The Health Blogosphere: What It Means for Policy Debates and Journalism (16 July, 2008)

Kaiser Alert
Wednesday, July 16, 2008
The Health Blogosphere: What It Means for Policy Debates and Journalism

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On Tuesday, July 29, the Kaiser Family Foundation is sponsoring a discussion about the growing influence of blogs on health news and policy debates. Only in the past few years has the blogosphere become mainstream. In the health policy arena, we now see policymakers, journalists, researchers and interest groups utilizing this new media tool to deliver information to their audiences.

The briefing will highlight how the traditional health policy world has embraced blogging and will feature a keynote address by U.S. Department of Health and Human Services Secretary Michael Leavitt, the first cabinet officer to author an official blog, followed by a moderated discussion with a variety of health policy bloggers and a media analyst. Questions to be explored with the panelists include: Why do individuals and organizations blog? How does blogging impact the broader work of an organization? Are there different standards used when blogging versus other writing? Have blogs impacted the news business significantly? What kind of influence are blogs having on political and policy debates?

Welcome and Introduction

Drew Altman, President and Chief Executive Officer,
Kaiser Family Foundation

Keynote Address

The Honorable Michael O. Leavitt
Secretary, U.S. Department of Health and Human Services

Panel Discussion

Vicky Rideout (moderator)
Vice President, Kaiser Family Foundation and
Director, Kaiser Forum on Health Journalism and the News Business

Jacob Goldstein, Wall Street Journal

Michael Cannon, Cato Institute

Ezra Klein, American Prospect Magazine

John McDonough, Office of Senator Edward Kennedy and formerly of Health Care for All in Massachusetts

Tom Rosenstiel, Center for Excellence in Journalism

WHEN: Tuesday, July 29, lunch served at 12:30 p.m. and program begins at 1:00 p.m.
Add this event to your Outlook Calendar (Please note that all times are ET).

WHERE: Barabara Jordan Conference Center, 1330 G Street, NW, Washington, DC. For those who cannot attend, the event will be webcast live.

RSVP: If you plan to attend the event, please send your name and affiliation to rsvp@kff.org.

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Women ‘using web for abortions’ (BBC, 2008)

Women ‘using web for abortions’
By Jane Dreaper
Health correspondent, BBC News

Some women in countries where abortion is restricted are using the internet to buy medication enabling them to abort a pregnancy at home, the BBC has learned.

Women in Northern Ireland and over 70 countries with restrictions have used one of the main websites, Women on Web.

A British Journal of Obstetrics and Gynaecology review of 400 customers found nearly 11% had needed a surgical procedure after taking the medication.

The website says it can help reduce the problems linked with unsafe abortions.

‘Stressful experience’

But anti-abortion campaigners called the development of such sites “very worrying indeed”.

The research into those who had used Women on Web found that about 8% did not end up using the medication they had ordered.

Almost 11% went on to need a surgical procedure - either because the drugs had not completed the abortion or because of excessive bleeding.
I think it’s very important women have this resource to turn to in that situation
Women on Web customer

Almost 200 women answered questions about their experiences - 58% said they were just grateful to have been able to have had an abortion in this way, while 31% had felt stressed but found the experience acceptable.

Women on Web posts the drugs only to countries where abortion is heavily restricted, and to women who declare they are less than nine weeks’ pregnant.

A US woman, who has a rare medical complication meaning pregnancy is life-threatening to her, described her experience when she used the website while in Thailand.

FROM THE TODAY PROGRAMME

Please turn on JavaScript. Media requires JavaScript to play.

“Women on Web kept in contact with me via e-mail. The medication arrived through Customs, properly blister-packed, with complete paperwork and a doctor’s signature.

“Medication from other websites came in unmarked bottles with no instructions or paperwork - it was quite frightening.

“I was not very far along - only three or four weeks. It went smoothly for me.

“I think it’s very important women have this resource to turn to in that situation - and they can need it for a number of reasons.”

‘Reputable site’

The Family Planning Association in Northern Ireland has had several calls from women considering buying abortion pills online.

ABORTION IN NORTHERN IRELAND
Northern Ireland was not included in the 1967 Abortion Act, which liberalised access to termination on the mainland.
At present a woman is generally given an abortion if she has a serious medical or psychological problem that endangers her life if she continues with her pregnancy, has severe learning difficulties, or if doctors detect foetal abnormalities.
Social abortions are less easily accessible, although critics say the law lacks clarity.

