Harvard Mental Health Letter

In Brief: Genetic counseling in psychiatry

In Brief

Genetic counseling in psychiatry

Explaining genetic aspects of mental health problems is only a small part of psychiatric treatment, according to an article in the Harvard Review of Psychiatry, but scientific advances will increase both the demand for genetic counseling and the need to understand its uses and limitations.

Most psychiatric disorders, including major mental illness — schizophrenia, bipolar disorder, and major depression — are highly heritable. Family history is one of the best indicators of a person's risk for mental illness. Naturally, patients and families want more detailed information. If they have overestimated the risk, they may be reassured. If they have underestimated the risk, they will be on notice.

American Psychiatric Association guidelines already endorse genetic counseling to aid family planning for people with bipolar disorder. Genetic information can also guide clinicians; for example, a patient undergoing a first episode of depression who has close relatives with bipolar disorder may be better off taking a mood stabilizer rather than a standard antidepressant.

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