction of improved systems to manage genetic data and to integrate information about physical and mental health.
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