The FPA said that on two occasions, women bought drugs without appropriate medical information. They experienced complications and needed aftercare.

Northern Ireland FPA director Audrey Simpson said: “The Women On Web site is very helpful and reputable.

“But for Northern Ireland women, it is encouraging them to break the law - and as an organisation, we have to work within the law.

“We’re really concerned about women accessing the rogue sites - we’re hearing about it and we know it’s happening.

“There are potentially serious medical complications for women from sites which aren’t well managed and this could be the new era of backstreet abortions.”

Anti-abortion campaigners said they were appalled by such websites.

Josephine Quintavalle, from the group Comment on Reproductive Ethics, said: “This is very worrying indeed. It represents further trivialisation of the value of the unborn child.

“It’s like taking abortion into the shadows. These drugs have side-effects and tragedies will increase.”

Are you affected by the issues in this story? What are your experiences? Send us your comments using the form below.

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Story from BBC NEWS:
http://news.bbc.co.uk/go/pr/fr/-/1/hi/health/7500237.stm

Published: 2008/07/11 04:28:40 GMT

© BBC MMVIII

MBA: Is cyber medicine turning us into a nation of expert patients?

MBA: Is cyber medicine turning us into a nation of expert patients?

Researchers from Manchester Business School and The University of Glasgow are undertaking an in-depth study into the impact of cybermedicine, such as virtual health communities and self-help sites, on face-to-face healthcare. They are looking for volunteers to share their experiences and take part in an online survey.

Funded by the NHS National Institute of Health Research Service Delivery and Organisation Programme, the research responds to the rise of the ‘expert patient’ who uses cybermedicine to self-diagnose, and the decline in the deference traditionally linked to professional judgement.

Dr Debbie Keeling, research associate at Manchester Business School explains:

“The project examines how a patient’s use of the internet affects their interaction with healthcare professionals, how they select the most appropriate treatment and most importantly, how it impacts upon their health. The study aims to provide a detailed analysis of cybermedicine, which will be used to help ensure patients receive the best possible choice of treatments and services from health professionals in the future.”

The key aims of the project are:

to quantify the extent and patterns of patients’ use of the internet as a health information resource and identify the factors that lead to variations in behaviour arising from accessing information
to identify the search strategies employed by patients in accessing health information on the internet and the evaluative approaches used in assessing the quality of available information
to analyse the membership, content and dynamics of virtual health communities and identify how participation in such communities is integrated into patients’ engagement with healthcare services
to document and conceptualise the evolving nature of patient-professional interaction arising from patient access to healthcare information and the subsequent format of the healthcare encounter
to assess the effect of changing patient access to information and the renegotiation of the healthcare encounter on patterns of patient decision making, health behaviour and, where feasible, measurable health outcomes
The research will focus on patients affected by cancer (breast and prostate), diabetes and depression. It aims to help determine future NHS policy and strategic planning, and improve organisation and service delivery, training and development.

Professor Angus Laing, The University of Glasgow, said:

“The internet is changing the way we live our lives and the consequences for healthcare is profound  - changing the expectations of patients and confronting professionals with new challenges. The image in the popular media is of hard-pressed doctors besieged by patients waving internet-printout. Yet such simplification disguises a much more complex pattern of change, where increasing diversity of behaviour is the key change.”

The Nintendo Wii and BMI

Nintendo Apologizes for Wii Fit BMI Offenses

http://news.softpedia.com/news/Nintendo-Apologizes-for-Wii-Fit-BMI-Offenses-86028.shtml

- Backlash continues against the fitness game

By: Andrei Dumitrescu, Games Editor

Enlarge picture

Last week, we reported on the girl who was offended by the fact that the Wii Fit game considered her to be… a little above the recommended weight as it was constructed based on her other physical attributes. The story itself seems a bit on the fishy side but, nevertheless, the parents of other kids,

presumably overweight themselves, expressed outrage at the fact that a game would dare to imply that their kids were fat.

If you ask me, this is snowballing into something newsworthy just because it’s about the Wii Fit, which is a clear success as far as videogames go. The sole purpose of the game is to get people back into exercising and it’s only natural that it would make an evaluation of the Body Mass Index of the person so that it can recommend the best exercises. It’s absurd to ask from a game not to hurt someone’s feelings. It’s only numbers that the game shows and it’s up to you to draw the appropriate conclusions from them.

