Hostname: page-component-7c8c6479df-27gpq Total loading time: 0 Render date: 2024-03-27T02:46:56.955Z Has data issue: false hasContentIssue false

Opportunities for psychiatry from genetic findings

Published online by Cambridge University Press:  03 January 2018

Michael Rutter*
Affiliation:
MRC Child Psychiatry Unit and Social, Genetic and Developmental Psychiatry Research Centre
Robert Plomin
Affiliation:
Social, Genetic and Developmental Psychiatry Research Centre
*
Professor Sir Michael Rutter, Institute of Psychiatry, Denmark Hill, London SE5 8AF

Abstract

Background

The opportunities for psychiatry deriving from available or likely genetic advances are reviewed.

Method

Clinical implications are considered in the context of both the misconceptions and benefits associated with relevant genetic findings.

Results

Misconceptions include that: heritability estimates have a ‘true’ fixed value; a high heritability means that environmental interventions will be ineffective; a high heritability within groups means that differences between groups will also be due to genes; genetic effects are determinative; ‘genetic’ means single abnormal genes; genes associated with disease must be bad and justify eugenic measures; gene therapy will be widely applicable; and genetic screening of the general population will be useful. The benefits include demonstrations that: both genes and environment have an ubiquitous influence; some prevailing diagnostic assumptions are mistaken; genes influence development; the effects of nature and nurture are not separate; and environmental effects tend to be person-specific. The potential value of molecular genetics lies in elucidation of causal processes as they apply to both brain systems and nature—nurture interplay; improving diagnosis and genetic counselling; and the development of improved pharmacological interventions.

Conclusion

Advances in genetics will make a major impact on clinical psychiatry, and should bring practical benefits for both prevention and treatment.

Type
Review Article
Copyright
Copyright © 1997 The Royal College of Psychiatrists 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

See editorial pp. 201–202, this issue.

