Predictive and prenatal diagnosis of Hunington's disease: attitudes of mexican neurologists, psychiatrists, and psychologists

ABSTRACT

Background. Huntington's disease (HD) is a hereditary disease of the central nervous system. Its molecular diagnosis has allowed predictive and prenatal diagnosis to be done, and it is now a model for the study of the ethical, legal, and social problems arising from the diagnosis of such diseases. Methods. This study explores the knowledge and attitudes of a groups of Mexican specialistis regarding the disease and its diagnosis. A self-administered, 30-item multiple-choice questionnaire was completed anonymously by neurologists, psychiatrists, and psychologists. Results. Fifty-five percent of the professionals had experience with HD patients, 59 percent claimed to know the hereditary risk, and 20 percent answered incorrectly concerning the risks. Neurologists had the most exposure to HD; 74 percent acknowledged the existence of predictive diagnosis, although only 10 percent knew the international guidelines for testing. Eighty-six percent of the participants recommended predictive diagnosis, the reasons being: 55 percent, if the patients considered having offspring; 41 percent, for the patients's professional reasons; 6 percent, if a treatment was available, and 12 percent did not answer. In cases in which the patient wanted to have offspring, 38 percents thought that this should be avoided. Thirty-six percent of the subto have offspring, 38 percent thought that this should be avoided. Thirty-six percent of the subjects considered prenatal diagnosis justified in a couple with a carrier, and 51 percent justified abortion affected fetuses. Conclusions. Genetic counseling and predictive diagnosis in Mexico must be the responsibility of genetic units and specialists who are of inheritance risks and of guidelines for HD programs. The number of patients requiring such attention is increasing rapidly