Jehannine Austin

Associate Professor, Psychiatry & Medical Genetics , University of British Columbia

Dr. Jehannine Austin researches matters related to genetic testing, genetic counselling and psychiatric disorders

Media

What is Psychiatric Genetic Counseling?

Have you wondered about what genetic counseling for psychiatric illness might *really* be all about?

Personal Health Data Sharing for Personalized Medicine

Webcast sponsored by the Irving K. Barber Learning Centre and hosted by the LSI Lecture Series. Come together for conversations about types of personal health data, opportunities that arise from integrating these data for health and economic benefits, and issues in secure and ethical storage and sharing of these data. ‘Conversationists’Dr Elodie Portales-Casamar, Clinical Informatics Specialist, Child & Family Research InstituteDr Nancy Meagher, Executive Director, Population Data BCDr Larry Lynd, Professor, UBC Collaboration for Outcomes Research and Evaluation (CORE)Dr Zsuzsanna Hollander, PROOF CentreDr Paul Terry, President & CEO, PHEMI Health Systems Inc.Dr Alice Virani, Clinical Ethicist, Children’s and Women’s Hospital of BC. Moderator: Dr. Jehannine Austin – Associate Professor, UBC Psychiatry/Medical GeneticsDiscussion Document: Roadmap for Bringing Personalized Medicine to British Columbians. In the Media:Vancouver company Phemi’s software promises to keep private data secure

CBC/Radio-Canada, May 8, 2015Radio/Podcast

URL: http://www.cbc.ca/player/play/2666771096

Earlier this year, a controversial science experiment in China where scientists "edit" a human embryo, to tweak its DNA, has some calling for a moratorium on anything like it in the future. But others say, it offers hope for a much brighter future.

Unique genetic counselling program helps empower people with mental health disorders

Vancouver Sun, December 26, 2013Online

URL: http://www.vancouversun.com/health/Unique+genetic+counselling+program+helps+empower+people+with+mental+health+disorders/9325226/story.html

“We’re seeing the adult children of parents with mental illness,” said Austin, noting they come to counselling to find out what their chances are of developing a mental illness, or whether their own children could face problems. “A lot of them come in these doors with a sense of fatalism,” she said. “In the absence of a really coherent explanation, people will construct their own explanations. And those explanations for themselves can make them feel doomed. They think: ‘Just because my mother has schizophrenia, so will I.’ But these are not conditions that are entirely caused by genes.”...

Serving families with science and empathy

Science Magazine, June 2, 2016Online

URL: http://www.sciencemag.org/careers/2016/06/serving-families-science-and-empathy

Genetic counselors offer at least part of the psychological support that patients and families need to adjust to their new condition, which often starts with helping them accept the diagnosis itself. “Genetic counseling fundamentally is about helping people to understand what we know from research about the illness that they have or that their family member has,” says NSGC President Jehannine Austin, “and it’s helping them to deal with all of the emotional issues that … relate to explanations for why somebody developed the illness that they did … so that that family can adapt in a more healthy way.”...

Release from Shame: Genetic counselling can relieve people of guilt that accompanies mental illness

Vancouver Sun, April 11, 2016Online

URL: http://vancouversun.com/health/local-health/release-from-shame-genetic-counselling-can-relieve-people-of-guilt-that-accompanies-mental-illness

Genetic counselling is often misunderstood as a way to select genetically superior offspring, according to Jehannine Austin, professor of psychiatry and medical genetics at the University of B.C. The process was originally used to counsel parents of children born with genetic disorders — such as Down Syndrome — and for people dealing with adult-onset diseases such as Huntington’s disease. “Huntington’s is one of those diseases that is entirely genetic. If you have the gene, you will get the disease,” said Austin, who founded the world’s first genetic counselling clinic. “Psychiatric disorders such as schizophrenia, bipolar disorder, depression and anxiety are quite different — they are not entirely genetic in origin.”

Genes help explain why anxiety strikes during adolescence

Stat News, March 21, 2016Online

URL: https://www.statnews.com/2016/03/21/genetics-anxiety-teens/

While this certain version of the FAAH gene is associated with decreased anxiety, anxiety is a complex disorder that develops from the interplay between many gene variations and experiences. At this point genetic testing would not be helpful, said Jehannine Austin, associate professor at the University of British Columbia. This variant is just “one of a whole large number of different genetic variants that can increase or decrease vulnerability,” she explained...