References

Andrews, L. B., Fullarton, J. E., Holtzman, N. A., et al (1994) Assessing Genetic Risks: Implications for Health and Social Policy. Report of the Committee on Assessing Genetic Risks. Institute of Medicine. Washington, DC: National Academy Press.Google Scholar
Antonarakls, S. E. & Scott, H. S. (1996) The human genome project and its impact in medicine. European Review. 4, 415426.Google Scholar
Bailey, A., Phillips, W. & Rutter, M. (1994) Autism Towards an integration of clinical, genetic, neuropsychological, and neurobiological perspectives. Journal of Child Psychology and Psychiatry Annual Research Review, 37, 89126.CrossRefGoogle Scholar
Baumrind, D. (1993) The average expectable environment is not good enough: A response to Scarr. Child Development, 64, 12991317.CrossRefGoogle Scholar
Biederman, J., Rosenbaum, J. F., Chaloff, J., et al (1995) Behavioral inhibition as a risk factor for anxiety disorders. In Anxiety Disorders in Children and Adolescents (ed. J. L. March), pp. 6181. New York: Guilford.Google Scholar
Birnstiel, M. L. (1996) Gene therapy. European Review, 4, 335356.Google Scholar
Blacker, D., Haine, J. L., Rodes, L., et al (1997) ApoE–4 and age at onset of Alzheimer's disease: The NIMH Genetics Initiative. Neurology, 48, 139147.Google Scholar
Block, N. (1995) How heritability misleads about race. Cognition. 56, 99128.Google Scholar
Bohman, M. (1996) Predisposition to criminality: Swedish adoption studies in retrospect. In Genetics of Criminal and Antisocial behaviour. Ciba Symposium No. 194 (eds G. R. Bock & J. A. Goode). pp. 99114. Chichester: Wiley.Google Scholar
Cadoret, R. J., Yates, W. R., Troughton, E., et al (1995) Genetic–environmental interaction in the genesis of aggressivity and conduct disorders. Archives of General Psychiatry. 52, 916924.Google Scholar
Capecchi, M. R. (1994) Targeted gene replacement. Scientific American, 270, 3441.Google Scholar
Caron, C. & Rutter, M. (1991) Comorbidity in child psychopathotogy: Concepts, issues and research strategies. Journal of Child Psychology and Psychiatry, 32, 10631080.CrossRefGoogle Scholar
Chen, Z., Pato, R., Collins, R., et al (1991) Serum cholesterol concentration and coronary heart disease in population with low cholesterol concentrations. British Medical Journal. 303, 276282.Google Scholar
Cloninger, C. R., Adolfsson, R. & Svraklc, N. M. (1996) Mapping genes for human personality. Nature Genetics, 12, 34.Google Scholar
Cookson, W. (1994) Gene Hunters: Adventures in the Genome Jungle. London: Aurum Press.Google Scholar
Crabbe, J. C., Belknap, J. K. & Buck, K. J. (1994) Genetic animal models of alcohol and drug abuse. Science. 264, 17151723.CrossRefGoogle ScholarPubMed
Crystal, R. G. (1995) Transfer of genes to humans: Early lessons and obstacles to success. Science, 270, 404410.CrossRefGoogle ScholarPubMed
Detera-Wadleigh, S. D., Badner, J. A., Goldin, L. R., et al (1996) Affected-sib-pair analyses reveal support of prior evidence for a susceptibility locus for bipolar disorder on 21–Q. American Journal of Human Genetics, 58, 12791285.Google Scholar
Dunn, J. & Plomin, R. (1990) Separate Lives: Why Siblings Are So Different. New York: Basic Books.Google Scholar
Eaves, L. J., Silberg, J. L., Meyer, J. M., et al (1997) Genetics and developmental psychopathology: 2. The main effects of genes and environment on behavioural problems in the Virginia Twin Study of Adolescent Behavioural Development. Journal of Child Psychology and Psychiatry, in press.Google Scholar
Erlenmeyer-Kimling, L., Squires-Wheeler, E., Adamo, U. H., et al (1995) The New York High-Risk Project: Psychoses and Cluster A personality disorders in offspring of schizophrenic parents at 23 years of follow-up. Archives of General Psychiatry, 52, 857865.Google Scholar
Farmer, A. & Owen, M. J. (1996) Genomics: the next psychiatric revolution? British Journal of Psychiatry, 169, 135138.Google Scholar
Fletcher, J. C. (1995) Gene therapy in mental retardation: Ethical considerations. Mental Retardation and Developmental Disabilities Research Reviews, 1, 713.Google Scholar
Glover, J. (1996) The implications for responsibility of possible genetic factors in the explanation of violence. In Genetics of Criminal and Antisocial Behaviour. Ciba Foundation Symposium No. 194 (eds G. R. Bock & J. A. Goode), pp. 237243. Chichester: Wiley.Google Scholar
