The Genetics of Schizophrenia
I wanted to discuss a recent bill that was passed into law that may be of interest to people with schizophrenia and their loved ones. It’s an unfortunate truth that many people living with schizophrenia are stigmatized by their illness in many ways. Aside from living with the burden of such a severe illness, patients regularly tell me about moments during their day when people will insult them or judge decisions they make about their lives because they have schizophrenia. One in particular is the decision to have children. There’s no question that genetics plays an important role in the development of schizophrenia, a person who has a first degree relative (a parent, child, or sibling) with the disorder has almost 10 times the risk of developing it themselves. In studies of twins separated at birth, if one twin develops schizophrenia, there is a much greater chance that the other twin will as well. It’s important to note that inheritance is not guaranteed; in fact an identical twin does not have a 100% chance of developing schizophrenia if their sibling has it; how their childhood proceeds and random chance play roles in disease development as well. Schizophrenia is not unique with regards to this situation; many neurologic and psychiatric disorders have a significant genetic component. One of the classic examples is Huntington ’s disease, in which if a person has one parent who has the illness, he or she has a 1 in 2 chance of contracting the illness themselves.
People who have such genetically loaded diseases often face ridicule or anger from other people if they decide to have children. Also, there is serious concern about outright discrimination from insurance companies and prospective employers as the technology for identifying genes for illnesses becomes more accurate and cheaper. On May 21, a bill was signed by President Bush into law that may help alleviate some of the fears associated with genetic discrimination. The Genetic Information Nondiscrimination Act (GINA) of 2007 was recently passed and will hopefully lead to more privacy safeguards for patients with illnesses with a large genetic component. This law has been debated in Congress in various forms for 13 years and passed almost unanimously in both the House and Senate. This law (in principle, at least) should allow patient to get genetic screenings that are currently available, such as the one widely used for Huntington’s Disease. Patients should also be able to get genetic therapy (if available for their illness) without insurance carriers raising rates, canceling existing coverage, or refusing coverage for patients with genetic disorders. This law also should similarly protect patients from genetic discrimination from employers as well. It’s an exciting development in the history of medical law, and I am hopeful this will lead to less stigma associated with disorder like Huntington ’s disease and schizophrenia. I welcome your posts about incidents of discrimination because of psychiatric illness, and as always, I invite comments on any aspect of living with schizophrenia.
Check out Paul Ballas's post on treatment for schiziphrenia, particularly in women, by clicking here.