K. Abe et Y. Itoyama, PSYCHOLOGICAL CONSEQUENCES OF GENETIC TESTING FOR SPINOCEREBELLAR ATAXIA IN THE JAPANESE, European journal of neurology, 4(6), 1997, pp. 593-600
To evaluate the psychological consequences of genetic testing for spin
ocerebellar ataxia (SCA), state and trait anxiety inventories (SAI and
TAI) and social desirability scale (SDS) were assessed and analyzed i
n patients and their family members diagnosed with spinocerebellar ata
xias such as spinocerebellar ataxia type 1 and Machado-Joseph disease
(MJD). The results obtained prior to and after the genetic testing wer
e compared to a control group that included more severe hereditary neu
rological disorders such as Huntington's disease and familial amyotrop
hic lateral sclerosis. Genetic counseling was undertaken during the st
udy. Of the 62 total participants, 37 were diagnosed with SCA, and 25
as asymptomatic family members. The SCA patients had higher baseline S
AI, TAI and SDS scores than their asymptomatic family members. Genetic
testing did not significantly increase the scores for all the patient
s and their asymptomatic family members, whereas the SAI value was gre
atly reduced in those subjects who received negative results and were
not carriers of the defective gene. Similar results were obtained even
in the control group with more severe diseases except for a reduction
of SAI values in the patients. Patients, their SCA asymptomatic famil
y members, and the disease control generally had some apprehension for
the testing, but, at the same time, were not so anxious if remedial o
r curative therapy was available. Furthermore, most participants in th
is study showed a high degree of acceptance and did not express much r
egret in undergoing the genetic testing regardless of having the disea
se or finding out the results of the predictive testing. These results
suggest that the psychological health of the asymptomatic family memb
ers with negative results for SCA gene abnormality recovered after gen
etic testing, and genetic testing was not disadvantageous for the psyc
hological well-being of the patients and even for those with positive
predictive results.