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Family Practice Vol. 18, No. 1, 78-83
© Oxford University Press 2001

Psychological Problems

A randomized controlled trial to assess the psychological impact of a family history screening questionnaire in general practice

Nadeem Qureshi, PJ Standena, Rhydian Hapgood and Joanna Hayesa

Division of General Practice and
a Division of Psychiatry, University of Nottingham, Nottingham, UK.

Correspondence to Dr Qureshi, Division of General Practice, Medical School, Nottingham University, Queens Medical Centre, Nottingham NG7 2UH, UK.

Background. It has been postulated that systematic enquiry about patients' family histories of inherited illnesses would lead to a population of ‘worried well’.

Objective. The purpose of the present study was to evaluate if the use of a family history screening questionnaire (FHSQ) as part of a general practice health check leads to psychological distress.

Method. We conducted a randomized controlled trial of a self-administered FHSQ in a single general practice. Individuals who had not had a health check within the previous 2 years were randomized within three age group strata to intervention group (receiving health check and FHSQ) or control group (only receiving health check). A total of 156 patients were offered health checks; 100 accepted and 76 of them were followed through to the 3-month end point. Responses to the six-item Spielberger State–Trait Anxiety Inventory (STAI), Perception of Health questionnaire and Family History Concern questionnaire were compared between intervention and control groups.

Results. A two-way analysis of variance on the STAI scores 1 and 2 weeks after the health check with baseline scores as a covariate showed that at both times anxiety was higher in the intervention group than in the controls (F = 6.4; d.f. = 1,73; P = 0.014). Three months later, there was no significant difference between the two groups. The Perception of Health questionnaire only showed a significant result at 1 week, the intervention group having a more pessimistic response to the question eliciting patient's concerns about future health (P = 0.025).

Conclusion. Short-term psychological distress due to the family history screening questionnaire was identified but did not persist.

Keywords. Anxiety, genetic screening, medical history taking, primary health care, randomized controlled trial.


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