• Clinical applications of psychiatric genetic research
• Psychiatric genetic counselling
• The roles of genes and environment in the etiology of postpartum psychiatric disorders and psychotic disorders

I am interested in finding ways to make advances in our understanding of the genetic contribution to major mental illnesses clinically relevant for affected families. I am particularly interested in how families respond to receiving education about genetics as it relates to the psychiatric illness. By exploring the explanations that families affected by major mental illness have for why the illness emerged, as well as their perceptions of genetic risk, I aim to find ways to use education about genetics to decrease stigma and guilt relating to mental illness, and to develop a sense of control.

I am also interested in finding ways to translate advances in our understanding of the role that genes play in major mental illness into practical strategies for reducing the chances of developing the illness in at-risk individuals.

The MTHFR C677T polymorphism and postpartum mental illness in at-risk women
Psychotic disorders, which include schizophrenia, schizoaffective disorder and bipolar disorder, are common mental illnesses affecting approximately 3% of the population. Among the difficult issues faced by women affected by these disorders are some special considerations surrounding pregnancy, delivery and childrearing. Women who have a history of a psychotic disorder have substantial risks for a postpartum episode of mental illness like depression or psychosis. Postpartum mental illness carries risks for suicide and infanticide, as well as other less dramatic but still significant problems like difficulties with parenting skills and problems with mother-child bonding and attachment. As a result, the risk for postpartum mental illness for this population of women is an important consideration. Despite this, little remains known about factors that may increase or decrease risk for developing it. We do know that psychotic disorders arise as a result of interactions between genetic and environmental influences, and some of the genetic variations that contribute to illnesses like schizophrenia are beginning to be discovered. This study aims to investigate whether one particular genetic variation (methylenetetrahydrofolate reductase C677T) contributes to risk for postpartum episodes of mental illness in women who have a history of psychosis. The gene of interest is known to encode a protein whose function is dependant on a particular B vitamin, folate. Thus, if our hypotheses are supported, it may be possible to decrease risk for postpartum episodes of mental illness by providing folate supplements for women who have the genetic variation.

Investigating the utility and potential implications of psychiatric genetic counselling
I am interested in the potential impact of psychiatric genetic counselling for (a) women with a history of a psychotic disorder who wish to become pregnant, and (b) the parents of individuals with early psychosis. These populations are relatively under-researched from the perspective of genetic counselling. I am interested in whether psychiatric genetic counselling can increase knowledge, and decrease guilt and perceived stigma. To date, the research concerning the potential impact of genetic counselling has concentrated primarily on variables including decisions made, anxiety, depression, knowledge, behavioural modification, and satisfaction. However, it is possible that in a disorder-specific manner other measurable psychosocial variables may be affected.

The use of directed research to establish foundations from which to develop evidence-based best practices in knowledge translation for complex disorders
I am interested in perceptions of mental illness (severity, risk, causes, concern for other family members); attitudes towards family planning and predictive testing; and perceived needs for education/intervention among individuals with psychotic disorders and their families. To address some of these issues, I am conducting an online survey on affected individuals and their family members, whose aim is to gain some insight into the existing psychosocial context into which a knowledge translation enterprise like psychiatric genetic counselling would be introduced. Collaborations with researchers in China, Taiwan, Hong Kong, the Netherlands, and India have led to the translation of the survey into Chinese, Dutch and Punjabi, and will allow cross-cultural comparisons.

Austin JC, Palmer C, Sheidley B, McCarthy Veach P, Gettig B, Peay HL. Psychiatric disorders in clinical genetics II: Individualizing recurrence risks for psychiatric disorders. Journal of Genetic Counseling 2008 17(1) p18-29.

Peay HL, Palmer C, Sheidley B, McCarthy Veach P, Gettig B, Austin JC. Psychiatric disorders in clinical genetics I: Assessing family histories of psychiatric disorders. Journal of Genetic Counseling 2008 17(1) p6-17.

Austin JC, and Honer WG. The genomic era and serious mental illness: a potential application for psychiatric genetic counseling. Psychiatric Services 2007. 58(2) p254-261

Austin J. and Peay, H.L. Applications and Limitations of Empiric Data in Provision of Recurrence Risks for Schizophrenia: A practical review for healthcare professionals providing clinical psychiatric genetics consultations. Clinical Genetics 2006. 70 (3) p177-187

Austin J, Smith G.N., and Honer W. The genomic era and families' perceptions of psychotic disorders: Genetic risk estimation, associations with reproductive decisions and views about predictive testing. American Journal of Medical Genetics: Neuropsychiatric Genetics  2006.  141(8) p926-928

Austin, J. Schizophrenia: An update and review. Journal of Genetic Counselling. 2005 14(5) p. 329- 340.

Austin JC, and Honer W. Potential impact of genetic counselling for mental illness. Clinical Genetics. 2005 67(2) pp134-142.

Huezo-Diaz P, Arranz MJ, Munro J, Osborne S, Makoff A, Kerwin RW, Austin J, O'Donovan MC. An association study of the neurotensin receptor gene with schizophrenia and clozapine response. Schizophrenia Research. 2004 66(2-3) pp193-195.