Posted by Tomatheus on November 27, 2005, at 12:29:29
In reply to Re: where to get Serotonin Transporter gene testing?, posted by jamestheyonger on November 27, 2005, at 11:28:46
> "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?"
>
> Common sense. Having a gene does not guarantee getting the disease linked to it, in all cases.
> The specific protein a gene encodes for may cause may conditions. You cannot say a gene causes a disease, only that it makes you more likely to get it.As you probably understand, a statistically significant correlation between a genetic variant and a disease is a correlation between two variables that unlikely to be due to sheer chance. So, it appears that you're not really disputing the statistically significant relationships between genetic variants and psychiatric illnesses, merely stating that "having a gene does not guarantee getting the disease linked to it, in all cases." I understand this, but I think you're missing my point. When people choose to see a psychiatrist, they do following the onset of symptoms associated with at least one psychiatric illness. I am well aware that people can carry a genetic predisposition for a particular illness without ever exhibiting the symptoms of the illness. But these are not the individuals who go in to see psychiatrists. It's the individuals with functional impairment due to psychiatric symptoms who see psychiatrists. If these individuals are diagnosed with a psychiatric illness during their visit to a psychiatrist, then they do have the illness. It is at this point when treatment decisions are made.
If a patient is diagnosed with a given psychiatric illness (such as major depression, for example), genetic testing would give the patient's psychiatrist the opportunity to know if the patient has any of the genetic abnormalities that have shown statistically significant associations with that illness. And if the patient has one particular genetic variant that has been associated with the illness (such as a variant of the serotonin transporter gene that encodes for abnormally slow reuptake), the psychiatrist could make a more informed treatment decision (which would involve considering a drug that accelerates the reuptake of serotonin instead of an SSRI). Certainly, the results of a genetic test should not be the only factor that psychiatrists should consider when making treatment decisions. And psychiatrists and patients alike should always be aware that there is still so much more about the causes of mental illnesses that we still do not understand. But I think it's a mistake to not take advantage of what we *do* know to help psychiatrists understand as much about their patients' illnesses as they possibly could. It is in this sense that I think genetic testing would be helpful.
Tomatheus
poster:Tomatheus
thread:582481
URL: http://www.dr-bob.org/babble/20051126/msgs/582684.html