Elective Rotation: Psychiatry

Attention-deficit/hyperactivity disorder, bipolar disorder, generalized anxiety disorder, major depression, obsessive compulsive disorder, schizophrenia, and substance abuse/dependence.  These are all psychiatric illnesses and are all relatively common.  In fact, if you go through someone’s family history you will more than likely run across at least one family member with a history of mental illness.  But how many of them can be seen running in families and have a known genetic component?  If you said all of them, you are correct.

Most of our training as genetic counseling students is focused on less common diseases with better characterized genetics: cystic fibrosis, Lynch syndrome, neurofibromatosis 1 & 2, sickle cell anemia, etc.  However, we all invariably encounter families containing members with more common diseases, such as cancer, diabetes, heart disease, and, of course, mental illness.  While we do receive training in discussing the genetics of these conditions with patients, we rarely get to see patients for whom these diseases and how they affect their families are a main concern. 

Cincinnati Genetic Counseling Program
As a person whose life has been tremendously impacted by mental illness in many ways, I have been especially interested in learning more about these conditions. I was also interested in learning about the experiences of individuals and families affected by these conditions, including  ways to help people cope with mental illness and decrease the stigma surrounding mental illness.

One of the greatest aspects of the University of Cincinnati’s genetic counseling program is that we have the option to do an elective rotation in our second year.  An even better feature is that we have the opportunity and the support to create a rotation if we have a specific interest.  After discussing my interest in psychiatry with our program faculty, I talked to the director of the Division of Psychiatry at Cincinnati Children’s who was very interested in the idea of an elective rotation and helped me set up a 5-week observational rotation with a few psychiatrists.

During my rotation, I shadowed three psychiatrists in very different settings.  I was in a general pediatric psychiatry setting, the Tuberous Sclerosis clinic, and an inpatient unit for children with both psychiatric diagnoses and developmental disabilities.  I saw a total of 19 patients outside of the inpatient unit with a wide variety of psychiatric diagnoses, averaging three per patient.

I learned quite a bit about different psychiatric illnesses: how they are diagnosed, how they present, and how they are treated.  Along those same lines, I was able to create a resource for myself and others containing a list of commonly prescribed medications and what they are primarily used to treat.  During my rotation, I picked up as many resources as I could find in the form of flyers, newsletters, and pamphlets that are specific to the psychiatric services at Cincinnati Children’s.

I hope that my experience in psychiatry and in setting up the rotation will inspire others to pursue a similar rotation.  As psychiatric genetic counseling becomes more widespread, it will be easier for others to get involved in talking to families about the genetics of mental illness.  For now, though, I think it is important that we start that conversation with psychiatry and really show them our interest in merging the two fields.

- Meghann Reardon, second year student