Gottesman, I. I., & Bertelsen, A. (1996) Legacy of German psychiatric genetics: hindsight is always 20/20. American Journal of Medical Genetics, 67, 317322.3.0.CO;2-J>CrossRefGoogle ScholarPubMed
Grigorenlco, E. L., Wood, F. B., Meyer, M S., et al (1997) Susceptibility loci for distinct components of dyslexia on chromosomes 6 and 15. American Journal of Human Genetics, 60, 2739.Google Scholar
Hardy, J. A. & Higgins, G. A. (1992) Alzheimer's disease: The amyloid cascade hypothesis. Science, 256, 184187.CrossRefGoogle ScholarPubMed
Hardy, J. A. & Hutton, M. (1995) Two new genes for Alzheimer's disease. Trends in Neuroscience, 18, 436.Google Scholar
Jensen, A. R. (1969) How much can we boost IQ and scholastic achievement? Harvard Education Review, 39, 1123.Google Scholar
Handler, K. S. (1996) Parenting: A genetic—epidemiologic perspective. American Journal of Psychiatry, 153, 1120.Google Scholar
Handler, K. S., McGuire, M., Gruenberg, A., et al (1993) The Roscommon Family Study: III. Schizophrenia-related personality disorders in relatives. Archives of General Psychiatry, 50, 781788.Google Scholar
Handler, K. S., Kessler, R. C., Walters, E. E., et al (1995a) Stressful life events, genetic liability, and onset of an episode of major depression in women. American Journal of Psychiatry, 152, 833842.Google Scholar
Handler, K. S., Neale, M. C. & Walsh, D. (1995b) Evaluating the spectrum concept of schizophrenia in the Roscommon Family Study. American Journal of Psychiatry, 152, 749754.Google Scholar
Knowles, M. R., Hohneker, K. W., Zhou, Z., et al (1995) A controlled study of adenoviral-vector-mediated gene transfer in the nasal epithelium of patients with cystic fibrosis. New England Journal of Medicine, 333, 823831.Google Scholar
Kramer, P. D. (1994) Listening to Prozoc. Harmondsworth, Middlesex: Penguin.Google Scholar
Lahey, B. B., McBurnett, K., Loeber, R., et al (1995) Psychobiology of conduct disorder. In Conduct Disorders in Children and Adolescents: Assessments and Interventions (ed. G. P. Sholevar), pp. 2744. Washington, DC: American Psychiatric Press.Google Scholar
Lander, E. S. (1996) The new genomics: Global views of biology. Science. 274, 536639.Google Scholar
Lander, E. S. & Schork, N. J. (1994) Genetic dissection of complex traits. Science. 265, 20372048.Google Scholar
Lapham, E. V., Kozma, C. & Weiss, J. O. (1996) Genetic discrimination: perspectives of consumers. Science, 274, 621624.Google Scholar
Marshall, E. (1996) The genome program's conscience. Science. 274, 488490.Google Scholar
Masood, E. (1996) Gene tests: Who benefits from risk? Nature, 379, 389392.Google Scholar
Matheny, A. P. Jr (1989) Children's behavioral inhibition over age and across situations: Genetic similarity for a trait during change. Journal of Personality, 57, 215235.Google Scholar
Matheny, A. P. Jr (1990) Developmental behavior genetics: Contributions from the Louisville Twin Study. In Developmental Behaviour Genetics: Neural. Biometrical, and Evolutionary Approaches (eds M. E. Hahn, J. K. Hewitt, N. D. Henderson, et al). pp. 2539. New York: Oxford University Press.Google Scholar
McGrath, J., Castle, D. & Murray, R. (1995) How can we judge whether or not prenatal exposure to influenza causes schizophrenia? In Neural Development and Schizophrenia (eds S. A. Mednick & J. M. Hollister). pp. 203214. New York: Plenum.Google Scholar
McGue, M. (1993) From proteins to cognitions: the behavioral genetics of alcoholism. In Nature Nurture and Psychology (eds R. Ptomin & G. E. McClearn), pp. 245268. Washington, DC: American Psychological Association.CrossRefGoogle Scholar
McGuffin, P. & Katz, R. (1986) Nature, nurture and affective disorder. In The Biology of Depression (ed. J. F. W. Deakin). pp. 2652. London: Royal College of Psychiatrists.Google Scholar
McGuffin, P. & Sergeant, M. P. (1991) Genetic markers and affective disorder. In The New Genetics of Mental Illness (eds P. McGuffin & R. Murray), pp. 165181. Oxford: Butterworth-Heinemann.Google Scholar
McGuffin, P., Owen, M. J., O'Donovan, M., et al (1994) Seminars in Psychiatric Genetics. London: Gaskell.Google Scholar
Mednick, S. A. & Hollister, J. M. (eds) (1995) Neural Development and Schizophrenia. New York: Plenum Press.Google Scholar
Morton, N. E. (1974) Analysis of family resemblance. I. Introduction. American Journal of Human Genetics, 26, 318330.Google Scholar
