Abstract
The question of whether genetic carrier testing should be performed on children has been the subject of much debate. However, one important element has been lacking from this debate. There has been practically no knowledge of how those tested in childhood have experienced carrier testing. Twenty three subjects in families affected by Duchenne muscular dystrophy and 23 in families affected by haemophilia A, all of whom had been tested during childhood for carriership in the Department of Medical Genetics, University of Helsinki, from 1984 to 1988, participated in our study. We investigated long term psychosocial consequences of carrier testing in childhood. A questionnaire relating to sociodemographic background and life situation was used, together with assessment of health related quality of life (HRQOL) using the RAND 36 item Health Survey 1.0 (RAND). RAND results showed that the emotional, social, and physical well being of the young female subjects was not statistically different from those of control female subjects at a similar age. We also found no statistically significant differences in means in any RAND dimension (p<0.146) between carriers, non-carriers, and a group in which carrier status was uncertain. However, two out of seven carriers reported that they were worried and three that they were slightly worried about the test result. Four out of 22 young female subjects in the uncertain group reported being worried and 11 reported being slightly worried. Keywords: carrier testing in childhood; health related quality of life; psychosocial consequences; RAND
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- Axworthy D., Brock D. J., Bobrow M., Marteau T. M. Psychological impact of population-based carrier testing for cystic fibrosis: 3-year follow-up. UK Cystic Fibrosis Follow-Up Study Group. Lancet. 1996 May 25;347(9013):1443–1446. doi: 10.1016/s0140-6736(96)91683-9. [DOI] [PubMed] [Google Scholar]
- Balfour-Lynn I., Madge S., Dinwiddie R. Testing carrier status in siblings of patients with cystic fibrosis. Arch Dis Child. 1995 Feb;72(2):167–168. doi: 10.1136/adc.72.2.167. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Bekker H., Denniss G., Modell M., Bobrow M., Marteau T. The impact of population based screening for carriers of cystic fibrosis. J Med Genet. 1994 May;31(5):364–368. doi: 10.1136/jmg.31.5.364. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Childs B., Gordis L., Kaback M. M., Kazazian H. H., Jr Tay-Sachs screening: social and psychological impact. Am J Hum Genet. 1976 Nov;28(6):550–558. [PMC free article] [PubMed] [Google Scholar]
- Clow C. L., Scriver C. R. Knowledge about and attitudes toward genetic screening among high-school students: the Tay-Sachs experience. Pediatrics. 1977 Jan;59(1):86–90. [PubMed] [Google Scholar]
- Cobb E., Holloway S., Elton R., Raeburn J. A. What do young people think about screening for cystic fibrosis? J Med Genet. 1991 May;28(5):322–324. doi: 10.1136/jmg.28.5.322. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Denayer L., Welkenhuysen M., Evers-Kiebooms G., Cassiman J. J., Van den Berghe H. The CF carrier status is not associated with a diminished self-concept or increased anxiety: results of psychometric testing after at least 1 year. Clin Genet. 1996 May;49(5):232–236. doi: 10.1111/j.1399-0004.1996.tb03779.x. [DOI] [PubMed] [Google Scholar]
- Devinsky O., Vickrey B. G., Cramer J., Perrine K., Hermann B., Meador K., Hays R. D. Development of the quality of life in epilepsy inventory. Epilepsia. 1995 Nov;36(11):1089–1104. doi: 10.1111/j.1528-1157.1995.tb00467.x. [DOI] [PubMed] [Google Scholar]
- DudokdeWit A. C., Tibben A., Duivenvoorden H. J., Niermeijer M. F., Passchier J., Trijsburg R. W. Distress in individuals facing predictive DNA testing for autosomal dominant late-onset disorders: comparing questionnaire results with in-depth interviews. Rotterdam/Leiden Genetics Workgroup. Am J Med Genet. 1998 Jan 6;75(1):62–74. doi: 10.1002/(sici)1096-8628(19980106)75:1<62::aid-ajmg14>3.0.co;2-q. [DOI] [PubMed] [Google Scholar]
- Duggan M. M., Woodson J., Scott T. E., Ortega A. N., Menzoian J. O. Functional outcomes in limb salvage vascular surgery. Am J Surg. 1994 Aug;168(2):188–191. doi: 10.1016/s0002-9610(94)80065-0. [DOI] [PubMed] [Google Scholar]
- Evers-Kiebooms G., Denayer L., Welkenhuysen M., Cassiman J. J., Van den Berghe H. A stigmatizing effect of the carrier status for cystic fibrosis? Clin Genet. 1994 Nov;46(5):336–343. doi: 10.1111/j.1399-0004.1994.tb04174.x. [DOI] [PubMed] [Google Scholar]
