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Developmental and epileptic encephalopathy: Personal utility of a genetic diagnosis for families

OBJECTIVES: Identifying genetic pathogenic variants improves clinical outcomes for children with developmental and epileptic encephalopathy (DEE) by directing therapy and enabling accurate reproductive and prognostic information for families. We aimed to explore the additional personal utility of re...

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Autores principales: Jeffrey, Jennifer S., Leathem, Janet, King, Chontelle, Mefford, Heather C., Ross, Kirsty, Sadleir, Lynette G.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7918330/
https://www.ncbi.nlm.nih.gov/pubmed/33681658
http://dx.doi.org/10.1002/epi4.12458
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author Jeffrey, Jennifer S.
Leathem, Janet
King, Chontelle
Mefford, Heather C.
Ross, Kirsty
Sadleir, Lynette G.
author_facet Jeffrey, Jennifer S.
Leathem, Janet
King, Chontelle
Mefford, Heather C.
Ross, Kirsty
Sadleir, Lynette G.
author_sort Jeffrey, Jennifer S.
collection PubMed
description OBJECTIVES: Identifying genetic pathogenic variants improves clinical outcomes for children with developmental and epileptic encephalopathy (DEE) by directing therapy and enabling accurate reproductive and prognostic information for families. We aimed to explore the additional personal utility of receiving a genetic diagnosis for families. METHODS: Semi‐structured interviews were conducted with fifteen families of children with a DEE who had received a genetic diagnosis. The interviews stimulated discussion focusing on the impact of receiving a genetic diagnosis for the family. Interview transcripts were analyzed using the six‐step systematic process of interpretative phenomenological analysis (IPA). RESULTS: Three key themes were identified: “Importance of the label,” “Relief to end the diagnostic journey,” and “Factors that influence personal utility.” Families reported that receiving a genetic label improved their knowledge about the likely trajectory of the DEE, increased their hope for the future, and helped them communicate with others. The relief of finally having an answer for the cause of their child's DEE alleviated parental guilt and self‐blame as well as helped families to process their grief and move forward. Delay in receipt of a genetic diagnosis diluted its psychological impact. SIGNIFICANCE: To date, the factors associated with the personal utility of a genetic diagnosis for DEEs have been under appreciated. This study demonstrates that identifying a genetic diagnosis for a child's DEE can be a psychological turning point for families. A genetic result has the potential to set these families on an adaptive path toward better quality of life through increased understanding, social connection, and support. Early access to genetic testing is important as it not only increases clinical utility, but also increases personal utility with early mitigation of family stress, trauma, and negative experiences.
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spelling pubmed-79183302021-03-05 Developmental and epileptic encephalopathy: Personal utility of a genetic diagnosis for families Jeffrey, Jennifer S. Leathem, Janet King, Chontelle Mefford, Heather C. Ross, Kirsty Sadleir, Lynette G. Epilepsia Open Full‐length Original Research OBJECTIVES: Identifying genetic pathogenic variants improves clinical outcomes for children with developmental and epileptic encephalopathy (DEE) by directing therapy and enabling accurate reproductive and prognostic information for families. We aimed to explore the additional personal utility of receiving a genetic diagnosis for families. METHODS: Semi‐structured interviews were conducted with fifteen families of children with a DEE who had received a genetic diagnosis. The interviews stimulated discussion focusing on the impact of receiving a genetic diagnosis for the family. Interview transcripts were analyzed using the six‐step systematic process of interpretative phenomenological analysis (IPA). RESULTS: Three key themes were identified: “Importance of the label,” “Relief to end the diagnostic journey,” and “Factors that influence personal utility.” Families reported that receiving a genetic label improved their knowledge about the likely trajectory of the DEE, increased their hope for the future, and helped them communicate with others. The relief of finally having an answer for the cause of their child's DEE alleviated parental guilt and self‐blame as well as helped families to process their grief and move forward. Delay in receipt of a genetic diagnosis diluted its psychological impact. SIGNIFICANCE: To date, the factors associated with the personal utility of a genetic diagnosis for DEEs have been under appreciated. This study demonstrates that identifying a genetic diagnosis for a child's DEE can be a psychological turning point for families. A genetic result has the potential to set these families on an adaptive path toward better quality of life through increased understanding, social connection, and support. Early access to genetic testing is important as it not only increases clinical utility, but also increases personal utility with early mitigation of family stress, trauma, and negative experiences. John Wiley and Sons Inc. 2021-01-19 /pmc/articles/PMC7918330/ /pubmed/33681658 http://dx.doi.org/10.1002/epi4.12458 Text en © 2020 The Authors. Epilepsia Open published by Wiley Periodicals LLC on behalf of International League Against Epilepsy This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.
spellingShingle Full‐length Original Research
Jeffrey, Jennifer S.
Leathem, Janet
King, Chontelle
Mefford, Heather C.
Ross, Kirsty
Sadleir, Lynette G.
Developmental and epileptic encephalopathy: Personal utility of a genetic diagnosis for families
title Developmental and epileptic encephalopathy: Personal utility of a genetic diagnosis for families
title_full Developmental and epileptic encephalopathy: Personal utility of a genetic diagnosis for families
title_fullStr Developmental and epileptic encephalopathy: Personal utility of a genetic diagnosis for families
title_full_unstemmed Developmental and epileptic encephalopathy: Personal utility of a genetic diagnosis for families
title_short Developmental and epileptic encephalopathy: Personal utility of a genetic diagnosis for families
title_sort developmental and epileptic encephalopathy: personal utility of a genetic diagnosis for families
topic Full‐length Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7918330/
https://www.ncbi.nlm.nih.gov/pubmed/33681658
http://dx.doi.org/10.1002/epi4.12458
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