Nevertheless, Nintendo has released a statement in which it apologizes for any sensibilities hurt. The statement reads: “Nintendo would like to apologize to any customers offended by the in-game terminology used to classify a player’s current BMI status, as part of the BMI measurement system integrated into Wii Fit. Wii Fit is still capable of measuring the BMI for people aged between two and 20 but the resulting figures may not be entirely accurate for younger age groups due to varying levels of development”.

Despite this, the backlash against Nintendo and its Body Mass Index continues. Tam Fry, who represents the United Kingdom’s National Obesity Forum, stated that “I’m absolute aghast that children are being told they are fat. BMI is far from perfect, but with children it simply should not be used. A child’s BMI can change every month and it is perfectly possible for a child to be stocky, yet still very fit”.

Nintendo has announced that it does not plan to change the way the game displays BMI, since it is clear in the fact that it does not judge anyone, but only offers accurate data on the fitness level of the player.

Google Health

Article at the Hastings Center’s Bioethics Forum:

Thursday, May 22, 2008
Google Health: Organizing Your Medical Information
BY KARAMA C. NEAL

http://www.bioethicsforum.org/Google-health-electronic-medical-records-patient-privacy-advertising.asp

The press and blogs have been talking about it for a while, but on May 19, Google finally launched Google Health, a service that allows those who sign up for it to create their own personal electronic medical record system. Users will be able to enter their health information, manage it, and access it anywhere they

Personal electronic health records: MySpace or HealthSpace? (BMJ

BMJ, doi:10.1136/bmj.39567.550301.80 (published 6 May 200

The NHS, through Connecting for Health, is introducing two types of online health record for everybody in England—the summary care record and HealthSpace.^{1 2} The summary care record is being introduced in five “early adopter” pilot sites. An independent evaluation of this implementation was released this week.³ Delays in deployment, with summary care records in only two sites to date, mean that the evaluation cannot provide the concrete answers that many people were hoping to see regarding consent, patient acceptance, and clinical benefits.

The summary care record is a centrally stored summary of health information created initially from general practitioner records. It contains information on current medications, adverse reactions, and allergies. Proponents of the summary care record expect to see improved patient safety, with reductions in preventable errors, improved access to vital information, and better informed patients.¹

HealthSpace is a separate initiative that allows patients to record selected data in their . . . [Full text of this article]

Tim Berners Lee on the Medicalization of Cyberspace

Well, more or less. He recently invoked an example of concern about online surveillence:

http://news.bbc.co.uk/1/hi/technology/7299875.stm 

Sir Tim said he did not want his ISP to track which websites he visited.

“I want to know if I look up a whole lot of books about some form of cancer that that’s not going to get to my insurance company and I’m going to find my insurance premium is going to go up by 5% because they’ve figured I’m looking at those books,” he said.

This speaks to Chapters 4 and 7 in our book!.

Medicine 2.0 (un)conference (Toronto, 2008, Sept 4-5)

Medicine 2.0 (un)conference - How Social Networking and Web 2.0 Changes
Health, Health Care, and Biomedical Research

Toronto/Canada, MaRS Discovery District, Sept 4-5th
http://www.medicine20congress.com/
=============================

(to blog about this event use banners provided at
http://www.medicine20congress.com/sponsors.php)

Medicine 2.0 (http://www.medicine20congress.com/) is an international
conference on Web 2.0 applications in health and medicine, organized and
co-sponsored by the Journal of Medical Internet Research, the International
Medical Informatics Association, the Centre for Global eHealth Innovation,
CHIRAD, and a number of other sponsoring organizations. It takes place at
the MaRS Discovery District in Toronto/Canada, Sept 4th-5th, 2008.

Pre-register now to get on our mailing list:
http://www.medicine20congress.com/preregistration.php

IMPORTANT DATES
———————–
Conference Abstract / Panel Proposal Submission Deadline: May 2nd, 2008
Abstract Decisions emailed to Presenters: June 16th, 2008
Early Bird Registration Deadline & Speaker Registration Deadline: June
30th, 2008
Hotel Reservation Deadline: July 25th, 2008
Medicine 2.0 Conference: September 4-5th, 2008

———————————————————
CALL FOR ABSTRACTS AND PANEL PROPOSALS
———————————————————
(see http://www.medicine20congress.com/ocs/callforpapers.php)

The Medicine 2.0 Congress on Sept 4-5th in Toronto is now accepting
abstracts, speaker and panel proposals.

The conference invites academic and international contributions, and also
covers areas such as social networking for consumers and health
professionals, Science 2.0, Peer-Review 2.0, and others.

