To the Editor: Previous studies have shown two types of guilt feelings appearing after the disclosure of genetic test results. The first is associated with the transmission of a genetic disease to a child (1), and the second is termed "survivor guilt" (2). Both of these feelings usually involve a reaction formed after an individual learns of the positive test results of blood relatives. We report on a man who felt guilty after hearing of positive test results for the family members of individuals in his support group.

Familial adenomatous polyposis is a rare, heredity, autosomal-dominant disease caused by a germline mutation. Those who are affected by it experience great relief from sharing information and concern with other patients and families. The strong bond that develops among the members of such groups may explain the patient’s feelings of guilt. The patient did not fulfill DSM-IV criteria for major depression and had no personal or family history of psychiatric illness. Consequently, the patient’s primary care physician and nurses had difficulty explaining his anhedonia. The present case suggests that psychiatric specialists should be involved in the genetic counseling system. Moreover, health care providers should pay attention to potential feelings of guilt in their patients that may be directed toward the family members of individuals participating in a support group who may be receiving the results of genetic tests.