Neurogenetic determinism and the new euphenics

Editor—Various implications of advances in understanding of the genetic contribution to susceptibility to neuropsychiatric disorders must be debated. Rose’s article on this subject, however, contains important errors of fact, severely misrepresents current research, and is neither reasoned nor balanced.1 He accuses researchers of simplistically assuming that behaviours are genetically determined. In fact, most researchers in the field, ourselves included, are fully aware of the complexity of pathogenesis and accept a model in which both genetic and non-genetic factors influence susceptibility to disease.2–4 Rose makes the unfounded and disingenuous presumption that researchers seek to identify genes “with a view to ... aborting fetuses which show the potential for ... undesirable characteristics or generating drugs which will alleviate the condition, turn gays into straights, or radicals into conservatives.” This emotive statement both misrepresents and trivialises the aim of most research, which is to better define the pathophysiology of major psychiatric disorders such as schizophrenia and bipolar disorder. Rose gives the impression that this desirable end is a fortuitous byproduct of research. In fact, it is the primary motivation. Rose also attacks psychiatrists for creating illnesses where none exist. He offers attention deficit hyperactivity disorder as an example that he claims “was almost unknown in the United Kingdom a decade ago” and berates psychiatrists for prescribing the stimulant methylphenidate as a treatment. Attention deficit hyperactivity disorder may be a new name, but it describes a syndrome that has undergone almost a century of study and is certainly not merely a label for naughty and disruptive children.5 Rose is wrong to claim that it is not a valid diagnosis, and to maintain that people with this condition should not have the opportunity to benefit from potentially effective treatment seems both unsympathetic and arrogant. Most researchers in psychiatric genetics reject the notion of neurogenetic determinism. Their modest goal is to contribute to improved understanding and treatment of the major psychiatric illnesses that cause so much suffering to so many. Rose should stop propounding his familiar but outdated antipsychiatry, antigenetic message and adopt a more constructive and informed position. We need to work together to ensure that the opportunities provided by molecular genetics are used to the benefit of our patients.