Patient and family attitudes about schizophrenia: implications for genetic counseling

Psychiatrists are giving increased attention to genetic counseling for mental illness. However, the burden of these illnesses are perceived by families and the degree to which families feel a need for genetic counseling have yet to be established. Attitudes and perceptions measured in this study focus on etiology, familial risk, and socioeconomic burden of schizophrenia, as well as childbearing plans and the acceptability of genetic counseling. Members of 17 families, each with a child diagnosed schizophrenic, were studied using the Family Attitudes Questionnaire. The results demonstrate that the well family members view schizophrenia as a severe and debilitating illness. The results also show that there is a disparity between the attitudes of well family members and patients: 92 percent of parents compared to 25 percent of patients identified schizophrenia as a disorder associated with extreme burden. Regarding childbearing decisions, 29 percent of parents compared to 66 percent of patients say they would have children (in hindsight or in future) based on what they now know about schizophrenia in their family. This result corroborates reports from genetic counselors for other illnesses: the wish for children appears to override considerations of risk and burden for those potentially genetically affected persons who have not reached their desired family size.