Attitudes on pharmacogenetic testing in psychiatric patients with treatment-resistant depression.

BACKGROUND: Novel technologies make it possible to incorporate pharmacogenetic testing into the medical management of depression. However, previous studies indicate that there may be a subset of subjects who have concerns about genetic testing and may be psychologically vulnerable. If so, pharmacogenetic testing in depressed subjects could negatively impact their mental health and undermine treatment goals. METHODS: In this study, we developed a standardized instrument to assess motivations and attitudes around pharmacogenetic testing in a cohort of 170 depressed Veterans participating in a multi-center clinic trial. RESULTS: Testing reveals that subjects were largely positive about the use of genetic testing to guide pharmacological treatment and help plan their future. Most subjects showed only modest concerns about the impact on family, inability to cope with the results, and fear of discrimination. The severity of depression did not predict the concern expressed about negative outcomes. However, non-Caucasian subjects were more likely on average to endorse concerns about poor coping and fear of discrimination. CONCLUSIONS: These data indicate that while the overall risk is modest, some patients with depression may face psychosocial challenges in the context of pharmacogenetic testing. Future work should identify factors that predict distress and aim to tailor test results to different populations.

Agricultural medicine core course: building capacity for health and safety professionals.

In 1987 the University of Iowa began training health care professionals to care for farmers' occupational health needs. The training enables health professionals from various disciplines to function in the anticipation, diagnosis, treatment, and prevention of occupational illnesses and injuries in the farm community. A grant from National Institute for Occupational Safety and Health (NIOSH) entitled "Building Capacity for Health and Safety Professionals" allowed for the expansion of this training to other states. This paper describes the challenges, successes, and lessons learned from dissemination of Agricultural Medicine Core Course.