Genetic testing for cancer in children. Short-term psychological effect
A. M. Codori, G. M. Petersen, P. A. Boyd, J. Brandt and F. M. Giardiello
Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Md, USA.
OBJECTIVE: To study the psychological effect of genetic testing in
children. DESIGN: We evaluated the psychological effect of predictive
genetic testing through surveys of children at risk for familial
adenomatous polyposis. Their psychological state was assessed before
testing and 3 months later. SETTING: A research clinic. PARTICIPANTS: A
volunteer sample of 41 children, aged 6 to 16 years, and their parents.
MAIN OUTCOME MEASURES: Self-report inventories of depression, anxiety,
behavior problems, and competence. RESULTS: Nineteen children were found to
have a gene mutation (mutation-positive) and 22 did not
(mutation-negative). Their depression, anxiety, and behavior problem and
competence scores remained in the normal range after testing. Also,
parents' depression scores remained within normal limits at follow-up.
There were subclinical changes, however. Mutation-positive children with
affected mothers had significantly higher depression scores at follow-up.
Also, regardless of test results, children with affected mothers had
significantly increased anxiety scores after testing. In families with
mutation-positive and mutation-negative children, familial adenomatous
polyposis-unaffected parents experienced significantly increased depressive
symptoms at follow-up. CONCLUSIONS: Predictive testing of children at risk
for familial adenomatous polyposis did not lead to clinically significant
psychological symptoms in tested children or their parents. However, it is
premature to conclude that long-term follow-up will be equally favorable.
Additional study will be needed to determine the families' understanding of
the genetic information and the effect of the information on familial
relationships.
