Stigma through the generations

One in three people with a strong family history of bipolar disorder (manic depression) are reluctant to have children due to the hereditary nature of the illness and its perceived social stigma, new research from the University of New South Wales (UNSW) has found.

The findings, to be published this month in the journal Psychological Medicine, suggest the negative attitude to childbearing is significantly more pronounced with bipolar disorder than with other hereditary diseases such as Huntington disease or hereditary cancer - even when the genetic risks are lower.

Researchers from UNSW's Faculty of Medicine surveyed 200 people with a strong family history of bipolar disorder, including 105 with the illness, and found that more than a third (35 per cent) was either unwilling or less willing to have children. That number rose to 50 per cent among those diagnosed with the condition.

Lead author of the study, Associate Professor Bettina Meiser, from the School of Psychiatry at UNSW and the Psychosocial Research Group at Sydney's Prince of Wales Hospital, said the attitude was pronounced.

"The proportion of people less willing or unwilling to have children is not in line with other genetic disorders," Meiser said.

"We know from studies into childbearing among people at high risk of cancer, for example, where the lifetime risk for a gene mutation carrier can be 80 per cent or more, that attitudes to child bearing are not affected in any significant way.

"Even having a very serious disorder, such as Huntington disease, doesn't deter that many people from having children.

"Our research shows that what makes bipolar disorder unique is the stigma.

"Even people unaffected but with a strong family history of the disease suffered 'associative stigma' and a perception in society that they may be unsuitable marriage partners and parents.

"The main message of this study is the stigma; its detrimental effects on childbearing attitudes, and the psychological distress it creates."

Meiser said the study pointed to the need for more education.

"Providing families with genetic risk information is important, but this study suggests that society as a whole needs to be better educated about mental health disorders, and in particular the effective treatments available for these."

UNSW researchers Professor Philip Mitchell, Dr Nadine Kasparian, Dr Shab Mireskandari, Dr Laila Tabassum and Professor Peter Schofield (Prince of Wales Medical Research Institute) were co-authors on the study alongside Ms Kim Strong and Associate Professor Judy Simpson from the University of Sydney.

Source: UNSW