Moser, H. W. (1995) A role for gene therapy in mental retardation. Mental Retardation and Developmental Disabilities Research Reviews, 1, 46.CrossRefGoogle Scholar
Nicholls, R. D. (1994) New insights reveal complex mechanisms involved in genomic imprinting. American Journal of Human Genetics, 54, 733740.Google ScholarPubMed
Nuffield Council on Bioethks (1993) Genetic Screening: Ethical Issues. London: Nuffield Foundation.Google Scholar
Owen, M. J. & McGuffin, P. (1993) Association and linkage: Complementary strategies for complex disorders. Journal of Medical Genetics, 30, 638639.Google Scholar
Pauls, D. L., Raymond, C. L., Stevenson, J M., et al (1991) A family study of Giles de la Tourette syndrome. American Journal of Human Genetics, 48, 154163.Google Scholar
Pauls, D. L., Alsobrook, J. P., Goodman, W., et al (1995) A family study of obsessive—compulsive disorder. American Journal of Psychiatry 152, 7684.Google Scholar
Patterson, G. R. (1982) Coercive Family Process. Eugene. OR: Castalia Publishing Company.Google Scholar
Pelosi, A. & David, A. (1989) Ethical implication of the new genetics for psychiatry. International Review of Psychiatry, 1, 315320.Google Scholar
Peltonen, L. (1995) Schizophrenia: All out for chromosome six. Nature, 378, 665666.Google Scholar
Petronis, A. & Kennedy, J. L. (1995) Unstable genes — unstable mind? American Journal of Psychiatry, 152, 164172.Google Scholar
Petursson, H. & Lader, M. (1984) Dependence on Tranquillizers. Maudsley Monographs 28. Oxford: Oxford University Press.Google Scholar
Plomin, R. (1986) Development. Genetics, and Psychology. Hillsdale, NJ: Erlbaum.Google Scholar
Plomin, R. (1991) Genetic risk and psychosocial disorders: links between the normal and abnormal. In Biological Risk Factors for Psychosocial Disorders (eds M. Rutter & P. Casaer). pp. 101138. Cambridge: Cambridge University Press.Google Scholar
Plomin, R. (1994) Genetics and Experience: The Interplay Between Nature and Nurture. Thousand Oaks, CA: Sage.Google Scholar
Plomin, R. & Daniels, D. (1987) Why are children in the same family so different from one another? Behavioral and Brain Sciences, 10, 115.Google Scholar
Plomin, R., Rende, R. & Rutter, M. (1991) Quantitative genetics and developmental psychopathology. In Rochester Symposium on Developmental Psychopathology, Vol. 2: Internalizing and Externalizing Expressions of Dysfunction (eds D. Cicchetti & S. Toth). pp 155202. Hillsdale. NJ: Erlbaum.Google Scholar
Plomin, R. & Bergeman, C. S. (1991) The nature of nurture: Genetic influences on “environmental” measures. Behavioral and Brain Sciences, 14, 373386.Google Scholar
Plomin, R., Owen, M. J. & McGuffin, P. (1994) The genetic basis of complex human behaviours. Science, 264, 17331739.CrossRefGoogle Scholar
Plomin, R., DeFries, J., McClearn, G. E., et al (1997) Behavioral Genetics (3rd edn). New York: W. H. Freeman.Google Scholar
Plomin, R. & Rutter, M. (1997) Child development, molecular genetics and what do we do with genes once they are found. Child Development, in press.Google Scholar
Pokorski, R. J. (1995) Genetic information and life insurance. Nature. 376, 1314.Google Scholar
Reiss, D., Hetherington, M., Plomin, R., et al (1995) Genetic questions for environmental studies: Differential parenting and psychopathology in adolescence. Archives of General Psychiatry, 52, 925936.Google Scholar
Risen, N. & Merikangas, K. (1996) The future of genetic studies of complex human diseases. Sciences, 273, 15161517.Google Scholar
Rose, S. (1995) The rise of neurogenetic determinism. Nature, 373, 380382.CrossRefGoogle ScholarPubMed
Rutter, M. (1989) Psychiatric disorder in parents as a risk factor for children. In Prevention of Mental Disorders, Alcohol and Other Drug Use in Children and Adolescents (eds D. Shaffer, I. Philips & N. B. Enzer et al), pp. 157189. OSAP Prevention Monograph 2. Rockville. MD: Office for Substance Abuse Prevention. US Department of Health & Human Services.Google Scholar
Rutter, M. (1994) Psychiatric genetics: Research challenges and pathways forward. American Journal of Medical Genetics (Neuropsychiatric Genetics), 54, 185198.Google Scholar
Rutter, M. (1997) Nature-nurture integration: The example of antisocial behavior. American Psychologist, 52, 390398.CrossRefGoogle Scholar
