Skip to main content
SpringerLink
Log in

The contingency of psychiatric genomics in a Dutch research consortium

  • Original Article
  • Published:
BioSocieties Aims and scope Submit manuscript

Abstract

Psychiatric genomics is made in practice. Developments in psychiatric genomics are the result of an open, contingent process in which different stakeholders – scientists, policymakers, professionals and patients – are involved. This article examines the practices and perspectives of scientists in two long-term, large-scale Dutch psychiatric research consortia that are mapping the origin and development of psychosis, anxiety and depression. The article also explores the perspectives of the funding agency and patients and patient organizations that are in contact with the research consortium on psychoses. What are the issues and concerns of scientists involved in psychiatric genomics, what do they expect genomics will mean for psychiatry, what kind of research are they conducting? What are the issues, concerns and expectations of the main funding agency? How do patients and patient organizations regard developments in psychiatric genomics, and how do they relate to the ongoing research? The conclusion is that different psychiatric futures – not necessarily resulting in geneticized disorders – may emerge from multiple developments in the field. Developments in this case study appear to be contingent on international developments in scientific research; on scientists’ different perspectives of what psychiatric disorders are; on national and European traditions in psychiatry, and on the input of patients and patient organizations into research.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

Notes

  1. GROUP (Genetic Risk and Outcome of Psychosis) is the consortium that is conducting research into the factors that can make individuals vulnerable to a non-affective psychosis or factors that can protect them against such a psychosis. The collaboration involves a total of four university medical centres (AMC Amsterdam, Groningen, Utrecht and Maastricht) and 33 Dutch mental health institutions. The research commenced in May 2004, the recruitment of subjects is now complete, and the database includes over 3000 individuals. NESDA (Netherlands Study of Anxiety and Depression) is researching the aetiology and course of depression and anxiety, having got under way in August 2004. Three academic medical centres are involved in the collaboration (VU Amsterdam, Groningen and Leiden), together with 8 mental health institutions and several other institutions, including client interest groups. Here too, the enrolment of subjects is now complete. The NESDA database encompasses some 3000 people. Both studies will run until 2012. See: www.group-project.nl and www.nesda.nl.

  2. The names of all respondents in this article, scientists and patients, are fictitious.

  3. Although patients consider the link between psychosis and trauma important, it is anathema to many psychiatric researchers since they do not wish to become embroiled, once again, in hypotheses suggesting that there may be a link between the parents’ behaviour and psychosis in their children. This hypothesis has now resurfaced in the scientific community – albeit in combination with a genetic susceptibility to psychosis.

  4. On an overall level there are no differences to be pointed out between GROUP and NESDA. The differences in NESDA are less sharp for two reasons: (1) anxiety and depression are common disorders with both minor and major forms of expression, while psychoses are considered to be major disabling disorders; (2) there is no NESDA member that represents a ‘hard core’ biological perspective.

  5. From a historical viewpoint there is nothing new here. Freud already spoke of an Ergänzungsreihe (‘complementary series’) of endogenous and environmental factors involved in mental disorders. The point here is that despite all this, under the influence of the Human Genome Project, biological psychiatry in the 1990s and early twenty-first century saw a wave of genetic reductionism. A possible explanation might be found in the fact that shifts in dominant explanations of mental disorders during the last century – from psychoanalytical and social psychiatric to biological perspectives – often involved firm standpoints and animosity between competing professional communities. This situation fostered extreme standpoints, biological as well as social ones (Shorter, 1997).

  6. The psychoanalytical perspective in the bio-psycho-social model in the Netherlands has been marginalized, and came in for harsh criticism in the interviews. Rivers, for example, dubbed the psychoanalytical perspective on autism in French psychiatry as ‘criminal’. Psychology mostly means cognitive psychology.

  7. There is a debate in the philosophy of psychiatry about whether we need naturalistic categories to answer the question ‘what is mental disorder’. Bolton (2008) defends the viewpoint that a disorder comes about through personal suffering and social demarcations between ‘normality’ and ‘abnormality’.

