In 2001, after more than a decade of work, scientists completed the Human Genome Project – a herculean effort that has helped us decode the unique combination of genes required to make a human being. With modern technology, this entire process can be completed over the course of an evening.
The relative ease with which genetic information can be obtained and analysed has revolutionised how we treat and prevent cancer – but what impact is it having on mental health? Can genetics deliver the breakthroughs we need? And is it even ethical to use DNA for this purpose?
How are genetic studies being used to further our understanding of mental illness?
Professor Sir Michael Owen, director of the MRC centre for Neuropsychiatric Genetics and Genomics at Cardiff University, is looking into the ways genetic information can be used to improve mental health. Michael is quick to stress that whilst genetic studies are informative, they can be difficult to interpret and are rarely able to provide a complete picture of a given mental illness. “Recent research has shown that psychiatric disorders are highly polygenic,” explains Michael. “This means that an individual’s risk of developing a psychiatric disorder is conferred by the combined effects of many hundreds of different genes.” These genetic risk factors act alongside a range of other factors – things like stress, bereavement or physical illness – to determine our overall chances of developing a mental health condition.
In the future, Michael predicts roles for genetic testing in both the diagnosis and treatment of mental health conditions. “The way that we currently diagnose individuals is far from perfect and it is difficult to match the right treatment to the right patient. We are currently hopeful that we will be able to use genetic information to help identify groups of patients that are more likely to respond to a given treatment.”
These aspirations are shared by Thalia Eley, Professor of Developmental Behavioural Genetics at Kings College London. Thalia is a pioneer in the emerging area of Therapygenetics, an exciting subject that aims to improve the way we treat mental illness. “Therapygenetics is a new field which uses genetic information to predict how well an individual does after they receive psychological treatment for anxiety or depression,” Thalia explains. “Specifically, we obtain DNA from individuals who are receiving psychological therapy and we test whether we can predict their treatment outcome from the genetic information we gather.”
When asked about the ethical concerns associated with their research, both Michael and Thalia agree that the responsible handling of patient data is an important issue. “We have to be very careful in how we look after the DNA samples that our participants provide us with,” says Thalia. “There are tight guidelines about how to keep these samples, and the data they produce, safe. We always store samples with a barcode rather than a name, and all data produced is strictly confidential.”
This view is supported by Michael: “Genetic information, like much other personal information, is highly sensitive and we are careful to ensure that we obtain fully-informed consent and comply with high standards of data security.”
Do genetic studies over-simplify the causes of mental illness?
Whilst the handling of patient data is clearly an important issue, it is not the only ethical challenge associated with genetic studies in the field of mental health. Dr Camillia Kong, Director of Research Strategy for NeuroGenE in the Department of Psychiatry at the University of Oxford, has been investigating the potential consequences that gene-based approaches can have on people with mental illnesses.
“Psychiatry is moving rapidly towards a direction which focuses on trying to clarify the genetics behind serious mental disorders,” says Camillia. “I am curious about how this focus on our genes could have unintended consequences.”
A common criticism of genetic based studies is that they paint an unrealistic picture of complex mental health conditions. “It is important that we don’t oversimplify the science and overpromise what it can achieve,” Camillia explains. “Without caution, people can start to believe that their genes ‘predetermine’ whether or not they will have a mental disorder. To be clear, this is not the scientific view.”
Camillia believes that people who think their condition is caused solely by their genes may be less likely to see an improvement in their symptoms. “This way of thinking can obstruct the motivation to seek help and participate in treatment,” says Camillia. “If someone believes that their genes make their condition inevitable, it will affect the optimistic outlook that is so vital to successful treatment.”
With this in mind, it is important that we don’t overemphasise the role of genetics in mental health. Mental illnesses are incredibly complex and caused by a multitude of factors. These factors differ from person to person and just because an individual possesses a certain genetic risk factor, it does not mean that they are destined to go on and develop a mental health condition. In the words of Camillia: “Sometimes we can’t help but feel like a positive genetic result will mean we have faulty genes, or that we’ll pass it onto our children, or that it’s inevitable that we’ll experience a particular disorder. None of these are necessarily the case.”
Genetic studies are having a profound impact on mental health research and are continuously expanding our knowledge of mental illness. However, if we are to study the genes of people with mental illnesses in an ethical manner, it is important that we don’t ignore the personal experiences of each individual and the unique combination of factors that has caused them to become unwell. If people are provided with the correct support and their personal information is handled in a sensitive manner, we will be able to realise the benefits of genetics in mental health research.
Professor Sir Michael Owen, Professor Thalia Eley and Dr. Camillia Kong will be speaking at MQ’s Mental Health Science Meeting in London on 1-2 February 2018. For further information and to register your interest, please click here.
Last updated: 30 January 2018