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Congress on Preventive Psychiatry
Athens, 1999 Feb. 24-28

Inherited mental disorders can be prevented

Preventing inherited mental disorders may sound like an oxymoron but is already a fact. Much more will become feasible in a few years. For diseases with Mendelian inheritance patterns, family history and/or screening to detect carriers permits pre-conceptual counseling (to avoid pregnancy if abortion is rejected as an option) and pre-natal detection and abortion of affected fetuses. Thus, screening amniocentesis and abortion have reduced Tay-Sachs births in North America by more than 90%.
 
Neonatal screening to identify metabolic and endocrine abnormalities permits dietary or hormonal interventions to prevent neuropsychiatric abnormalities. The genotype is unchanged but the phenotype is normal or near normal. Thus, in the case of PKU prevented, the child still lacks phenylalanine hydroxylase but the provision of a low phenylalanine diet prevents damage to CNS.
 
However, the common mental disorders are not Mendelian in their inheritance. Though they display familial patterns, they result from interactions between multiple genes and environmental factors. The specification of the human genone, likely to be completed within the next three to five years, will accelerate identifying genes conferring risk; it will make it possible to identify environmental precipitants (viral? dietary? psychological? social?) that interact with the genotype to produce disease.The new knowledge will permit interventions tailored to individual susceptibilities to prevent psychiatric disorders.

L. Eisenberg, MD
Harvard Medical School, Boston

Main Menu

- Introduction
- First things first: Fight the stigma.
- Promotion of the psychosocial health of infants through primary health care.
- Teaching Bioethics in Medical School.
- Strategies for the prevention of suicide: emphasis on suicide attempters with concurrent psychiatric disorder.
- The ICD-10 training kit.
- Aniracetam treatment for lithium-produced cognitive deficits of bipolar patients.
- Brain plasticity and the course of mood disorders: Possible implications for secondary prevention.
- Inherited mental disorders can be prevented.
- Methodological issues in the study of Psychiatric Prevention.
- Co-operative management of chronic mental patients to prevent re-hospitalization.
- Components of a community-based chronic illness support system.
- Mobile units for rural areas in the service of psychiatric prevention.
- Prevention of personality disorders: realistic or utopic?.
- Prevention and treatment strategies should be multidimensional, continuous, multimodal and ecclectic.
- Early education intervention in schools and immediate environment.
- Before prevention.
- The relevance of comprehensive clinical diagnosis to prevention and health promotion.
- Preventive interventions for children of parents with a mental disorder: a multicomponent approach.
- Development and implementation of preventive measures for children with mentally ill parents.
- Nutrition and behavior changing concepts, changing concerns.
- The impact of perinatal care on the prevention of mental diseases.
- The WHO educational program on mental disorders in primary care.
- Biopsychosocial background and prevention of suicide.
- Current psychiatric prevention strategies in Japan.
- A case report regarding current psychiatric prevention strategies in Japan.

 

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