BlueCross BlueShield of Tennessee Medical Policy Manual

Genetic Testing for Mental Health Conditions

DESCRIPTION

Individual genes and genetic variances have been associated with certain mental health disorders. Individual and panel genetic tests have been proposed as a diagnostic tool and a predictor of risk for several mental health conditions, including schizophrenia, psychotic disorders, depression, bipolar, obsessive-compulsive disorder and substance-related and addictive disorders. Genetic variants that have been implicated in mental health disorders include, but are not limited to:

Note: For genetic testing associated with appropriate medications and their dosing see MCG Psychotropic Medication Pharmacogenetics – Gene Panels ACG: A-0861 (AC).

POLICY

See also: Cytochrome p450 Genotyping

IMPORTANT REMINDERS

ADDITIONAL INFORMATION

Although studies have suggested that there may be a number of genetic variants associated with increased risk of mental health disorders, estimates of the increased risk vary across studies. Evidence is needed showing that testing for variants in these genes leads to changes in clinical management.

SOURCES

BlueCross BlueShield Association. Medical Policy Reference Manual. (6:2016). Genetic testing for mental health conditions (2.04.110). Retrieved June 27, 2017 from BlueWeb. (57 articles and/or guidelines reviewed)

Dubovsky, S. (2016, April) The limitations of genetic testing in psychiatry. Psychotherapy & Psychosomatics, 85:129-135. (Level 5 evidence)

Gatt, J., Burton, K., Williams, L., & Schofield, P. (2015). Specific and common genes implicated across major mental disorders: a review of meta-analysis studies. Journal of Psychiatric Research, 60, 1-13. Abstract retrieved July 18, 2016 from PubMed database.

Jiang, H., Qiao, F., Li, Z., Zhang, Y., Cheng, Y., Xu, X., & Yu, L. (2015). Evaluating the association between CACNA1C rs1006737 and schizophrenia risk: a meta-analysis. Asia Pacific Psychiatry, 7 (3), 260-267. Abstract retrieved July 18, 2016 from PubMed database.

Liu, L., Fan, D., Ding, H., Hu, Y., Cai, G., Wang, L., et al. (2014). The relationship between DRD2 gene polymorphisms (C957T and C939T) and schizophrenia: a meta-analysis. Neuroscience Letters, 583, 43-48. Abstract retrieved July 18, 2016 from PubMed database.

McGrath, L., Cornelis, M., Lee, P., Robinson, E., Duncan, L., Barnett, J., et. al., (2013) Genetic predictors of risk and resilience in psychiatric disorders: A cross-disorder genome-wide association study of functional impairment in major depressive disorder, bipolar disorder, and schizophrenia. American Journal of Medical Genetics Part B: Neuropsychiatric Genetics, 0 (8): 779–788. (Level 1 evidence)

Winifred S. Hayes, Inc. Hayes GTE Synopsis. (2016, April). Genecept assay (Genomind). Retrieved July 18, 2016 from www.Hayesinc.com/subscribers.

ORIGINAL EFFECTIVE DATE:  5/10/2014

MOST RECENT REVIEW DATE:  8/10/2017

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Policies included in the Medical Policy Manual are not intended to certify coverage availability. They are medical determinations about a particular technology, service, drug, etc. While a policy or technology may be medically necessary, it could be excluded in a member's benefit plan. Please check with the appropriate claims department to determine if the service in question is a covered service under a particular benefit plan. Use of the Medical Policy Manual is not intended to replace independent medical judgment for treatment of individuals. The content on this Web site is not intended to be a substitute for professional medical advice in any way. Always seek the advice of your physician or other qualified health care provider if you have questions regarding a medical condition or treatment.

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