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Genetic methods and preventive psychiatry.
1Section on Psychogenetics, National Institute of Mental Health, Bethesda, Maryland.
Progress in Neuro-Psychopharmacology
|January 1, 1979
Summary
High heritability of psychiatric disorders means families account for most diagnostic variance. Tracing illness within pedigrees, not community models, improves case finding and treatment for affective and other disorders.
Area of Science:
- Psychiatry
- Genetics
- Public Health
Background:
- Psychiatric disorders exhibit high heritability, indicating familial aggregation of diagnostic variance.
- Traditional community mental health models assume random risk distribution, which is inefficient for genetically influenced conditions.
Purpose of the Study:
- To evaluate the utility of family study methods for identifying and treating psychiatric illness.
- To demonstrate efficient case finding through pedigree analysis in affective disorders.
Main Methods:
- Conducted a family study of 86 Bipolar I probands at the US National Institute of Mental Health.
- Interviewed first-degree relatives and second-degree relatives with indicated psychopathology.
Main Results:
- Identified previously untreated cases of Bipolar illness (1.2%) and Unipolar illness (2.7%) among first-degree relatives.
- Discovered milder forms of illness, including personality disorders (4%) and behavioral disorders (2%), in relatives.
Conclusions:
- Family study methods are effective for secondary prevention by identifying and treating unrecognized and milder forms of psychiatric illness.
- Pedigree-based case finding is more efficient than random distribution models for heritable psychiatric disorders.