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The Future of Genetic Psychiatry | Jordan Smoller | Wondros Podcast EP 214

Originally aired on July 19, 2023

Blurred Boundaries: Exploring the Intersection of Genetics and Psychiatry

How much of mental illness is influenced by our genes versus our environment and experiences? This question lies at the heart of Dr. Jordan Smoller’s fascinating research exploring the complex relationship between genetics and psychiatric disorders.

Dr. Smoller explains that while psychiatric conditions have long been known to run in families, it has only been in recent decades with advances in genetic analysis that researchers have been able to directly study the role of DNA variations. Early twin studies comparing identical and non-identical twins provided initial evidence that genetics substantially contribute to most psychiatric disorders.

However, unlike classic genetic diseases caused by single gene mutations, psychiatric conditions involve a more complex combination of small variations in thousands of genes that add up to increase risk. Environmental factors still play a key role as well. Dr. Smoller notes the boundaries between normal variation in human personality and behavior versus clinical definitions of mental illness remain blurry.

With modern big data analysis and machine learning, Dr. Smoller’s team strives to improve prediction of serious psychiatric outcomes like suicide risk and matching patients to optimal treatments. They have developed algorithms analyzing electronic health records that show promise to identify individuals in need of early intervention. He cautions about the ethical use of such tools, as biases can inadvertently be embedded in the data.

Social connection and physical activity consistently emerge from their studies as protective factors that can overcome even high genetic risk for depression after trauma. The pandemic’s spotlight on mental health offers opportunities to advance research and expand access to care. While optimism exists about developing more targeted treatments based on genetic pathways, Dr. Smoller stresses a balanced, holistic approach remains key.

How has research enhanced our understanding of the genetic basis for psychiatric disorders?

  • Twin studies first demonstrated high heritability of mental illness
  • Genetic analysis now identifies DNA variations that increase risk
  • Combination of small gene variations rather than single mutations

What are some of the ethical concerns when applying big data to mental health?

  • Prediction algorithms can inadvertently embed societal biases
  • Must ensure responsible use of individuals’ data and predictions
  • Important to involve diverse perspectives

How might insights from genetics guide more precise psychiatric care?

  • Predict individuals at highest risk for suicide or other adverse outcomes
  • Match patients to optimal medication based on genetic profile
  • Develop treatments targeting specific biological pathways

What emerged as protective factors against depression in the research?

  • Social connection lessened depression risk even with high genetic risk
  • Physical activity also lowered odds of developing depression
  • Findings highlight need for holistic approach beyond just medication

How has the pandemic shifted perspectives on mental health challenges?

  • Mass trauma increased public awareness of mental health crisis
  • Creates opportunities to advance research and expand care access
  • But must maintain balanced view incorporating social and biological factors