DR. jehannine Austin

Vancouver General Hospital Research Pavilion

Room 211 - 828 West 10th Street

Vancouver, BC V5Z 1L8

Psychotic Disorders

Postpartum Mental Illness

Psychiatric Genetic Counseling

The MTHFR C677T polymorphism and postpartum mental illness in at-risk women. Psychotic disorders (which include schizophrenia, schizoaffective disorder and bipolar disorder) are common mental illnesses, altogether they affect approximately 3% of the population. Amongst the difficult issues faced by women affected by these disorders, are some special considerations surrounding pregnancy, delivery and childrearing. Women who have a history of a psychotic disorder have substantial risks for a postpartum episode of mental illness like depression or psychosis. Postpartum mental illness carries risks for suicide and infanticide, as well as other less dramatic but still significant problems like difficulties with parenting skills and problems with mother-child bonding and attachment. As a result, the risk for postpartum mental illness for this population of women is an important consideration. Despite this, little remains known about factors that may increase or decrease risk for developing it. We do know that psychotic disorders arise as a result of interactions between genetic and environmental influences, and some of the genetic variations that contribute to illnesses like schizophrenia are beginning to be discovered. This study aims to investigate whether one particular genetic variation (methylenetetrahydrofolate reductase C677T) contributes to risk for postpartum episodes of mental illness in women who have a history of psychosis. The gene of interest is known to encode a protein, whose function is dependant on a particular B vitamin, folate. Thus, if our hypotheses are supported, it may be possible to decrease risk for postpartum episodes of mental illness by providing folate supplements for women who have the genetic variation.

Investigating the utility and potential implications of psychiatric genetic counseling. I am interested in the potential impact of psychiatric genetic counseling for (a) women with a history of a psychotic disorder who wish to become pregnant, and (b) the parents of individuals with early psychosis. These populations are relatively under-researched from the perspective of genetic counseling. I am interested in whether psychiatric genetic counseling can increase knowledge, and decrease guilt and perceived stigma. To date, the research concerning the potential impact of genetic counseling has concentrated primarily on variables including: decisions made, anxiety, depression, knowledge, behavioural modification, and satisfaction. However, it is possible that in a disorder-specific manner, other measurable psychosocial variables may be affected.

Austin JC, and Honer W. Potential impact of genetic counselling for mental illness. Clinical Genetics.2005 67 (2) p134-142.

Austin, J. Schizophrenia: An update and review. Journal of Genetic Counselling. 2005 14(5) p. 329- 340

Austin JC, Smith G.N., and Honer W. The genomic era and families’ perceptions of psychotic disorders: Genetic risk estimation, associations with reproductive decisions and views about predictive testing. American Journal of Medical Genetics: Neuropsychiatric Genetics  2006.  141(8) p926-928

Austin JC. and Peay, H.L. Applications and Limitations of Empiric Data in Provision of Recurrence Risks for Schizophrenia: A practical review for healthcare professionals providing clinical psychiatric genetics consultations. Clinical Genetics 2006. 70 (3) p177-187

Austin JC, and Honer WG. The genomic era and serious mental illness: a potential application for psychiatric genetic counseling. Psychiatric Services 2007. 58(2) p254-261