The digital revolution has transformed society and forever altered the practice of psychiatry. Technology permeates our daily lives and poses new social and professional challenges (Table 1).1 The speed, range, and permanence of digital communication magnify both its efficiency and the effects of breeches in professionalism. Few standards exist regarding the use of technology in medicine, and those that do exist can become quickly outdated as technology advances and patient expectations and standard-of-care practices continue to change. In psychiatry, professional challenges are heightened by the importance of the psychiatrist-patient relationship. Because of its intimacy, the sensitivity of clinical content, and stigma about mental illness, the psychiatrist-patient relationship must be one of safety and trust. However, psychiatric patients deserve the same access to medical information and up-to-date clinical care practices that all medical patients merit and that technology may enhance. How can psychiatrists integrate technology professionally into clinical practice? This article addresses key concerns that can arise with the use of technology. It then looks at promising technological opportunities that can be integrated into psychiatric practice while respecting professional boundaries. Finally, recommendations for use of technology in psychiatric practice are discussed. Clinical care and liability While technology offers opportunities for improving … Continue reading →

Genome-wide association studies (GWAS) represent an unbiased and hypothesis-free method based on the data produced by the human HapMap Project and the fact that genetic variance at one locus can predict, with high probability, genetic variance at adjacent loci.49 As such, the human genome can be surveyed for common variants (those present in more than 5% of the population) by genotyping about 500000 accurately chosen markers, so-called tag single nucleotide polymorphisms.50 GWAS have led to the identification of thousands of loci that affect susceptibility to complex disorders, broadening understanding of the pathogenesis of many diseases.51 However, inherent drawbacks of these studies are an inability to identify sequence variants (the studies identify loci) and rare alleles, detection of non-coding variants of unknown effect, reproducibility, and, in most cases, identification of susceptibility variants that confer only a small risk of disease. In a genome-wide scan (followed by hierarchical fine mapping in a larger dataset) of six multiplex families with familial idiopathic pulmonary fibrosis from southeastern Finland, Hodgson and colleagues52 identified a shared haplotype on chromosome 4q31 that was more common in affected individuals than in healthy controls. This haplotype harboured ELMOD2, a gene expressed in alveolar macrophages and alveolar epithelium. Although ELMOD2 … Continue reading →

Inheritance Dr. Sharon Moalem (Grand Central Publishing) In Town: The author will appear at the Ottawa Writers Festival on April 24 at 6:30 p.m., Knox Presbyterian Church, 120 Lisgar St. When Californian Craig Venter sequenced his own genome in the year 2000, he wittingly started a great transformation that is now taking hold in the delivery of health care. But that change is unfolding in a global society that is not ready. Thats the warning delivered by Dr. Sharon Moalem, a medical doctor, geneticist, businessman, inventor and author of the book Inheritance: How Our Genes Change Our Lives and Our Lives Change Our Genes. Moalem will appear at the Ottawa Writers Festival and what he has to say is kind of mind-blowing. First of all, because we now have the ability to sequence everyones genome and see all the markers that a person has, we can see clearly the consequences of personal choices. For example, one person may not be able to metabolize caffeine and probably shouldnt drink a lot of coffee, while another has no problem with sugar and can drink all the soft drinks she wants. For Moalem, who has focused on rare diseases over his career, sequencing … Continue reading →