The conference will be accompanied by a JMIR Theme Issue on Medicine 2.0,
containing invited and contributed full papers (selected abstract/panel
presenters may be invited to submit a full paper).

Medicine 2.0 will contain a mix of traditional academic/research, practice
and business presentations, keynote presentations, and panel discussions to
discuss emerging issues. We strive for an interdisciplinary mix of
presenters from different disciplines (e.g. health care, social sciences,
computer sciences, engineering, business) and with a different angle
(research, practice, and business).
Participants are invited to either submit a 500 word abstract to propose a
15 minute single-presenter talk, or can submit a a 500 word panel proposal
to present or discuss a topic in a 45-60 min session with 3-4 colleagues
from other organizations/institutions (panel proposals with all authors
from the same institution are discouraged). Panel presentations are the
preferred format for non-research presentations.

Possible Topics
——————-
• Blogs

• Building virtual communities and social networking applications for
health professionals

• Building virtual communities and social networking applications for
patients and consumers

• Business models in a Web 2.0 environment

• Collaborative biomedical research, academic / scholarly communication,
publishing and peer review

• Consumer empowerment, patient-physician relationship, and
sociotechnical issues

• Ethical & legal issues, confidentiality and privacy

• Health information on the web: Supply and Demand

• Innovative RSS/XML applications

• Personal health records and Patient portals

• Public (e-)health, population health technologies, surveillance

• Search, Collaborative Filtering and Recommender Technologies

• Semantic Web (”Web 3.0″) applications

• The nature and dynamics of social networks in health

• Usability and human factors on the web

• Virtual (3D) environments, Second Life

• Web 2.0 approaches for behaviour change, public health and
biosurveillance

• Web 2.0 approaches for clinical practice, clinical research, quality
monitoring

• Web2.0-based medical education and learning

• Wikis

• Youth and Digital Learning

• other

———————————————————
General Submission Instructions
———————————————————

Note that all abstracts and panel proposals must be submitted on this site
(http://www.medicine20congress.com/ocs/submit.php) only. Submissions by
email will be ignored.
After submission you can edit or change your abstract by returning to the
conference site at http://www.medicine20congress.com/ocs/submit.php before
the abstract submission deadline.

Note that before you can submit you have to pre-register! You will need to
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If you have already preregistered and you forgot your password, go to help.

Please also note that for all submissions you will be asked to nominate two
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pubmed.gov, search for published articles that are in the broadest sense
similar to your abstract/proposal, and make a note of the name and email
address of the corresponding author. You will need the email address, which
is listed in some (but not all) publications in PubMed (affiliation field).
If you have a name/affiliation but not an email address, you may try to
Google it.

Policy on simultaneous or previous publications/other conferences. Results
presented at the Medicine 2.0 congress should preferably be new results,
but overlaps with prior publications or prior/simultaneous submissions to
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The conference language is English. No simultaneous translation will be
provided. All abstracts and proposals must be submitted in English.

For all tracks and presentation formats
———————————————————
Do not use any HTML or attempt to hyperlink to websites.
References. You can cite up to 5 bibliographic or webreferences (note that
cited URLs are treated as reference). The in-text citation must be a number
in square brackets like this [1]. IMPORTANT: Cited webpages (URLs) which are
not journal articles must be archived with WebCite [2].
The References section at the end of the abstract should start with the
word “References”, followed by a line break, and a numbered (1. , 2., …)
list of references in JMIR format (but you do not have to include Medline
links or DOIs, as specified in these instructions). Put each reference on a
new line. See the following example:

References
1. JMIR Instructions for Authors.
URL:http://www.jmir.org/?Instructions_for_Authors:Instructions_for_Authors_of_JMIR#References
WebCite: http://www.webcitation.org/query?id=95905 [cached 29.12.2005)
2. Eysenbach G, Trudel M. Going, Going, Still There: Using the WebCite
Service to Permanently Archive Cited Web Pages. J Med Internet Res
2005;7(5):e60 [URL: http://www.jmir.org/2005/5/e60/]

On submission, authors can select one of the following presentation
formats:

• Oral presentation only
• Oral or poster presentation (let organizers decide)
• Poster presentation

Call for Panel Proposals
———————————————————
Submit panel proposals at http://www.medicine20congress.com/ocs/submit.php
(select “single paper presentation”).
Panels are 45-60 min presentations or debate sessions of a group of leaders
in a field discussing a broad issue of general interest from various
perspectives. Panels are the preferred format for non-research
presentations. If you have an idea for a panel topic, please approach 3-4
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that all potential speakers are available (please also ask your fellow
panelists to preregister). Then draft a short panel proposal, and submit
it.