Genetic Counseling May Help Dispel Myths About Mental Illness For Psychiatric Patients

Medical Daily, February 24, 2016Online

URL: http://www.medicaldaily.com/genetic-counseling-schizophrenia-patients-374987

"Traditionally genetic counselling is applied to conditions that are caused entirely by genes like Huntington's disease," said senior author Dr. Jehannine Austin, an associate professor at the University of British Columbia, in a statement. "Psychiatric disorders arise because of a combination of genes and experience and our study shows that genetic counselling is just as valuable for these patients."...

Genetic counseling: A growing area of opportunity

Science Magazine, June 13, 2016Online

URL: http://www.sciencemag.org/careers/2016/06/genetic-counseling-growing-area-opportunity

This expansion is already underway in the United States, and the need for these trained professionals will continue growing into the foreseeable future, the U.S. Bureau of Labor Statistics forecasts. It predicts a 29% growth rate for genetic counseling jobs between 2014 and 2024, as compared to an average rate of 7% across all occupations. “So we’re in a position at the moment where people who graduate with genetic counseling [master’s] degrees essentially have their pick of what they would like to do,” says National Society of Genetic Counselors (NSGC) President Jehannine Austin...

Genome Magazine Kicks Off “Code Talkers” National Essay Contest to Honor Genetic Counselors, Sponsored by Invitae

Business Wire, June 23, 2016Online

URL: http://www.businesswire.com/news/home/20160623005235/en/Genome-Magazine-Kicks-%E2%80%9CCode-Talkers%E2%80%9D-National-Essay

“As the leading voice for genetic counselors, NSGC is honored to host presentation of Genome’s Code Talker Award during our conference,” said Jehannine Austin, NSGC President. “As we celebrate the 35th anniversary of our members coming together for education and networking, it is fitting that we provide this unique opportunity for patients to celebrate the impact of genetic counselors on their lives and the lives of their family members.”...

DNA testing to identify best psychiatric drug for patients still uncertain: study

Latinos Health, October 5, 2015Online

URL: http://www.latinoshealth.com/articles/10387/20151005/dna-testing-identify-best-psychiatric-drug-patients-still-uncertain-study.htm

Dr. Jehannine Austin, PhD wrote in the Psychiatric Times in 2013, "No genetic test can predict with certainty who will and who will not become mentally ill. Despite this, there remains considerable value in identifying the genetic variants that increase risk of psychiatric disorders."...

A medical test that aims to wean America off painkillers

CNBC, May 6, 2016Online

URL: http://www.cnbc.com/2016/05/06/a-medical-test-that-plans-to-wean-us-off-opioid-painkillers.html

Jehannine Austin, president of the National Society of Genetic Counselors and associate professor of psychiatry and medical genetics at the University of British Columbia, said that while the Proove test is novel, it targets an important problem, and she knows of no other test like it. Yet she worries about the appeal of genetic testing's potential profits moving ahead of the science to support them. "Opioid addiction, like most human behavioral traits, is a very complex issue that is hugely unlikely to be comprehensively explained by a small set of genetic variations," said Austin. "Most human behaviors and common conditions like addictions seem to result from the combined effects of genes and experiences working together. ... I worry that this is too simple of a strategy to address the real issue." She added, "There is danger associated with people assuming that any problems that they have with addictions are entirely genetically determined. It can lead to fatalism or overestimation of risk for children experiencing similar problems."...

