Curing mental illness.
Scientific understanding of the connection between genetics and mental illness is accelerating, offering hope for treating and preventing such problems as depression, schizophrenia, Alzheimer's disease, and alcoholism, according to a new book, Mending Minds.
"Recognition of the importance of genes in psychiatric disease represents an about-face from the view that prevailed a couple of decades ago," says author Leonard L. Heston, a professor of psychiatry at the University of Washington Medical School. He notes that solid evidence favoring genetics' role comes from studies of adopted children and identical twins.
As scientists gain greater understanding of the physical and chemical properties of genes, they are also gaining the ability to apply that understanding to treating genetic-based diseases. We now know, for instance, that DNA - the genetic code - can and does change within the course of a lifetime, which means that "inheritance is not rigid, unchanging, or unforgiving," says Heston.
Only in the last few years has direct study of human DNA become possible, and the idea of mapping the human genome was first seen as a remote possibility in 1978. Locating the genes that cause a specific mental illness will radically alter the psychiatric profession, Heston suggests. Already, Huntington's disease can be located genetically, and the mapping of other disease will soon come. Once mapped, the diseases could eventually be prevented by manipulating the structure of DNA.
Meanwhile, scientist will have to try to understand how environment interacts with DNA to cause mental diseases. "We cannot expect to understand what DNA does wrong until we understand what it is responding to," Heston writes. Much study has been done on schizophrenia, and determining which individuals have DNA that is compatible with schizophrenia may soon be possible; however, so far it is not known what environmental factor or factors may trigger - or prevent - the condition from arising.
"Not a different mother, not gentler toilet training, not freedom from poverty, not avoiding preservatives in bread, not curtailing acid rain - no prescription based on evidence could be offered to help prevent schizophrenia," says Heston.
New, noninvasive technologies for studying the human body--such as magnetic resonance imaging and positron emitting tomography - could help psychiatrists understand what goes on chemically in the brain. But actually discovering ways to genetically "fix" or prevent mental disease and disorders is still a long way off, Heston believes.
"In all likelihood, ... we will have the power to identify disease carriers long before we learn how diseases can be prevented. . . . [Therefore], policies need to be established to apply during a period when we can predict outcome but have no way to influence it." Knowledge that an individual may be at risk of developing Huntington's disease, Alzheimer's, or other illnesses might be used to prevent that person from obtaining insurance or becoming "an airline pilot, an admiral, or President."
"Such questions will plague us until effective treatments, especially preventive ones, are developed. But after treatments are discovered, we will enter a world now hard to imagine. In principle, nearly all psychiatric disease could then be prevented - and at little cost," Heston concludes.
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Title Annotation: | World Trends and Forecasts |
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Publication: | The Futurist |
Date: | Jul 1, 1992 |
Words: | 509 |
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