- Ganz P. A., Coscarelli A., Fred C., Kahn B., Polinsky M. L., Petersen L. Breast cancer survivors: psychosocial concerns and quality of life. Breast Cancer Res Treat. 1996;38(2):183–199. doi: 10.1007/BF01806673. [DOI] [PubMed] [Google Scholar]
- Guyatt G. H., Feeny D. H., Patrick D. L. Measuring health-related quality of life. Ann Intern Med. 1993 Apr 15;118(8):622–629. doi: 10.7326/0003-4819-118-8-199304150-00009. [DOI] [PubMed] [Google Scholar]
- Hays R. D., Sherbourne C. D., Mazel R. M. The RAND 36-Item Health Survey 1.0. Health Econ. 1993 Oct;2(3):217–227. doi: 10.1002/hec.4730020305. [DOI] [PubMed] [Google Scholar]
- Jenkinson C., Coulter A., Wright L. Short form 36 (SF36) health survey questionnaire: normative data for adults of working age. BMJ. 1993 May 29;306(6890):1437–1440. doi: 10.1136/bmj.306.6890.1437. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Käriäinen H., Lindlöf M., Somer H., de la Chapelle A. Genetic counselling in Duchenne and Becker muscular dystrophy is problematic when carrier studies give controversial results. Clin Genet. 1990 Mar;37(3):179–187. doi: 10.1111/j.1399-0004.1990.tb03500.x. [DOI] [PubMed] [Google Scholar]
- Lehesjoki A. E., Rasi V., de la Chapelle A. Hemophilia B: diagnostic value of RFLP analysis in 19 of the 20 known Finnish families. Clin Genet. 1990 Sep;38(3):187–197. doi: 10.1111/j.1399-0004.1990.tb03570.x. [DOI] [PubMed] [Google Scholar]
- Lehesjoki A. E., Sistonen P., Rasi V., de la Chapelle A. Hemophilia A: genetic prediction and linkage studies in all available families in Finland. Clin Genet. 1991 Mar;39(3):199–209. doi: 10.1111/j.1399-0004.1991.tb03012.x. [DOI] [PubMed] [Google Scholar]
- Lindlöf M., Käriäinen H., Davies K. E., de la Chapelle A. Carrier detection and prenatal diagnosis in X linked muscular dystrophy using restriction fragment length polymorphisms. J Med Genet. 1986 Dec;23(6):560–572. doi: 10.1136/jmg.23.6.560. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Litwin M. S., Hays R. D., Fink A., Ganz P. A., Leake B., Leach G. E., Brook R. H. Quality-of-life outcomes in men treated for localized prostate cancer. JAMA. 1995 Jan 11;273(2):129–135. doi: 10.1001/jama.273.2.129. [DOI] [PubMed] [Google Scholar]
- MacKeigan L. D., Pathak D. S. Overview of health-related quality-of-life measures. Am J Hosp Pharm. 1992 Sep;49(9):2236–2245. [PubMed] [Google Scholar]
- Marteau T. M., van Duijn M., Ellis I. Effects of genetic screening on perceptions of health: a pilot study. J Med Genet. 1992 Jan;29(1):24–26. doi: 10.1136/jmg.29.1.24. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Mitchell J., Scriver C. R., Clow C. L., Kaplan F. What young people think and do when the option for cystic fibrosis carrier testing is available. J Med Genet. 1993 Jul;30(7):538–542. doi: 10.1136/jmg.30.7.538. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Rowley P. T., Lipkin M., Jr, Fisher L. Screening and genetic counseling for beta-thalassemia trait in a population unselected for interest: comparison of three counseling methods. Am J Hum Genet. 1984 May;36(3):677–689. [PMC free article] [PubMed] [Google Scholar]
- Sullivan M., Karlsson J., Ware J. E., Jr The Swedish SF-36 Health Survey--I. Evaluation of data quality, scaling assumptions, reliability and construct validity across general populations in Sweden. Soc Sci Med. 1995 Nov;41(10):1349–1358. doi: 10.1016/0277-9536(95)00125-q. [DOI] [PubMed] [Google Scholar]
- Vickrey B. G., Hays R. D., Rausch R., Sutherling W. W., Engel J., Jr, Brook R. H. Quality of life of epilepsy surgery patients as compared with outpatients with hypertension, diabetes, heart disease, and/or depressive symptoms. Epilepsia. 1994 May-Jun;35(3):597–607. doi: 10.1111/j.1528-1157.1994.tb02480.x. [DOI] [PubMed] [Google Scholar]
- Watson E. K., Mayall E. S., Lamb J., Chapple J., Williamson R. Psychological and social consequences of community carrier screening programme for cystic fibrosis. Lancet. 1992 Jul 25;340(8813):217–220. doi: 10.1016/0140-6736(92)90477-k. [DOI] [PubMed] [Google Scholar]
- Williams J. K., Schutte D. L. Benefits and burdens of genetic carrier identification. West J Nurs Res. 1997 Feb;19(1):71–81. doi: 10.1177/019394599701900105. [DOI] [PubMed] [Google Scholar]
- Wooldridge E. Q., Murray R. F., Jr The Health Orientation Scale: a measure of feelings about sickle cell trait. Soc Biol. 1988 Spring-Summer;35(1-2):123–136. doi: 10.1080/19485565.1988.9988694. [DOI] [PubMed] [Google Scholar]
- Zeesman S., Clow C. L., Cartier L., Scriver C. R. A private view of heterozygosity: eight-year follow-up study on carriers of the Tay-Sachs gene detected by high school screening in Montreal. Am J Med Genet. 1984 Aug;18(4):769–778. doi: 10.1002/ajmg.1320180424. [DOI] [PubMed] [Google Scholar]