  8. It is known that several heterogeneous factors both genetic and environmental are implicated in the manifestation of high blood pressure. It is often difficult to determine whether a person's blood pressure is too high for that particular individual. According to Rivers, the same also applies in the case of psychiatric symptoms.

  9. Once the International Evaluation Committee of ZonMw had identified the lack of patient participation as a weak point in the GROUP project, the GROUP board decided to rectify this situation by setting up a Patients involvement committee, including scientists, research assistants and members of Anoiksis and family organization Ypsilon (see below). Plans have been made (not yet executed) to develop a Top ten of research questions from a patient's and family's perspective that could be answered by using GROUP's huge database.

References

  • Allardyce, J. and Boydell, J. (2006) Review: The wider social environment and schizophrenia. Schizophrenia Bulletin 33: 592–598.

    Google Scholar 

  • Andreasen, N.C. (2001) Brave New Brain. Conquering Mental Illness in the Era of the Genome. Oxford, UK: Oxford University Press.

    Google Scholar 

  • Anthony, W.A. (2001) Editorial: Decade of the person. Psychiatric Rehabilitation Journal 24: 1.

    Article  Google Scholar 

  • Barry, A. (2001) Political Machines: Governing a Technological Society. London: The Athlone Press.

    Google Scholar 

  • Bentall, R. (2004) Madness Explained. London: Penguin.

    Google Scholar 

  • Boevink, W. (ed.) (2005) Stories of Recovery. Working Towards Experiential Knowledge in Mental Health Care. Utrecht, the Netherlands: Trimbos-instituut.

    Google Scholar 

  • Bolton, D. (2008) What is Mental Disorder? An Essay in Philosophy, Science and Values. Oxford, UK: Oxford University Press.

    Book  Google Scholar 

  • Braff, D.L. (2007) Introduction: The use of endophenotypes to deconstruct and understand the genetic architecture, neurobiology, and guide future treatments of the group of schizophrenias. Schizophrenia Bulletin 33: 19–20.

    Article  Google Scholar 

  • Braff, D.L., Freedman, R., Schork, N.J. and Gottesman, I.I. (2007) Deconstructing schizophrenia: An overview of the use of endophenotypes in order to understand a complex disorder. Schizophrenia Bulletin 33: 21–32.

    Article  Google Scholar 

  • Burmeister, M., McGinnis, M.G. and Zöllner, S. (2008) Psychiatric genetics: Progress among controversies. Nature Reviews Genetics 9 (7): 527–540.

    Article  Google Scholar 

  • Bijker, W.E. and Law, J. (eds.) (1992) Shaping Technology/Building Society: Studies in Sociotechnical Change. Cambridge, MA: The MIT Press.

    Google Scholar 

  • Cantor-Graae, E. and Selten, J.P. (2005) Schizophrenia and migration: A meta analysis and review. American Journal of Psychiatry 162: 12–24.

    Article  Google Scholar 

  • Caspi, A. and Moffit, T.E. (2006) Gene-environment interactions in psychiatry: Joining forces with the neurosciences. Nature Neuroscience 7 (7): 583–590.

    Article  Google Scholar 

  • Caspi, A., Sugden, K., Moffit, T.E., Taylor, A., Craig, I.W. and Harrington, H. (2003) Influence of life stress on depression: Moderation by a polymorphism in the 5-HTT gene. Science 301 (5631): 386–389.

    Article  Google Scholar 

  • Caspi, A. et al (2002) Role of genotype in the cycle of maltreated children. Science 297 (5582): 851–854.

    Article  Google Scholar 

  • Collins, H.M. and Evans, R. (2002) The third wave of science studies: Studies of expertise and experience. Social Studies of Science 32 (2): 235–296.

    Article  Google Scholar 

  • Conrad, P. and Gabe, J. (1999) Introduction: Sociological perspectives on the new genetics: An overview. Sociology of Health & Illness 21: 505–516.

    Article  Google Scholar 

  • Cougnard, A. et al (2006) Does normal development expression of psychosis combine with environmental risk to cause persistence of psychosis? A psychosis proneness-persistence model. Psychological Medicine 37: 1–14.

    Google Scholar 

  • Craddock, N. and Forty, L. (2006) Genetics of affective (mood) disorders. European Journal of Human Genetics 14: 660–668.