How to Talk with Families About Genetics and Psychiatric Illness
by Holly Landrum Peay & Jehannine Claire Austin
W. W. Norton & Company
January 1, 2011
978-0-393-70549-2

Addressing clients’ questions and concerns about the role of genetics in mental illness. As we learn more about how our biology and genes can play into the development of a mental health disorder, patients and their families are increasingly seeking answers to tough questions about common risk factors, the likelihood of recurrence, the need for genetic testing, and implications for future generations. A practical, go-to resource for all mental health clinicians, this guide explains just how to

Perinatal psychosis in mothers with a history of major depressive disorder

Published by Archives of Women's Mental Health

2016 While women with a history of major depressive disorder (MDD) have higher chances for postpartum depressive and manic episodes, little is known about their chance for postpartum psychosis (PPP). We prospectively assessed the frequency of perinatal psychotic symptoms among primiparous women with a history of MDD only (structured clinical interview was used to exclude women with pre-existing histories of mania or psychosis) and explored whether sex of the baby influenced these symptoms. The presence of symptoms of psychosis was defined using previously established cutoff scores on five key items from the Positive and Negative Syndrome Scale (PANSS), which was administered during pregnancy, at 1 week, 1 month, and 3 months postpartum. Fourteen of 60 women (23 %) scored above threshold for psychosis at one or more time points, with 6 experiencing postpartum onset. There was a non-significant trend (p = 0.073) towards higher frequency of these symptoms among mothers of girls. If controlled studies using diagnostic interviews confirm that psychotic symptoms are relatively common among women with MDD, monitoring for psychosis during the perinatal period may be indicated in this population. The potential effect of sex of the baby on mothers’ chance for PPP requires further study.

URL: http://link.springer.com/article/10.1007/s00737-015-0561-9

Obsessive-Compulsive Disorder: The Process of Parental Adaptation and Implications for Genetic Counseling

Published by Journal of Genetic Counseling

2015 Obsessive-compulsive disorder (OCD) has primarily pediatric onset and well-documented unique impacts on family functioning. Limited research has assessed the understanding that parents of children with OCD have of the etiology of the condition, and there are no data regarding potential applications of genetic counseling for this population. We recruited 13 parents of 13 children diagnosed with OCD from the OCD Registry at British Columbia Children’s Hospital, and conducted qualitative semi-structured telephone interviews to explore participants’ experiences with their child’s OCD, causal attributions of OCD, and perceptions of two genetic counseling vignettes. Interviews were audio-recorded, transcribed, and analyzed using elements of grounded theory qualitative methodology. Analysis revealed key components and contextual elements of the process through which parents adapt to their child’s OCD. This adaptation process involved conceptualizing the meaning of OCD, navigating its impact on family dynamics, and developing effective illness management strategies. Adaptation took place against a backdrop of stigmatization and was shaped by participants’ family history of mental illness and their child’s specific manifestations of OCD. Parents perceived genetic counseling, as described in the vignettes, as being empowering, alleviating guilt and blame, and positively impacting treatment orientation. These data provide insight into the process of parental adaptation to pediatric OCD, and suggest that genetic counseling services for families affected by OCD may help facilitate adaptation to this illness.

URL: http://link.springer.com/article/10.1007/s10897-015-9914-9

Mania and depression in the perinatal period among women with a history of major depressive disorders

Published by Archives of Women's Mental Health

2014 Women with a history of major depressive disorder (MDD) have increased risks for postpartum depression, but less is known about postpartum mania in this population. The objectives of this study were to prospectively determine the frequency with which mania occurs in the postpartum among women who have a history of MDD and to explore temporal relationships between onset of mania/hypomania and depression. We administered the Structured Clinical Interview for DSM IV disorders (SCID) to pregnant women with a self-reported history of MDD to confirm diagnosis and exclude women with any history of mania/hypomania. Participants completed the Edinburgh Postnatal Depression Scale and Altman Self-Rating Mania Scale (ASRM) once during the pregnancy (∼26 weeks) and 1 week, 1 month, and 3 months postpartum. Among women (n = 107) with a SCID-confirmed diagnosis of MDD, 34.6 % (n = 37) experienced mania/hypomania (defined by an ASRM score of ≥6) at ≥1 time point during the postpartum, and for just over half (20/37, 54 %), onset was during the postpartum. The highest frequency of mania/hypomania (26.4 %, n = 26) was at 1 week postpartum. Women who experienced mania/hypomania at 1 week postpartum had significantly more symptoms of mania/hypomania later in the postpartum. A substantive proportion of women with a history of MDD may experience first onset of mania/hypomania symptoms in the early postpartum, others may experience first onset during pregnancy. Taken with other recent data, these findings suggest a possible rationale for screening women with a history of MDD for mania/hypomania during the early postpartum period, but issues with screening instruments are discussed.

