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Source: ONE News -
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International research on young New Zealanders may re-write a key guide for mental health clinicians.
The New Zealand-based research has shown that a quick family history of depression, anxiety, or substance abuse can predict not only how likely a patient is to develop the disorder, but how serious that illness will be.
Such a quick and cheap screening could help doctors decide which young patients may simply grow out of behavioural problems and which ones need significant psychiatric help.
The findings come from the Dunedin Multidisciplinary Health and Development Study, which has followed 981 people born at Queen Mary Hospital in Dunedin in 1972-73 from birth through to age 32.
The researchers have been tracking the physical and mental health and lifestyles of study members since they were three years old and talked to the participants and family members - nearly 8000 assessments.
"We already knew that mental illnesses tend to run in families, and are among the most heritable of all disorders," said Professor Richie Poulton, director of the "Dunedin Study" and one of the research authors.
"What we didn't know was how closely family history was linked to the seriousness of mental illnesses, and that's what this study has helped us find out."
Co-authors on the study included Barry Milne of Auckland University, HonaLee Harrington, and Terrie Moffitt of the Duke Institute for Genome Sciences and Policy (IGSP), and Michael Rutter of London's King's College.
"There are lots of kids with behaviour problems who may outgrow them on their own without medication, versus the minority with mental illnesses that need treatment," Professor Moffitt said in a statement. "Family history is the quickest and cheapest way to sort that out."
She noted that the "bible of psychiatry", officially known as The Diagnostic and Statistical Manual of Mental Disorders (DSM) - the primary tool for making mental health diagnoses and delivering mental healthcare in the US and other countries - makes not mention of recording family history of mental patients.
"There's nothing about family history in the DSM even though it may be the most important," Moffitt said, who is on a panel of experts already revising the fourth issue of the DSM, for its next publication in 2012.
Researchers who are on the hunt for genes responsible for mental disorders are expected to take advantage of the discovery.
The report has been published in the July 2009 issue of Archives of General Psychiatry, after they tested each person's personal experience with depression, anxiety, alcohol dependence and drug dependence.
The results were compared to their family history "scores" - the proportion of their grandparents, parents and siblings over age 10 who were affected.
The analysis showed family history can predict a recurrent course for each of the four disorders, and also indicate those more likely to suffer a worse impairment and to make greater use of mental health services.
Moffitt said that health professionals had until now shied away from questioning people about their family history of mental illnesses because of the stigma attached to them.
"There's a sense that families are not as open about mental disorders -- that people may not know or may make incorrect assumptions," she said.
Funding for the study came from the New Zealand Health Research Council, US National Institutes of Mental Health, UK Medical Research Council, and the William Grant Foundation (USA).