    Article  Google Scholar 

  • Epstein, S. (1995) The construction of lay expertise: AIDS activism and the forging of credibility in the reform of clinical trials. Science Technology & Human Values 20 (4): 408–437.

    Article  Google Scholar 

  • Fearon, P. and Morgan, C. (2006) Environmental factors in schizophrenia: The role of migrant studies. Schizophrenia Bulletin 32: 405–408.

    Article  Google Scholar 

  • Flint, J. and Munafò, M.R. (2007) The endophenotype concept in psychiatric genetics. Psychological Medicine 37: 163–180.

    Article  Google Scholar 

  • Hedgecoe, A. (2001) Schizophrenia and the narrative of enlightened geneticization. Social Studies of Science 31: 875–911.

    Article  Google Scholar 

  • Hess, D.J. (2004) Medical modernisation, scientific research fields and the epistemic politics of health social movements. Sociology of Health & Illness 26 (6): 695–709.

    Article  Google Scholar 

  • Jacobs, N., Kenis, G., Peeters, F., Derom, C., Vlietinck, R. and van Os, J. (2006) Stress related negative affectivity and genetically altered serotonin transporter function. Evidence of synergism in shaping risk of depression. Archives of General Psychiatry 63: 989–996.

    Article  Google Scholar 

  • Johns, L.C. and van Os, J. (2001) The continuity of psychotic experiences in the general population. Clinical Psychology Review 21 (8): 1125–1141.

    Article  Google Scholar 

  • Kahn, R.S. (2006) De keuze voorbij: organisme en omgeving. Den Haag, the Netherlands: Gezondheidsraad.

    Google Scholar 

  • Kendler, K.S. (2005) Psychiatric genetics: A methodological critique. American Journal of Psychiatry 162 (1): 3–11.

    Article  Google Scholar 

  • Kessing, L.V. (2007) Epidemiology of subtypes of depression. Acta Psychiatrica Scandinavica 433: 85–89.

    Article  Google Scholar 

  • Lakhan, S.E. and Vieira, K.K. (2009) Schizophrenia pathophysiology: Are we any closer to a complete model? Annals of Genetic Psychiatry (May 15) 8: 12.

  • McCabe, J., O'Daly, R., Murray, P., McGuffin, P. and Wright, P. (2006) Beyond Nature and Nurture in Psychiatry: Genes, Environment and their Interplay. London: Informa Healthcare.

    Book  Google Scholar 

  • Moffit, T.E., Caspi, A. and Rutter, M. (2006) Measured gene-environment interactions in psychopathology. Concepts, research strategies, and implications for research, intervention, and public understanding of genetics. Perspectives on Psychological Science 1: 5–28.

    Article  Google Scholar 

  • Morgan, C. and Fisher, H. (2007) Environmental factors in schizophrenia: Childhood trauma – a critical review. Schizophrenia Bulletin 33: 3–10.

    Article  Google Scholar 

  • Nowotny, H. (2005) The increase of complexity and its reduction. Emergent interfaces between the natural sciences, humanities and social sciences. Theory, Culture & Society 22 (5): 15–31.

    Article  Google Scholar 

  • Oudshoorn, N. and Pinch, T. (eds.) (2003) How Users Matter. The Co-construction of Users and Technology. Cambridge, MA/London: The MIT Press.

    Google Scholar 

  • Perälä, J. et al (2007) Lifetime prevalence of psychotic and bipolar I disorders in a general population. Archives of General Psychiatry 64: 19–28.

    Article  Google Scholar 

  • Pickersgill, M. (2009) Between soma and society: Neuroscience and the ontology of psychopathy. BioSocieties 4: 45–60.

    Article  Google Scholar 

  • Psychiatric GWAS Consortium Steering Committee. (2008) A framework for interpreting genome-wide association studies of psychiatric disorders. Molecular Psychiatry 14: 10–17.

  • RGO (Raad voor GezondheidszOnderzoek). (2007) Patiëntenparticipatie in onderzoek. Den Haag, the Netherlands: RGO Advies.

