Analysis of 88 adult patients referred for genetics evaluation

We present a series of 88 adult patients referred for diagnostic genetic services in two settings. Patients referred for prenatal diagnosis, adult‐onset neurodegenerative disease or cancer susceptibility counseling were specifically excluded from analysis. Information was obtained regarding age, gender, referral sources, previous genetics evaluation, referring diagnosis, final diagnosis, diagnostic test, and recommendations. The patients were able to be grouped into seven general categories: multiple congenital anomalies with or without mental retardation (26 patients), collagen‐connective tissue disorders (18 patients), mental retardation (12 patients), chromosomal abnormalities (12 patients), bone growth disorders (6 patients), endocrine/metabolic (8 patients), and miscellaneous (6 patients). Patients and referring providers were not surveyed regarding utility of the evaluation. However, genetics notes were reviewed on all patients and potential benefits of the evaluation were identified. All patients had at least one potential benefit, with the majority having several. This study represents one of the largest published groups of non‐institutionalized adult patients that have undergone comprehensive genetic evaluation. The role of the clinical geneticist as a member of the health care team in this population will be discussed. © 2007 Wiley‐Liss, Inc.

[1]  M. Butler,et al.  Clinical and cytogenetic survey of institutionalized mentally retarded patients with emphasis on the fragile-X syndrome. , 2008, Journal of intellectual disability research : JIDR.

[2]  J. Edwards,et al.  Lost in transition: Challenges in the expanding field of adult genetics , 2006, American journal of medical genetics. Part C, Seminars in medical genetics.

[3]  J. Moeschler,et al.  Clinical Genetic Evaluation of the Child With Mental Retardation or Developmental Delays , 2006, Pediatrics.

[4]  E. Mignot,et al.  Kleine-Levin syndrome: a systematic review of 186 cases in the literature. , 2005, Brain : a journal of neurology.

[5]  L. Ruddick Health of people with intellectual disabilities: a review of factors influencing access to health care. , 2005, British journal of health psychology.

[6]  K. Ormond,et al.  Outline of a medical genetics curriculum for internal medicine residency training programs , 2004, Genetics in Medicine.

[7]  P. McCallion,et al.  Health characteristics and health services utilization in older adults with intellectual disability living in community residences. , 2002, Journal of intellectual disability research : JIDR.

[8]  M. Porteous Management of genetic syndromes , 2002, Human Genetics.

[9]  Alastair Baker,et al.  Crossing the Quality Chasm: A New Health System for the 21st Century , 2001, BMJ : British Medical Journal.

[10]  F Olesen,et al.  Improving the interface between primary and secondary care: a statement from the European Working Party on Quality in Family Practice (EQuiP) , 2001, Quality in health care : QHC.

[11]  R. Wender,et al.  Defining responsibility for screening. , 1999, Surgical oncology clinics of North America.

[12]  K. Devriendt,et al.  Down syndrome in a population of elderly mentally retarded patients: genetic-diagnostic survey and implications for medical care. , 1999, American journal of medical genetics.

[13]  B. D. de Vries,et al.  Dilemmas in counselling females with the fragile X syndrome , 1999, Journal of medical genetics.

[14]  Hegele Ra Lifestyle and genetic susceptibility , 1998 .

[15]  B. Knoppers,et al.  Bioethics for clinicians: 14. Ethics and genetics in medicine. , 1998, CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne.

[16]  S. Michie,et al.  Genetic counselling: the psychological impact of meeting patients' expectations. , 1997, Journal of medical genetics.

[17]  M. Hayden,et al.  Adverse psychological events occurring in the first year after predictive testing for Huntington's disease. The Canadian Collaborative Study Predictive Testing. , 1996, Journal of medical genetics.

[18]  J. E. Hand Summary of national survey of older people with mental retardation in New Zealand. , 1993, Mental retardation.

[19]  J. Fryns,et al.  A clinical, cytogenetic and familial study of 307 mentally retarded, institutionalized, adult male patients with special interest for fra(X) negative X‐linked mental retardation , 1991, Clinical genetics.

[20]  H B Newcombe,et al.  Genetic disorders in children and young adults: a population study. , 1988, American journal of human genetics.

[21]  R. Göstason Psychiatric Illness Among the Mentally Retarded: A Swedish population study , 1985, Acta Psychiatrica Scandinavica Supplementum.

[22]  H. Brunner,et al.  The clinical phenotype in institutionalised adult males with X-linked mental retardation (XLMR). , 2001, Annales de genetique.

[23]  H. Brunner,et al.  Metabolic studies in older mentally retarded patients: significance of metabolic testing and correlation with the clinical phenotype. , 2001, Genetic counseling.

[24]  P. Reid,et al.  Older adults with lifelong intellectual handicap in New Zealand: prevalence, disabilities and implications for regional health authorities. , 1996, The New Zealand medical journal.