Genetic Testing and Neuroimaging for Youth at Risk for Mental Illness: Trading off Benefit and Risk.
Genetic Testing and Neuroimaging for Youth at Risk for Mental Illness: Trading off Benefit and Risk.
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对有精神疾病风险的青少年进行基因检测和神经影像学：利益和风险的权衡。
DOI：
10.1007/7854_2014_335
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发表时间：
2015
影响因子：
--
通讯作者：
Illes,Judy
中科院分区：
文献类型：
--
作者：
Lee,Grace;Mizgalewicz,Ania;Borgelt,Emily;Illes,Judy
背景根据世界卫生组织的数据，精神疾病是全世界导致残疾的主要原因之一。精神疾病的首次发作通常发生在儿童或青春期，仅在美国就有近1200万确诊病例。神经成像和基因测试在行为、情感和注意力障碍的研究中具有非常宝贵的价值，特别是它们具有潜在的预测能力，以及提高诊断和减轻相关疾病负担的能力。这项研究特别关注心理健康提供者在儿童和青少年临床实践中神经成像和基因检测的作用。方法我们采访了38名精神病学家、心理学家和主要从事青少年工作的相关心理健康专业人员，了解他们对神经成像或基因检测的接受程度。访谈探讨了他们对这些模式在预测、诊断、治疗计划方面的预期作用以及他们预期的好处和风险。结果从业者预计在青少年心理健康护理中临床引入成像和基因测试有三个主要好处：(1)提高对大脑和精神疾病的理解，(2)比传统临床检查更准确的诊断，以及(3)治疗计划的合法化。他们还意识到了三个主要风险：(1)成像或基因数据的误用或误解，(2)青少年成年后对就业和保险的潜在不利影响，以及(3)对自尊或自我激励的侵犯。限制-访谈问题的性质集中在临床神经科学背景下神经成像和基因测试研究的未来。因此，采访参与者的回答是基于预期的，而不是实际的经验。结论继续将脑成像和基因测试扩展到临床护理将需要脑生物学的微妙平衡，以及对仍在发展中的年轻人认知和情感世界的自主性的尊重。
BackgroundAccording to the World Health Organization, mental illness is one of the leading causes of disability worldwide. The first onset of mental illness usually occurs during childhood or adolescence, with nearly 12 million diagnosed cases in the United States alone. Neuroimaging and genetic testing have been invaluable in research on behavioral, affective, and attentional disorders, particularly with their potential predictive capabilities, and ability to improve diagnosis and to decrease the associated burdens of disease. The present study focused specifically the perspectives of mental health providers on the role of neuroimaging and genetic testing in clinical practice with children and adolescents.MethodsWe interviewed 38 psychiatrists, psychologists, and allied mental health professionals who work primarily with youth about their receptivity toward either the use of neuroimaging or genetic testing . Interviews probed the role they foresee for these modalities for prediction, diagnosis, treatment planning, and the benefits and risks they anticipate.ResultsPractitioners anticipated three major benefits associated with clinical introduction of imaging and genetic testing in the mental health care for youth: (1) improved understanding of the brain and mental illness, (2) more accurate diagnosis than available through conventional clinical examination, and (3) legitimization of treatment plans. They also perceived three major risks: (1) misuse or misinterpretation of the imaging or genetic data, (2) potential adverse impacts on employment and insurance as adolescents reach adulthood, and (3) infringements on self-esteem or self-motivation.LimitationsThe nature of the interview questions focused on the future of neuroimaging and genetic testing research in the context of clinical neuroscience. Therefore, the responses from interview participants are based on anticipated rather than actual experience.ConclusionsContinued expansion of brain imaging and genetic testing into clinical care will require a delicate balance of brain biology and respect for autonomy in the still-evolving cognitive and affective world of young individuals.