The Genetics of Mental Illness ESTIE ROSE CERTIFIED GENETIC COUNSELOR

The Genetics of Mental Illness ESTIE ROSE CERTIFIED GENETIC COUNSELOR

Overview PART 1: Inheritance pattern of mental illness Types of psychiatric illness Recurrence risks Is there a Jewish genetic component? PART 2: Living with Mental Health Challenges, by Dr. Michelle Friedman PART 3: Marc Fein: Reflecting on Personal Experiences

Monogenic Diseases Result from a mutation in a single gene Easy to do genetic testing Ex: Cystic fibrosis, hemophilia, neurofibromatosis, Connexin-related deafness

Multifactorial Diseases Weak correlation to disease Strong correlation to disease Result from the effects of multiple genes or genes in combination with lifestyles and environmental factors Ex: Diabetes, heart disease, mental illness Genetic variant 1 Weak correlation to disease Environmental factor Moderate correlation to disease Genetic variant 2 Weak correlation to disease

Development of a Mental Illness From NSGC.org

Examples of Mental Illness Mood disorders depression, bipolar disease Psychotic disorders schizophrenia Anxiety disorders panic disorder, social anxiety, phobias Eating disorders anorexia nervosa, bulimia nervosa, pica Impulse/Control disorders attention deficit hyperactivity disorder, kleptomania, compulsive gambling, addiction Personality disorders antisocial personality disorder, paranoid personality disorder Obsessive-compulsive disorders Post-traumatic stress disorders Suicidal Tendencies

Mental Illness is NOT Cognitive disability Dementia (Alzheimer s) Parkinson s Autism

How common is mental illness in US adults? In 2012, there were an estimated 43.7 million adults aged 18 or older in the U.S. with mental illness. This represented 18.6% of all U.S. adults Major Depression 6.9% Schizophrenia 1.1% Anxiety Disorder 4.1% Obsessive Compulsive Disorder 0.5% Bipolar disorder 2.2% From National Institute of Mental Health

Other Forms of Mental Illness Acute -postpartum depression, PTSD Part of a larger syndrome -DiGeorge syndrome, homocystinuria, acute intermittent porphyria

Can you inherit mental illness? Yes, but it is not so simple bipolar anxiety depression d. suicide anxiety bipolar anxiety

Empiric Risk Data: Bipolar disease Population prevalence: 0.8-1.6% (approximately 1%) Risk to first-degree relatives: For bipolar disorder 5-20%, relative risk 7-10 For unipolar disorder 8-28%, relative risk 2-3 For any major affective disorder 20-30% Risk to offspring with one parent affected with either bipolar, unipolar, or schizoaffective disorder is 27% (i.e., risk is 27% to have any of the three disorders) Risk to offspring with both parents affected by bipolar disorder: 50-65% risk for bipolar; 50-75% risk for any affective disorder Risk to second-degree relatives: 5% Heritability: ~60% Early age-at-onset might indicate increased risk to relatives; female relatives at highest risk for any affective disorder. During postpartum period, women at increased risk for developing subsequent episodes. Commonly comorbid disorders Alcohol and drug use Anxiety disorders Disorders that may occur more frequently in family members (note: this does not necessarily indicate shared genetic etiology) Unipolar depression Schizoaffective disorder Cyclothymia Alcohol and drug abuse Eating disorders ADHD Anxiety disorders From National Coalition for Health Professionals Education in Genetics

Genetic Testing Not really done Diagnostic Predictive For personalized medicine However, a genetic counseling consultation may be helpful to families who are affected

Find a local genetic counselor @ www.nsgc.org You don't need to have genetic testing in order to benefit from genetic counseling

Jewish Link to Mental Illness Not particularly common in the Jewish community, but just as common as it is in all populations (which is common!) From National Alliance on Mental Illness

Haaretz, Nov. 26, 2013 Schizophrenia in the Jewish Community Ashkenazi Jews who have one of two variations in the NDST3 gene are 40 % more likely to contract a schizophreniarelated disorder than those without it The same variations increased the risk by only 15% in other populations

It s ok to ask for help

Funding for this series is provided in part by:... A generous grant in honor of Beatrice Milberg