URL: https://link.springer.com/article/10.1007/s00737-013-0408-1

Healthy Young Minds: The Effects of a 1-hour Classroom Workshop on Mental Illness Stigma in High School Students

Published by Community Mental Health Journal

2015 This study aimed to test the effects of a 1-h classroom-based workshop, led by medical students, on mental illness stigma amongst secondary school students. Students (aged 14–17) from three public secondary schools in British Columbia participated in the workshop. A questionnaire measuring stigma (including stereotype endorsement and desire for social distance) was administered immediately before (T1), immediately after (T2), and 1-month after the workshop (T3). A total of 279 students met the study inclusion criteria. Total scores on the stigma scale decreased by 23 % between T1 and T2 (p < 0.01). This was sustained 1-month post-workshop with a 21 % stigma reduction compared to pre-intervention (p < 0.01). This effect was primarily due to improvements in scores that measured desire for social distance. There were no significant changes in scores that measured stereotype endorsement. Adolescents’ stigmatizing attitudes can be effectively reduced through a 1-h easily implementable and cost-effective classroom-based workshop led by medical students.

URL: http://link.springer.com/article/10.1007/s10597-014-9763-2

Healthy young minds: The effects of a 1-hour classroom workshop on mental illness stigma in high school students

Published by Community Mental Health Journal

2014 This study aimed to test the effects of a 1-h classroom-based workshop, led by medical students, on mental illness stigma amongst secondary school students. Students (aged 14–17) from three public secondary schools in British Columbia participated in the workshop. A questionnaire measuring stigma (including stereotype endorsement and desire for social distance) was administered immediately before (T1), immediately after (T2), and 1-month after the workshop (T3). A total of 279 students met the study inclusion criteria. Total scores on the stigma scale decreased by 23 % between T1 and T2 (p < 0.01). This was sustained 1-month post-workshop with a 21 % stigma reduction compared to pre-intervention (p < 0.01). This effect was primarily due to improvements in scores that measured desire for social distance. There were no significant changes in scores that measured stereotype endorsement. Adolescents’ stigmatizing attitudes can be effectively reduced through a 1-h easily implementable and cost-effective classroom-based workshop led by medical students.

URL: https://link.springer.com/article/10.1007/s10597-014-9763-2

Disclosure of psychiatric manifestations of 22q11.2 deletion syndrome in medical genetics: A 12-year retrospective chart review

Published by American Journal of Medical Genetics

2015 Individuals with 22q11.2 deletion syndrome (22qDS) have increased risk for psychiatric disorders. However, while medical geneticists self-report discussing psychiatric features of 22qDS with families (though often only when the child is older), most parents of children with 22qDS report receiving information about the psychiatric manifestations of 22qDS from non-medical sources. In an attempt to reconcile these previous findings, we sought to objectively determine the frequency with which medical geneticists discuss the potential psychiatric manifestations of 22qDS: (i) in letters to referring physicians and (ii) with families, and to explore plans for follow-up. We abstracted data from charts of patients with 22qDS who were referred to a single medical genetics center between January 1, 2000 and December 31, 2012. Psychiatric disorders were discussed in consult letters to referring physicians for n = 57 (46%) of the 125 patients who met inclusion criteria—making them less frequently discussed than all other features of 22qDS. Despite exhaustive review of charts, the content of discussions with families was typically unclear. Follow-up in medical genetics was suggested for 50 people but only 18 (36%) of these patients returned. Disclosure of psychiatric features of 22qDS to families is necessary so that psychiatric disorders can be identified in time for early intervention to be implemented to achieve better prognosis for those affected. These empiric data offer some explanation as to why psychiatric services are underused by individuals with 22qDS.

URL: http://onlinelibrary.wiley.com/doi/10.1002/ajmg.a.37190/abstract

Effective self-management strategies for bipolar disorder: A community-engaged Delphi Consensus Consultation study

Published by Journal of Affective Disorders

2016 Self-management represents an important complement to psychosocial treatments for bipolar disorder (BD), but research is limited. Specifically, little is known about self-management approaches for elevated mood states; this study investigated self-management strategies for: (1) maintaining balance in mood, and (2) stopping progression into hypomania/mania.

