From determining genes to complex networks
On the geneticisation of mental illness

written by: Dr Ingrid Baart and Marjan Slob

© May 2008, VU University Medical Center

Psychiatric genomics has for some considerable time clung on to a relatively simplistic approach to genetics, but we are currently witnessing the emergence of complex genomics. Four inter-related developments are driving this transition: the modernisation of psychiatric research; fundamental changes in conceptualisation of psychiatric disorders; research into endophenotypes; and the gene-environment interaction model.

This essay analyses these developments and investigates whether, notwithstanding all the subtle distinctions, complex genomics does indeed lead to geneticisation, with genes as the fundamental arbiters. The research practices of two Dutch research consortia, which have been mapping the development and course of psychosis, anxiety and depression since 2004, will be used as a case study.

As a result of research findings within genomics, the current classification of psychiatric disorders will give way to newly defined disorders, and our knowledge of the development and course of these disorders will also change profoundly. This form of geneticisation will not, however, lead to genetic reductionism or determinism. Under the influence of this research, psychiatric disorders will emerge as the products of 'inward' and 'outward' factors − factors which, in isolation, frequently leave no visible traces in the organism. These developments present openings for changes in psychiatric interventions and in the shaping of subjectivity. The most likely scenario is that people with some form of mental illness will be less likely to be marginalised by society as 'mad', but at the same time they will be expected to take greater responsibility for their condition.