With the Arizona shooting deaths on January 9, 2011, discussion is focused on mental health issues that may trigger violent events. Profiles of shooters often reveal a history of psychiatric issues. Are there genetic tests that demonstrate a predisposition to mental health issues? Let’s look at one commonly diagnosed mental health condition: Bi-Polar or manic-depressive disorder.
The National Institute of Mental Health (NIMH) categorizes Bi-polar Disorder this way: “a brain disorder that causes unusual shifts in mood, energy, activity levels, and the ability to carry out day-to-day tasks. Symptoms of bipolar disorder are severe. They are different from the normal ups and downs that everyone goes through from time to time. Bipolar disorder symptoms can result in damaged relationships, poor job or school performance, and even suicide.”
Is there a way to test genetically if a person is predisposed to Bi-Polar Disorder? Dr. Alexander Niculescu, professor of psychiatry and medical neuroscience at Indiana University School of Medicine and staff psychiatrist at the Indianapolis VA Medical Center hopes to find out. Niculescu is a geneticist and specialist in mood disorders. He has been awarded a 2010 NIH Director’s New Innovator Award in the form of a $1.5 million grant to research genetic mood disorders. Niculescu and his team at IU’s INBRAIN are using the grant to research a prototype blood test can identify gene clusters matching those found in Bi-Polar Disorder.
Dr. Niculescu estimates that 1 out of 5 people suffer with mood disorders. He warns however that genetic testing for mood disorders like Bi-Polar is not as clear cut as genetic studies done on cystic fibrosis or Huntington’s Disease. Dr. Niculescu explains that the variance of genes linked to Bi-Polar, depression and mood disorders are found in every person. The specific pattern is difficult to isolate. He states that research shows that mood disorders develop from a variety of influences; genetics are only a small piece of the puzzle.
Ethics debates have centered around the use of genetic testing for predisposition to certain health conditions. The debate stems from several concerns. Some genetic studies opponents claim that this type of work is invades patient privacy. Others claim that geneticists try to “play God”. The most cogent concern is that genetics testing done on pregnant women to determine whether diseases are inherited. Genetic findings have been used in decisions about whether to abort a fetus.
The procedures used in prenatal genetic studies are extremely risky. Amniocentesis is a process of extracting fluid from the amniotic sac using a needle. I have undergone three amniocentesis procedures unrelated to genetic testing. Amniocentesis was needed to establish whether baby’s lungs could survive early induced labor after my placenta was damaged. Despite assurances that amniocentesis is not painful, my experience was that it was not only painful but also dangerous. During the procedure, baby is monitored on ultrasound while an extremely large needle is inserted down into the womb. We watched our baby move around, praying the needle wouldn’t injure her. I was told to stay very still which I did. However, my uterus and stomach muscles involuntarily contracted and caused the needle jerk and very nearly impale baby. I also lost two second trimester infants after this birth and there was some evidence these procedures created problems with my Rh factor and repeated Rhogam treatments.
These experiences and the risk of infection from the procedure lead me to warn against amniocentesis only cases of imminent danger to the fetus. Amniocentesis should not be used for genetic testing of any kind. DNA tests done using cheek swabs or blood tests like Dr. Niculescu’s are likely to be much safer and less invasive.