Predictive and prenatal diagnosis of Huntington's disease: Attitudes of Mexican neurologists, psychiatrists, and psychologists

Background. Huntington's disease (PID) is a hereditary disease of the centr al nervous system, Its molecular diagnosis, has allowed predictive and pren atal diagnosis to be done, and it is now a model for the study of the ethic al, legal, and social problems arising from the diagnosis of such diseases. Methods. This. study explores the knowledge and attitudes of a group of Mex ican specialists regarding the disease and its diagnosis. A self-administer ed, 30-item multiple-choice questionnaire was completed anonymously by neur ologists, psychiatrists, and psychologists, Results. Fifty-five percent of the professionals had experience with I-ID p atients, 59% claimed to know the hereditary risks, and 20% answered incorre ctly concerning the risks. Neurologists had the most exposure to HD; 74% ac knowledged the existence of predictive diagnosis, although only 10% knew th e international guidelines for testing. Eighty-six percent of the participa nts recommended predictive diagnosis, the reasons being: 55%, if the patien ts considered having offspring; 41%, for the patient's professional reasons ; 6%, if a treatment was available, and 12% did not answer. In cases in whi ch the patient wanted to have offspring, 38% thought that this should be av oided. Thirty-six percent of the subjects considered prenatal diagnosis jus tified in a couple with a carrier, and 51% justified abortion for affected fetuses. Conclusions, Genetic counseling and predictive diagnosis in Mexico must be the responsibility of genetics units and specialists who are aware of inher itance risks and of guidelines for HD programs, The number of patients requ iring such attention is increasing rapidly (C) 1999 IMSS. Published by Else vier Science Inc.