Genetic counseling could help bipolar patients adapt

By Eleanor McDermid, Senior medwireNews Reporter

Patients who believe their bipolar disorder is inherited tend to have a positive approach to coping with their condition, research suggests.

This suggests that genetic counseling could help patients to adapt to living with bipolar disorder, say lead study author Holly Peay (National Human Genome Research Institute, Bethesda, Maryland, USA) and colleagues.

“These novel findings have important implications for a holistic treatment approach in an era of increased knowledge about the etiology and pathophysiology of bipolar disorder,” they write in BMC Psychiatry.

The researchers drew their conclusions from the responses of 266 bipolar disorder patients, with at least one unaffected child aged 30 years or younger, who completed an online questionnaire. Of these, 83.7% were female and 68.0% were White.

The patients had an average score of 2.6 on the Psychological Adaptation Scale, meaning that “[o]verall, respondents were only moderately well-adapted” to their condition, says the team.

Better adaptation was significantly associated with active coping and/or using social support, as well as with dispositional optimism. Conversely, self-blame/denial coping was associated with poorer adaptation. Together, these variables explained 55.2% of the variance in adaptation.

Patients who used active and/or social support means of coping tended to have more dispositional optimism, but were also more likely to endorse genetics as the cause of their illness, rather than personal attributes or environmental factors.

Most patients believed that their children were at increased risk for developing bipolar disorder, and endorsing a genetic cause was strongly associated with this belief. By contrast, other factors, such as illness severity, current mood, and adaptation, were not, indicating that patients are aware of the risk to their children, “regardless of the state of management of their own [bipolar disorder],” say Peay et al.

“The positive relationship between endorsing a genetic/familial etiology and both active/social coping and risk perception reinforces the potential utility of genetic counseling in this population,” conclude the researchers.

“Genetic counseling that refines clients’ understanding of [bipolar disorder] etiology and related family risk may help patients manage uncertainty and worry, and facilitate coping and adaptation.”

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