These are exciting times for genetic research. The conclusion of the Human Genome Project in 2001 has exponentially enhanced public interest in and awareness of the roles of genetics in disease, susceptibility and drug response. The number of media articles highlighting scientific publications in the field of genetics/genomics has grown dramatically over the past five years. This new trend has, in turn, increased the level of sophistication of inquiries from patients and their relatives.
This Special Report updates genetic and genomic research in key areas of psychiatry, with an emphasis on practical aspects.
These articles summarize state-of-the-art research in genetics, two of which focus on how to integrate genetic data that are presently unfolding in clinical practice, using specific and useful examples.
In their superb review, Stephen V. Faraone, Ph.D., and Philip Asherson, MRCPsych, Ph.D., detail the significant scientific advances that have consolidated a role for genetics in attention-deficit/hyperactivity disorder and are helping to clarify the biological basis for this disorder. Results from approaches such as genome scan linkage, candidate gene studies and data derived from the concerted effort of the International Multi-Site ADHD Genetics (IMAGE) project are summarized. This article is superbly complemented by a review, by David A. Mrazek, M.D., of pharmacogenetic testing currently available to patients. In his article "Pharmacogenomic Screening for Depressed Children and Adolescents," Mrazek addresses the importance of genotyping drug metabolizing enzymes and focuses on the metabolism of antidepressants, specifically the cytochrome P450 (CYP450) enzyme 2D6. On a regular regimen of antidepressants, individuals who are ultra-rapid metabolizers may have drug levels below the therapeutic range, while individuals who are slow metabolizers may achieve toxic drug levels.
Finally, the other articles underscore the challenges of understanding the genetic contribution for complex gene-environmental conditions such as schizophrenia, posttraumatic stress disorder and suicidal behavior.