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

Abstract

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.