Panel titles should preferably have the word “panel” in the title, e.g.
“PHR 2.0 Panel”, “Accelerating Research with Web 2.0 Panel”, “Consumer
Empowerment Panel”, “Venture Capitalists and Entrepreneurs Panel”, etc.
Please note that normally we will not be able to cover the registration
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A complete panel proposal should be submitted as “single paper submission”.
Each panelist should be added as presenting coauthors (add an asterisk in
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should contain up to 500 words, containing a short overview of the common
issues and 1-2 sentences per presenter about the contribution of each
panelist.
Please note that research abstracts are better suited to be submitted in
the research track as “single abstract/paper submission”, not as panel
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Submit abstracts at http://www.medicine20congress.com/ocs/submit.php to
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ANY PART OF THE ABSTRACT. The Title Should be in “Title Case”, Meaning That
All Words Except Articles and Prepositions Should Be Capitalized Like in
This Sentence.

Abstracts are invited in 3 tracks: research, practice, and business.

Abstracts in the research track have higher acceptance standards and must
be structured into Background, Objective, Methods, Results, and
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with the respective heading in the same line (e.g. “Background: The
Internet has become…”), with a new section starting on a new line. DO NOT
CAPITALIZE THE SECTION HEADINGS (e.g. do not write “BACKGROUND:”, but
“Background:”). In the results section, make sure to include relevant
statistics, such as sample sizes, response rates, P-values or Confidence
Intervals.

References (citing previous and related work) are good scholarly tradition
and mandatory for Research abstracts. Submissions in the research track
which do not cite references may be rejected or moved to the practice
track. See below on how references should be cited.

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Pro-Ana on Facebook

A news story broke this week that there is a clinic in Cheadle, UK, campaigning to get the pro-ana (Pro-Anorexia) groups out of Facebook. It feels like 2001 all over again. Check out the Sky News story along with some of our quotes for journos below and then take our poll below:

Should Facebook remove Pro-Ana groups? 1) Yes 2) No 3) This is the wrong question 4) Let’s ask the users 5) Phone a friend View Results Make your own poll

We have a few chapters on this subject in our new book, The Medicalization of Cyberspace (Feb, 200 and Emma Rich has been focusing her recent years on these aspects of eating disorders and new media.

Our quotes for journalists:

“While we have no wish to promote eating disorders, we must be cautious not to respond to pro-ana sites as wholly dangerous. Calling for the removal of pro-ana spaces from Facebook will only obscure such communities even further.

As things stand, anyone can join these groups and the identities of users is much clearer than it is for other web spaces. So, if medics are concerned about the users within these communities, they stand a much better chance of offering support than they will by these groups existing in a lower profile webspace.

Rather than remove of these sites, we should be concerned more with the relationship between healthcare professionals and users of such environments. They offer spaces for intervention and support, which allow the concomitant avoidance of the traditional models of monitoring and regulation.

“It would be naïve to assume that people, especially young women, can be swayed into anorexia through social networking sites like facebook. All this does is further pathologise those experiencing the condition. If nothing else, these sites emerge from the desperate need for understanding and social support that these people seek. The content of these pro-ana networks varies greatly, in many instances one can find support from others experiencing an eating disorder.

We should also remember that these same arguments for their removal were used in 2001, when Google was urged to remove Pro-Ana sites from its search engine. What difference did it make, other than ensure that these communities were now out of our view? The users of these environments are far more capable of finding other spaces than regulators are at shutting them down.

Eating disorders are incredibly complex, damaging and isolating conditions, but often remain grossly unreported by those experiencing it. Many of the pro-ana users may not have sought help or reported their condition and facebook may be the only context in which they might be exposed to possible support. .

These spaces are also often the only context in which sufferers will talk about so openly about their experiences. There are few, other social spaces in their everyday lives where people experiencing anorexia can do this, without some form of censorship. Pro-ana sites may therefore offer us a greater insight in terms of helping us to better understand the condition. Anorexia is after all, experienced not simply as an illness, but as an identity, in this sense it is not surprising that communities are formed around it.

The sharing of stories through such environments is an integral part of the condition and so to call for a removal is simplistic and, potentially, more dangerous than their existence. The other point is about whether organizations like Facebook should be empowered to decide what goes on within its space and this level of censorship control extends their role considerably and makes them vulnerable to any high profile media campaign, which has been launched in this case.”

