Sri Lankan Twin Registry: Challenges, Barriers and Lessons Learned

Sumathipala A. & Siribaddana S.H.

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12th International Congress on Twin Studies (ICTS2007), Ghent, Belgium | International Society for Twin Studies

Twin Research and Human Genetics, Volume 10, Issue S1, Page 53

doi:10.1375/twin.10.supp.23

Abstract

As with any new initiatives, we faced many obstacles. Determination, commitment and team work were our strengths. Acquisition of basic knowledge was vital. This demanded networking with experienced international twin researchers. Collaboration was based on mutual benefits and scientific merit, but not on economically cheap and easy research in the developing world. As twin research unites diverse disciplines, forming a multidisciplinary team was essential, but for most local colleagues the concept was new. However, enlisting support was not difficult but consolidating what was achieved was challenging. Funding was the most difficult, as it so competitive and is usually available for people with credentials. Local ethical framework was inadequate.

Ethical guidelines had to be developed for informed consent processes, data collection, storage and access to the database and collection, storage and access to the human biological material including genetic material, funding, commercial exploitation, international collaboration, and dissemination of results and authorship. This was to safeguard the Sri Lankan interests as the moral ‘rights’ and ‘wrongs’ are not absolute but vary with the culture. We initiated a volunteer register and worked towards a population-based register. Local capacity building for twin research was one of the main objectives of the project. We have not only managed to achieve this goal of 20,000 population-based twins in one district (25 of such in Sri Lanka) but also gained a wealth of experience through the whole process. These include how to face challenges, barriers and hurdles in establishing an ethical research culture especially in the developing world.

A Successful Model of a North-South Collaboration

Abstract

Hotopf M., Hewage S., & Siribaddana S.H.

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12th International Congress on Twin Studies (ICTS2007), Ghent, Belgium | International Society for Twin Studies

Twin Research and Human Genetics, Volume 10, Issue S1, Page 35

doi:10.1375/twin.10.supp.23

Abstract

This presentation will describe the process of setting up a population-based twin study in Sri Lanka, funded by Wellcome Trust, and representing a collaboration between the Sri Lankan Twin Registry and the Institute of Psychiatry, King’s College London. This study has recruited nearly 2000 twin pairs, and 2000 singletons sampled from an identical sampling frame, and has collected data on common mental disorders, substance misuse, post-traumatic stress disorder and somatic symptoms.

The main issues in developing such a collaboration will be described and include: (a) gaining funding; (b) developing relations of trust; (c) developing research which is culturally appropriate; (d) learning to communicate from a distance; (e) having robust research governance; and (f) ensuring the project adds value for both parties.

The Heritability of Somatic Symptoms in a Sri Lankan Twin Sample

Ball H.A., Siribaddana S., Sumathipala A., McGuffin P., & Hotopf M.

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12th International Congress on Twin Studies (ICTS2007), Ghent, Belgium | International Society for Twin Studies

Twin Research and Human Genetics, Volume 10, Issue S1, Page 23

doi:10.1375/twin.10.supp.23

Abstract

Few twin studies have examined large representative samples in nonwestern, developing countries. This is important to address because the relative magnitude of environmental influences on common mental disorders may differ in populations experiencing qualitatively and quantitatively different environmental risk factors to those commonly experienced in more developed countries. It has been suggested that depressed people in nonwestern populations often present with a high rate of somatic symptoms. We measured somatic symptoms that are cross-nationally associated with depression and anxiety, using the Bradford Somatic Inventory (BSI), on our population-based twin sample (N = 930 adult pairs).

We ran variance components models in Mx to assess the relative contribution of genetic (A), shared environmental (C) and nonshared environmental (E) factors to the variance in BSI scores. The shared environmental factor accounted for 20% of the variance in BSI scores for females, but none for males. The rest of the variance was accounted for by genetic and nonshared environmental factors in approximately equal proportions. Environmental as well as genetic factors are important in explaining somatic symptoms in Sri Lanka, and the environmental influences differ in men and women. These results are a good indicator of the relative importance of genetic and environmental factors on anxious and depressive disorders in this population.