  • Rose, N. (2007) The Politics of Life Itself: Biomedicine, Power and Subjectivity in the Twenty-first Century. Princeton, NJ: Princeton University Press.

    Book  Google Scholar 

  • Shelton, R.C. (2007) The molecular biology of depression. Psychiatric Clinics of North America 30: 1–11.

    Article  Google Scholar 

  • Shorter, E. (1997) A History of Psychiatry: From the Era of the Asylum to the Age of Prozac. New York: John Wiley & Sons.

    Google Scholar 

  • Stefansson, H. et al (2008) Large recurrent microdeletions associated with schizophrenia. Nature 455 (7210): 232–236.

    Article  Google Scholar 

  • Stefansson, H. et al (2009) Common variants conferring risk of schizophrenia. Nature, 1 July, Epub ahead of print, pp. 1–4.

  • Stein, M.B., Schork, N.J. and Gelernter, J. (2007) Gene-by-environment (serotonin transporter and childhood maltreatment) interaction for anxiety sensitivity, an intermediate phenotype for anxiety disorders. Neuropsychopharmacology 33 (2): 312–319.

    Article  Google Scholar 

  • Sullivan, P., Neale, M.C. and Kendler, K.S. (2000) Genetic epidemiology of major depression: Review and meta-analysis. American Journal of Psychiatry 157: 1552–1562.

    Article  Google Scholar 

  • Tupasela, A. (2007) Re-examining medical modernization: Framing the public in Finnish biomedical research policy. Public Understanding of Science 16: 63–78.

    Article  Google Scholar 

  • van Os, J. (2003a) De nieuwe psychose, Trimbos lecture. Utrecht, the Netherlands: Trimbos-instituut.

    Google Scholar 

  • van Os, J. (2003b) Is there a continuum of psychotic experiences in the general population? Epidemiologia e psichiatria sociale 12 (4): 242–252.

    Article  Google Scholar 

  • van Os, J., Krabbendam, L., Myin-Germeys, I. and Delespaul, P. (2005) The schizophrenia environment. Current Opinion in Psychiatry 18: 141–145.

    Article  Google Scholar 

  • van Os, J., Park, S.B.G. and Jones, P.B. (2001) Neuroticism, life events and mental health: Evidence for person environment correlation. British Journal of Psychiatry 178 (suppl. 40): s72–s77.

    Google Scholar 

  • Veling, W., Selten, J.-P., Susser, E., Laan, W., Mackenbach, J.P. and Hoek, H.W. (2007) Discrimination and the incidence of psychiatric disorders among ethnic minorities in The Netherlands. International Journal of Epidemiology 36 (4): 761–768.

    Article  Google Scholar 

  • Vollema, M.G. (1999) Schizotypie: Towards the psychological heart of schizophrenia. Thesis, Rijksuniversiteit Groningen, the Netherlands.

  • Vonk, R., Van der Schot, A.C., Kahn, R.S., Nolen, W.A. and Drexhage, H.A. (2007) Is autoimmune thyroiditis part of the genetic vulnerability (or an endophenotype) for bipolar disorder? Biological Psychiatry 62 (2): 135–140.

    Article  Google Scholar 

  • ZonMw. (2006) Programma GeestKracht 2001–2011. Tussentijdse evaluatie. Den Haag, the Netherlands: ZonMw.

Download references

Acknowledgements

I thank GROUP, NESDA, Anoiksis, Ypsilon and ZonMw for their inspiring collaboration. The Mental illness, genomics and society project is part of the research programme of the Centre for Society and Genomics, based in Nijmegen, the Netherlands, which is funded by the Netherlands Genomics Initiative, in The Hague, the Netherlands.

Author information

Authors and Affiliations

  1. Metamedica Department, VU University Medical Centre, Van der Boechorststraat 7, Amsterdam, 1081 BT, The Netherlands

    Ingrid L M A Baart

Authors
  1. Ingrid L M A Baart
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Baart, I. The contingency of psychiatric genomics in a Dutch research consortium. BioSocieties 5, 256–277 (2010). https://doi.org/10.1057/biosoc.2010.2

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1057/biosoc.2010.2

Keywords

Search

Navigation