URL: http://www.jad-journal.com/article/S0165-0327(15)31434-8/abstract

Conceptualizing Genetic Counseling as Psychotherapy in the Era of Genomic Medicine

Published by Journal of Genetic Counseling

2014 Discussions about genetic contributions to medical illness have become increasingly commonplace. Physicians and other health-care providers in all quarters of medicine, from oncology to psychiatry, routinely field questions about the genetic basis of the medical conditions they treat. Communication about genetic testing and risk also enter into these conversations, as knowledge about genetics is increasingly expected of all medical specialists. Attendant to this evolving medical landscape is some uncertainty regarding the future of the genetic counseling profession, with the potential for both increases and decreases in demand for genetic counselors being possible outcomes. This emerging uncertainty provides the opportunity to explicitly conceptualize the potentially distinct value and contributions of the genetic counselor over and above education about genetics and risk that may be provided by other health professionals. In this paper we suggest conceptualizing genetic counseling as a highly circumscribed form of psychotherapy in which effective communication of genetic information is a central therapeutic goal. While such an approach is by no means new—in 1979 Seymour Kessler explicitly described genetic counseling as a “kind of psychotherapeutic encounter,” an “interaction with a psychotherapeutic potential”—we expand on his view, and provide research evidence in support of our position. We review available evidence from process and outcome studies showing that genetic counseling is a therapeutic encounter that cannot be reduced to one where the counselor performs a simple “conduit for information” function, without losing effectiveness. We then discuss potential barriers that may have impeded greater uptake of a psychotherapeutic model of practice, and close by discussing implications for practice.

URL: https://link.springer.com/article/10.1007/s10897-014-9728-1

A Pilot Randomized Clinical Trial Evaluating the Impact of Genetic Counseling for Serious Mental Illnesses

Published by The Journal of Clinical Psychiatry

2016 The serious mental illnesses schizophrenia, schizoaffective disorder, and bipolar disorder are complex conditions affecting 1% to 4% of the population. Individuals with serious mental illnesses express interest in genetic counseling, an intervention showing promise for increasing patient knowledge and adaptation. This trial aimed to evaluate the effects of genetic counseling for people with serious mental illnesses as compared to an educational intervention or wait list.

URL: http://www.psychiatrist.com/JCP/article/Pages/2016/v77n02/v77n0210.aspx

Biography

Dr. Jehannine Austin is an Associate Professor in Psychiatry & Medical Genetics at the University of British Columbia in Vancouver, Canada, where she holds the Canada Research Chair in Translational Psychiatric Genomics. She is President of the National Society of Genetic Counsellors and is Graduate Advisor to the UBC Genetic Counselling Training Program. Her research work uses a clinical genetics perspective to inform the development of interventions to improve outcomes for individuals with psychiatric disorders and to support their families. She investigates the effects of genetic counselling for people with psychiatric disorders, and in addition to writing a book on this subject, founded the worlds first specialist psychiatric genetic counselling service, which has now helped about 500 families in British Columbia. She received the 2013 International Leadership award from NSGC, and in 2015 received the inaugural professional practice, innovation and advocacy leadership award from the Canadian Association of Genetic Counsellors. She is happy to talk about matters related to genetic testing, genetic counselling and psychiatric disorders.

Recognition/Reconnaissance

Canada Research Chair in Translational Psychiatric Genomics | Professional

Tier 2

Additional Titles and Affiliations

Acting Head Department of Psychiatry University of British Columbia

2016 President National Society of Genetic Counselors

Expertise

  • Scientific Writing
  • Science
  • Neuroscience
  • Molecular Genetics
  • Lifesciences
  • Genomics
  • Genetics
  • Clinical Research

Education/Éducation

  • University of Wales College of Medicine
    Neuropsychiatric Genetics
    Ph.D., 2001
  • University of Bath
    Biochemistry
    B.Sc., 1997
  • University of British Columbia
    Genetic Counseling
    M.Sc., 2003