ELSIcon2022 • Paper • June 1, 2022
Stacey Pereira, Katrina Muñoz, Takahiro Soda, Brent Small, Laura Torgerson, Clarissa Sanchez, Jehannine Austin, Eric Storch, Gabriel Lázaro-Muñoz
Progress in the identification of genomic loci associated with psychiatric disorders has increased the reliability of psychiatric polygenic risk scores (PRS). Estimates suggest that the onset of psychiatric disorders and prodromal features start by mid-20s in most cases. Thus, as risk prediction tools, psychiatric PRS may be used with children and adolescents. Given the position of child and adolescent psychiatrists (CAP) to influence the implementation of psychiatric PRS, it is critical to understand their perspectives. This study assessed 962 US-based CAP’s experiences, perspectives, and potential uses of psychiatric PRS. Ten percent of respondents have had a patient/family bring PRS to them, 4% have generated PRS for patients, and 25% stated they would request PRS if a patient/caregiver asked. Most respondents (54%) believed psychiatric PRS are currently at least slightly useful and 87% believed they will be so in five years. More than 70% endorsed indicated they would take actions in response to a hypothetical child with a top 5th percentile psychiatric PRS but no diagnosis: 48% would increase prospective monitoring of symptoms, 42% would evaluate for current symptoms, and 4% would prescribe medications. Yet, most respondents were concerned that high PRS results could lead to overtreatment and negatively impact patients’ emotional well-being. Findings indicate emerging use of psychiatric PRS within child and adolescent psychiatry in the US. Thus, it is critical to examine the ethical and clinical challenges that PRS may generate and begin efforts to promote their informed and responsible use.