Rutter, M., Bolton, P., Harrington, R., et al (1990a) Genetic factors in child psychiatric disorders. I. A review of research strategies. Journal of Child Psychology and Psychiatry, 31, 337.Google Scholar
Rutter, M., Macdonald, H., Le Couteur, A., et al (1990b) Genetic factors in child psychiatric disorders. II. Empirical findings. Journal of Child Psychology and Psychiatry. 31, 3983.Google Scholar
Rutter, M. & Rutter, M. (1993) Developing Minds: Challenge and Continuity Across the Life Span. Harmondsworth, Middlesex: Penguin; New York: Basic Books.Google Scholar
Rutter, M., Champion, L., Quinton, D., et al (1995) Understanding individual differences in environmental risk exposure. In Examining Lives in Context: Perspectives on the Ecology of Human Development (eds P. Moen, G. H. Elder Jr & K. Lüscher), pp. 6193. Washington, DC: American Psychological Association.CrossRefGoogle Scholar
Rutter, M., & Smith, D. J. (eds) (1995) Psychosocial Disorders in Young People: Time Trends and their Causes. Chichester: Wiley.Google Scholar
Rutter, M., Sirnonoff, E. & Plomin, R. (1996) Genetic influences on mild mental retardation: Concepts, findings and research implications. Journal of Biosocial Science, 28, 509526.Google Scholar
Rutter, M., Bailey, A., Simonoff, E., et al (1997a) Genetic influences and autism. In Handbook of Autism (eds F. Volkmar & D. Cohen), pp. 370387. New York: Wiley.Google Scholar
Rutter, M., Dunn, J., Plomin, R., et al (1997b) Integrating nature and nurture: Implications of person–environment correlations and interactions for developmental psychopathotogy. Development and Psychopathology, in press.Google Scholar
Rutter, M., Maughan, B., Meyer, J., et al (1997c) Heterogeneity of antisocial behavior: Causes, continuities, and consequences. In Nebraska Symposium on Motivation: Vol. 44: Motivation and Delinquency (Series ed. R. Dienstbier & Vol. ed. D. W. Osgood). Lincoln, NE: University of Nebraska Press, in press.Google Scholar
Scarr, S. (1992) Developmental theories for the 1990s: Development and individual differences. Child Development, 63, 119.Google Scholar
Schuler, G. D., Boguski, M. S., Stewart, E. A., et al (1996) A gene map of the human genome. Science, 274, 540546.Google Scholar
Sibllia, M. & Wagner, E. F. (1996) Transgenic animals. European Review, 4, 371392.Google Scholar
Silberg, J., Meyer, J., Pickles, A., et al (1996a) Heterogeneity among juvenile antisocial behaviours: findings from the VTSABD. In Genetics of Criminal and Antisocial behaviour. Ciba Symposium No. 194 (eds G. Bock & J. Goode). pp. 7686. Chichester: Wiley.Google Scholar
Silberg, J., Rutter, M., Meyer, J., et al (1996b) Genetic and environmental influences on the covariation between hyperactivity and conduct disturbance in juvenile twins. Journal of Child Psychology and Psychiatry 37, 803816.Google Scholar
Simonoff, E., Bolton, P. & Rutter, M. (1996) Mental retardation: Genetic findings, clinical implications and research agenda. Journal of Child Psychology and Psychiatry, 37, 259280.Google Scholar
Silberg, J. & Rutter, M. (1996) Autism and other behavioral disorders. In Emery and Rimoin's Principles and Practice of Medical Genetics (3rd edn) (eds D. L. Rimoin, J. M. Connor, R. E. Pyeritz, et al), pp. 17911806. New York: Churchill Livingstone.Google Scholar
Taylor, E. (1994) Syndromes of attention deficit and overactivity. In Child and Adolescent Psychiatry: Modem Approaches (3rd edn) (eds M. Rutter, E. Taylor & L. Hersov), pp. 285307. Oxford: Blackwell.Google Scholar
Thapar, A. & McGuffin, P. (1994) A twin study of depressive symptoms in childhood. British Journal of Psychiatry, 165, 259265.Google Scholar
Tlenari, P., Wynne, L. C., Moring, J., et al (1994) The Finnish adoptive family study of schizophrenia: Implications for family research. British Journal of Psychiatry, 164 (suppl. 23), 2026.Google Scholar
Tizard, J. (1975) Race and IQ: The limits of probability. New Behaviour, 1, 69.Google Scholar
Weber, M. W. (1996) Ernst Rudin. 1874–1952: a German psychiatric geneticist. American Journal of Medical Genetics, 67, 323331.Google Scholar
Wyatt, R. J. (1996) Commentary: Neurodevelopmental abnormalities and schizophrenia: A family affair. Archives of General Psychiatry, 53, 1114.Google Scholar
Submit a response

eLetters

No eLetters have been published for this article.