Most mental health illnesses involve a complex interplay of genetic, environmental, and psychological factors. Research over the past twenty years has shown that genetics play an important role in many psychiatric disorders. But rarely are they the sole cause. Read on to learn more about the role of genetics and genetic testing in mental health
Genetics play a role in various mental illnesses as the research below indicates. While genetics contributes significantly to mental illness risk, they do not guarantee development. Gene-environment interactions are critical. Genetic testing (e.g., polygenic risk scores) for certain conditions is now possible to assist in early intervention, but current diagnoses still largely rely on clinical assessment.
As opposed to single genes as causal factors, most mental illnesses are polygenic, in which hundreds of genes contribute small effects. Trauma, stress, infections, or other environmental factors interact with hereditary tendencies (genes). For example, the probability of schizophrenia increases due to childhood trauma + genetic risk [6].
Modifications to DNA that affect whether a gene is turned on or off, but without altering the underlying DNA, are called epigenetic. These changes, due to stress or other factors, can influence the development of mental illness [7].
Illnesses such as schizophrenia and Autism Spectrum Disorder can arise from uninherited mutations [8].
The UK Royal College of Psychiatrists prepared an extensive report on genetic testing for mental health and other related illnesses. They identified several potential applications for genetic testing in psychiatry [9].
The College highlighted that when carrying out genetic testing for clinical purposes it is important to consider whether or not a test has utility and potential risks or harm, as well as advantages.
As with any medical investigation, before carrying out genetic testing it’s important to ask whether learning the results will have any influence on management or will helpfully predict prognosis.
In particular, a test which reports a small or moderate effect on the risk of developing an illness may not have clinical utility if there are no steps which can be taken to address these risks.
It is important to distinguish genetic test results that are essentially diagnostic from those that simply report that a patient may be at higher or lower risk of a particular condition. Testing to estimate disease risk, rather than to obtain a definitive diagnosis, should only be undertaken if the results will in some way have a useful impact.
A Canadian study on this topic provides an excellent overview and survey of this developing field [10]. Pharmacogenomic (how genes affect a person’s response to particular drugs) testing is a precision medicine technology. It studies genetic variation in the metabolism of medications, particularly those that affect the function of proteins identified as playing a role in drug metabolism.
Precision medicine, also known as personalized medicine, is an approach that tailors treatment decisions based on individual differences in genetics, lifestyle, and other factors.
The integration of pharmacogenomic testing into clinical practice may pave the way for a more efficient and effective delivery of mental health care.
Genetic variations can influence the absorption, distribution, metabolism, and excretion of medications. These variations contribute to the variability between individuals in response to mental health medications.
Before starting drug treatment, medical clinicians can test for genetic variations on genes of interest. This provides them and the patient with additional information to consider when making prescribing decisions.
The cost of genetic testing for mental health conditions in the U.S. is based on several factors. These include the type of test, insurance coverage, and purpose (diagnostic vs. pharmacogenomic). Here are ranges:
Direct-to-Consumer kits have significant limitations and potential for harm when their results are incorrectly interpreted or misunderstood. They use a variety of different methods and their accuracy is variable, which leads to the possibility of high false positive or false negative results and misleading polygenic risk score information [J].
They are often based on SNP arrays (without any standardisation across kits), with the variants being tested based on findings from people of largely European ancestry.
Furthermore, their clinical implications are not necessarily well described to consumers and many companies either do not offer or do not insist on genetic counselling in advance of testing.
The most important thing to be aware of is that there is only a weak association between polygenic risk score and risk itself. This means that somebody may be told they have a high polygenic risk score for a particular condition, but in reality their absolute risk of developing this condition may be increased only very slightly from that for the general population.
At Corner Canyon Health Center we use genetic testing to create personalized treatment plans for psychiatric services. These support medication management based on a patient’s unique genetic profile.
This can make it easier for a provider to prescribe medication or adjust dosages more accurately and also to identify potential side effects and drug interactions. By doing so, the risk of adverse reactions is reduced and treatment outcomes can be improved.
Treatment for mental health conditions and trauma is available in Utah. Are you or a loved one looking for a compassionate space to heal from anxiety, trauma, PTSD, CPTSD, other mental health conditions, or addictions? Our licensed trauma-informed professional therapists and counselors at Corner Canyon Health Centers can provide compassionate help using a range of therapeutic and holistic techniques.
Reach out to our Admissions team now at Corner Canyon. We’re in a peaceful setting bordered by the beautiful Wasatch Mountains.
[1] Multicenter Genetic Studies of Schizophrenia Consortium, Ripke, S, et al. 2013. Genome-wide association analysis identifies 13 new risk loci for schizophrenia. Nat Genet. Oct 2013; 45(10).
[2] Stahl EA, et al. 2019. Genome-wide association study identifies 30 loci associated with bipolar disorder. Nat Genet. 2019 May;51(5):793-803.
[3] Gaugler T, et al. 2014. Most genetic risk for autism resides with common variation. Nat Genet. 2014 Aug;46(8):881-5.
[4] Leejee Choi, Joon-Yong An. 2021. Genetic architecture of autism spectrum disorder: Lessons from large-scale genomic studies. Neuroscience & Biobehavioral Reviews, Volume 128, 2021, Pages 244-257.
[5] Howard, D.M., Adams, M.J., Clarke, TK. et al. 2019. Genome-wide meta-analysis of depression identifies 102 independent variants and highlights the importance of the prefrontal brain regions. Nat Neurosci 22, 343–352 (2019).
[6] Howard, D.M., Adams, M.J., Clarke, TK. et al. Genome-wide meta-analysis of depression identifies 102 independent variants and highlights the importance of the prefrontal brain regions. Nat Neurosci 22, 343–352 (2019)
[7] Nestler EJ, Peña CJ, Kundakovic M, Mitchell A, Akbarian S. Epigenetic Basis of Mental Illness. Neuroscientist. 2016 Oct;22(5):447-63.
[8] Fromer, M., Pocklington, A., Kavanagh, D. et al. De novo mutations in schizophrenia implicate synaptic networks. Nature 506, 179–184 (2014).
[9] Royal College of Psychiatrists (2023) College Report CR237– The role of genetic testing in mental health settings.
[10] Young C, MacDougall D. An Overview of Pharmacogenomic Testing for Psychiatric Disorders: CADTH Horizon Scan [Internet]. Ottawa (ON): Canadian Agency for Drugs and Technologies in Health; 2023 Jun.
We are specifically formulated to offer personalized therapeutic interventions to adult individuals with mental health disorders.
We provide a comprehensive Intensive Outpatient Program (IOP) that offers clients the opportunity to attend group therapy sessions three to five times a week.
Corner Canyon now accepts most major health insurance plans. Get in touch with our admissions team today.
