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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 

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Footnotes

See editorial pp. 201–202, this issue.

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