Prenatal genetic counselling for psychiatric disorders

The etiology of psychiatric disorders is complex and heterogeneous, and involves contributions of both genetic and environmental factors. Genetic testing cannot establish, confirm or refine a psychiatric diagnosis, and at present, in most cases, determining the chance for a child to develop a psychiatric condition is usually based on analyzing a detailed 3- generation psychiatric family history. Studies have shown that people often overestimate the chances for future children to develop psychiatric illness, and that this can have an impact on child bearing decisions and provoke anxiety. Genetic counselling is the process of helping people to “understand and adapt to the medical, psychological and familial implications of genetic contributions to disease. People with psychiatric problems and their families have expressed desire for prenatal genetic counselling and/or genetic testing to address their concerns about the risks of psychiatric illness for their children. As a psychiatrist we can plan an outline for the session. Discussing etiology of psychiatric illness. Discussing protective factors/self-management strategies. Communicating about risk for children to develop psychiatric illness. Deriving estimates of probabilities for children to develop psychiatric illness Special circumstances: managing issues related to maternal psychiatric problems By using the strategies outlined herein to engage patients in psychotherapeutically oriented discussions around etiology of psychiatric illness and techniques for managing mental health issues, and risk, clinicians are ideally placed to help patients to feel empowered.