PDF(Pubmed)
Abstract：
Recent advances in psychiatric genetics have enabled the use of polygenic risk scores (PRS) to estimate genetic risk for psychiatric disorders. However, the potential use of PRS in child and adolescent psychiatry has raised concerns. This study provides an in-depth examination of attitudes among child and adolescent psychiatrists (CAP) regarding the use of PRS in psychiatry. We conducted semi-structured interviews with U.S.-based CAP (n = 29) who possess expertise in genetics. The majority of CAP indicated that PRS have limited clinical utility in their current form and are not ready for clinical implementation. Most clinicians stated that nothing would motivate them to generate PRS at present; however, some exceptions were noted (e.g., parent/family request). Clinicians spoke to challenges related to ordering, interpreting, and explaining PRS to patients and families. CAP raised concerns regarding the potential for this information to be misinterpreted or misused by patients, families, clinicians, and outside entities such as insurance companies. Finally, some CAP noted that PRS may lead to increased stigmatization of psychiatric disorders, and at the extreme, could be used to support eugenics. As PRS testing increases, it will be critical to examine CAP and other stakeholders\' views to ensure responsible implementation of this technology.
摘要：
精神病学遗传学的最新进展使使用多基因风险评分（PRS）来估计精神疾病的遗传风险。然而,PRS在儿童和青少年精神病学中的潜在应用引起了人们的关注.这项研究深入检查了儿童和青少年精神病医生（CAP）对PRS在精神病学中使用的态度。我们对拥有遗传学专业知识的美国CAP（n=29）进行了半结构化访谈。大多数CAP表明PRS在其当前形式中具有有限的临床效用,并且还没有准备好临床实施。大多数临床医生表示，目前没有什么能激励他们产生PRS；然而，注意到一些例外情况(例如，父母/家庭请求)。临床医生谈到了与订购有关的挑战，口译,并向患者和家属解释PRS。CAP对这些信息可能被患者误解或滥用表示担忧，家庭,临床医生,以及保险公司等外部实体。最后,一些CAP指出，PRS可能导致精神疾病的污名化增加，在极端情况下，可以用来支持优生学。随着PRS测试的增加，这将是至关重要的检查CAP和其他利益相关者的意见，以确保负责任地实施这项技术。