The New story from Sky
Social Sites Push Pro-Ana Beliefs

Julia Reid
Updated:10:04, Monday February 25, 2008
Social networking sites are being used to encourage and promote eating disorders.

Site users seek starving advice

There is nothing new about so-called pro-ana websites that offer ‘thinspiration’ and suggest ways of hiding your problem from friends and family, but the advent of sites like Facebook has allowed groups to be set up very quickly and easily.

On one Facebook group, a user asks: “How can I convince myself not to be hungry?! I want to be thinner, a lot thinner!!”

On the discussion wall of another a member is looking for a ‘thin pal’.

“Anyone up for being weight loss penpals, sharing tips, that sort of thing?” she writes.

But this is not about a pound here or there. It is about fasting, starving, disappearing.

Internet gene tests provoke alarm

Story from Robin McKie in the Guardian last week…
Internet gene tests provoke alarm

http://www.guardian.co.uk/science/2008/feb/03/genetics.mentalhealth

Biotechnology checks for bipolar depression and schizophrenia will soon be sold over the web, despite warnings from leading psychologists

• Robin McKie, science editor
• The Observer,
• Sunday February 3 2008

This article appeared in the Observer on Sunday February 03 2008 on p15 of the News section. It was last updated at 00:08 on February 03 2008.

Plans to sell genetic tests over the internet so people can find out if they are at risk of developing mental illnesses have been denounced by leading UK psychiatrists. They say the technology is still primitive and is only likely to worsen individuals’ emotional and mental problems.

The tests, which biotechnology companies will begin selling in a few months, will allow people to find out, by sending off a spittle sample, if they possess gene variants that increase their chances of suffering bipolar depression or schizophrenia. The information will help both patients and doctors, it is claimed.

But scientists argue that selling these tests on the internet is dangerous. The technology is still in its infancy and cannot yet help make helpful diagnoses.

‘These tests will only worry, confuse and mislead the public and patients,’ said psychiatrist Professor Nick Craddock, of Cardiff University. ‘There is a long way to go before we have genetic tests that may be helpful to patients. Using tests at the moment is only likely to cause harm.’

This point was backed by Professor David Collier, of the Institute of Psychiatry, London. ‘At best, these tests are clinically useless. At worst, their results could cause serious worries for patients.’

The tests are based on recent discoveries of gene variants that can increase a person’s chance of succumbing to depression or schizophrenia. Each variant raises a person’s risks by only a slight margin but if tests for several variants are combined, this creates a useful risk assessment for an individual, firms say.

As a result, several - including NeuroMark in Colorado, Psynomics in California, and SureGene in Kentucky - have developed tests based on these variants and are preparing to sell them for several hundred pounds a test on the internet.

For example, Psynomics has developed a test for pinpointing individuals at risk of depression. ‘This is going to be initially driven by patients,’ John Kelsoe, chief executive, told Science magazine last week.

But the usefulness of such tests was disputed by Dr Cathryn Lewis, also of the Institute of Psychiatry. ‘The general risk of developing bipolar depression is around one per cent. If you possess the worst set of gene variants, then your risk rises to three per cent. That means you are three times more likely than average to get bipolar depression. That may seem worrying but it is still a very low risk. It is still 97 per cent likely that you won’t get depression. People are not likely to realise that, however.’

Another test - to be marketed by NeuroMark, first in the US and later this year in Europe - is based on genes that predispose people to react badly to stress. If a person inherits this gene section from both parents, he or she has an increased chance of suffering from severe depression after stressful situations. ‘About 20 per cent of people have this combination,’ said Kim Bechthold, chief executive of the biotechnology company. ‘It is useful information to know.’

But if a person proves positive, what action can they take to avoid risk and counter the risk they face? ‘We suggest joining a choir, eating chocolate or buying a puppy,’ said Bechthold.

These ideas were dismissed by Craddock. ‘Life is stressful. You cannot avoid it. It is extremely unhelpful to tell people that they face a risk like that.’

In addition, scientists have found only a small number of risk gene variants for psychiatric disorders. Many more await detection, it is thought. ‘The trouble is that if someone takes a test which suggests they face no risk, they could easily think they can then do what they want,’ added Craddock. ‘They might start taking recreational drugs again, which would pose problems if they are prone to depression. Other risk gene variants might later be discovered and new tests developed. Then we will find these people actually have an inherent proneness to depression after all. It will be too late by then, however.’”