Journal of Genetic Counseling

, Volume 23, Issue 4, pp 566–577 | Cite as

Genetic Testing of Children for Predisposition to Mood Disorders: Anticipating the Clinical Issues

  • Jessica A. Erickson
  • Lili Kuzmich
  • Kelly E. Ormond
  • Erynn Gordon
  • Michael F. Christman
  • Mildred K. Cho
  • Douglas F. LevinsonEmail author
Next Generation Genetic Counseling


Large-scale sequencing information may provide a basis for genetic tests for predisposition to common disorders. In this study, participants in the Coriell Personalized Medicine Collaborative (N = 53) with a personal and/or family history of Major Depressive Disorder or Bipolar Disorder were interviewed based on the Health Belief Model around hypothetical intention to test one’s children for probability of developing a mood disorder. Most participants (87 %) were interested in a hypothetical test for children that had high (“90 %”) positive predictive value, while 51 % of participants remained interested in a modestly predictive test (“20 %”). Interest was driven by beliefs about effects of test results on parenting behaviors and on discrimination. Most participants favored testing before adolescence (64 %), and were reluctant to share results with asymptomatic children before adulthood. Participants anticipated both positive and negative effects of testing on parental treatment and on children’s self-esteem. Further investigation will determine whether these findings will generalize to other complex disorders for which early intervention is possible but not clearly demonstrated to improve outcomes. More information is also needed about the effects of childhood genetic testing and sharing of results on parent–child relationships, and about the role of the child in the decision-making process.


Genetic testing Children Benefits Risks Positive predictive value Mood disorders Health Belief Model Mood disorders 



This work was supported by NIH grant P50 HG003389. The authors would like to thank Lisa Wawak for her contributions to the recruitment and participant follow-up. We thank Dr. Bettina Meiser for sharing her questionnaires, which served as a starting point for parts of our interview schedule.

Conflict of Interest

Authors Jessica A. Erickson, Lili Kuzmich, Kelly E. Ormond, Erynn Gordon, Michael F. Christman, Mildred K. Cho and Douglas F. Levinson declare that they have no conflict of interest.

Informed Consent

All study procedures were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2000. Informed consent was obtained from all participants for inclusion in the study.

Supplementary material

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Copyright information

© The Author(s) 2014

Open AccessThis article is distributed under the terms of the Creative Commons Attribution 2.0 International License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Authors and Affiliations

  • Jessica A. Erickson
    • 1
  • Lili Kuzmich
    • 2
  • Kelly E. Ormond
    • 1
    • 3
  • Erynn Gordon
    • 4
  • Michael F. Christman
    • 4
  • Mildred K. Cho
    • 1
    • 5
  • Douglas F. Levinson
    • 1
    • 6
    Email author
  1. 1.Center for the Integration of Research on Genetics and Ethics of the Stanford Center for Biomedical EthicsStanford UniversityStanfordUSA
  2. 2.Center for Reproductive HealthUniversity of California San Francisco Medical CenterSan FranciscoUSA
  3. 3.Department of GeneticsStanford UniversityStanfordUSA
  4. 4.Coriell Personalized Medicine CollaborativeCoriell Institute for Medical ResearchCamdenUSA
  5. 5.Department of PediatricsStanford UniversityStanfordUSA
  6. 6.Department of Psychiatry and Behavioral SciencesStanford UniversityStanfordUSA

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