Polygenic Risk Scores in Child and Adolescent Psychiatry Survey

儿童和青少年精神病学调查中的多基因风险评分

• 批准号: 9927929
• 负责人: Gabriel Lazaro-Munoz
• 金额: $ 15.96万
• 依托单位: BAYLOR COLLEGE OF MEDICINE
• 依托单位国家: 美国
• 财政年份: 2015
• 资助国家: 美国
• 起止时间: 2015-08-01 至 2020-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9927929
• 关键词: Address; Adolescence; Adolescent; Adolescent Psychiatry; Age of Onset; Attention deficit hyperactivity disorder; Attitude; Benefits and Risks; Bipolar Disorder; Child; Child Psychiatry; Child Rearing; Childhood; Clinical; Delphi Technique; Disease; Early Intervention; Ethics; Fostering; General Population; Genomics; Goals; Guidelines; Healthcare; Individual; Knowledge; Mental Depression; Mental Health; Mental disorders; Morbidity - disease rate; Onset of illness; Outcome; Parents; Policies; Prevention; Psychiatrist; Research; Research Personnel; Risk; Schizophrenia; Services; Surveys; Symptoms; Testing; autism spectrum disorder; clinical care; emerging adult; expectation; high risk; improved; prevent; psychogenetics; social; social stigma; suicidal risk; tool

PROJECT SUMMARY (Supplement) Psychiatric genetics researchers have recently identified numerous genomic loci associated with schizophrenia, depression, autism spectrum disorder, bipolar disorder, attention deficit hyperactivity disorder, and other disorders. The identification of these genomic loci makes it possible to generate polygenic risk scores (PRS) to stratify an individual’s risk for different psychiatric disorders compared to the general population. The usual age of onset for most psychiatric disorders is during childhood, late adolescence, and early adulthood. As many as 20% of children and adolescents in the U.S. have a diagnosable psychiatric disorder. Numerous studies suggest that early intervention improves clinical outcomes, however, the average duration of untreated symptoms and disorders is generally in the order of years. Thus, there is great need for tools such as PRS to help improve the identification of children and adolescents at higher risk for psychiatric disorders in order to take steps to potentially prevent or delay the onset of disease, minimize morbidity and risk for suicide, or provide early intervention. The promise of reliable PRS in mental health care and prevention is considerable, but there are critical potential ethical and policy challenges. For example: which children and adolescents, if any, should be tested; when, if at all, should children and adolescents be tested; where should they be tested; should PRS testing require a clinician’s order or could it be done through direct-to-consumer services; who should have access to children and adolescents’ psychiatric PRS results; how should these results be used; what kind of impact would PRS results have on children and adolescents who are at increased risk; how may high PRS impact parents/guardians’ expectations and parenting practices; would PRS exacerbate or decrease mental health stigma and self-stigma for those identified to be at higher risk? The long-term goal of this research is to develop ethically-justified and empirically-informed guidelines and tools to address the ethical and policy challenges raised by the use of psychiatric PRS with children and adolescents. The objective of this supplement, which is the first step in pursuit of this goal, is to identify child and adolescent psychiatrists’ knowledge, practices, attitudes, expectations, and perceived benefits and risks about the use of psychiatric PRS. To achieve this objective, we will first use the Delphi technique with expert child and adolescent psychiatrists to develop the “PRS in Child and Adolescent Psychiatry Survey.” Then, we will administer the survey to child and adolescent psychiatrists and examine correlates of outcomes. Next steps include developing an R01 application to more comprehensively examine ethical principles and develop ethically-justified guidelines to promote the responsible use of psychiatric PRS with children and adolescents.

项目摘要（补充） 精神病遗传学研究人员最近确定了与 精神分裂症，抑郁症，自闭症谱系障碍，躁郁症，注意力缺陷多动障碍， 和其他疾病。这些基因组基因局的识别使得产生多基因 与之相比 一般人口。大多数精神疾病的通常发病年龄是在童年时期，晚了 青少年和成年初。美国多达20％的儿童和青少年有 可诊断的精神疾病。大量研究表明，早期干预改善了临床结果， 但是，未经治疗的症状和疾病的平均持续时间通常是在数年的时间内。那， PRS等工具非常需要帮助改善儿童和青少年的识别 较高的精神疾病风险，以便采取措施潜在地预防或延迟发作 疾病，最大程度地减少自杀的发病率和风险，或提供早期干预。 可靠的PR在心理保健和预防方面的承诺是相当大的，但是有关键 潜在的道德和政策挑战。例如：哪些儿童和青少年（如果有）应该是 测试；如果有的话，应该对儿童和青少年进行测试；应该在哪里测试；应该prs 测试需要临床订单，或者可以通过直接面向消费者服务来完成；谁应该有 获得儿童和青少年的精神病学PRS结果；这些结果应如何使用；什么样的 PRS结果会对风险增加的儿童和青少年产生影响；高公关怎么可能 影响父母/监护人的期望和育儿惯例； PR会加重或减少心理 确定有较高风险的人的健康污名和自我污名？ 这项研究的长期目标是制定具有道德和经验知觉的准则，以及 解决与儿童一起使用精神病和政策挑战所面临的道德和政策挑战的工具 青少年。这种补充的目的是追求这一目标的第一步，是确定孩子 以及青少年的精神科医生的知识，实践，参加者，期望以及感知的福利和风险 关于使用精神病PR。为了实现这一目标，我们将首先将Delphi技术与专家一起使用 儿童和青少年精神科医生开发“儿童和青少年精神病学调查中的PR”。然后，我们 将对儿童和青少年精神科医生进行调查，并进行结局的检查。下一个 步骤包括开发R01应用程序以更全面地研究道德原则并发展 道德约束的准则，旨在促进对儿童和青少年对精神病的负责使用。

项目成果

Child and Adolescent Psychiatrists' Perceptions of Utility and Self-rated Knowledge of Genetic Testing Predict Usage for Autism Spectrum Disorder.

• DOI: 10.1016/j.jaac.2021.01.022
• 发表时间: 2021-06
• 期刊: Journal of the American Academy of Child and Adolescent Psychiatry
• 影响因子: 13.3
• 作者: Soda T;Pereira S;Small BJ;Torgerson LN;Muñoz KA;Austin J;Storch EA;Lázaro-Muñoz G
• 通讯作者: Lázaro-Muñoz G

Perceptions of best practices for return of results in an international survey of psychiatric genetics researchers.

• DOI: 10.1038/s41431-020-00738-0
• 发表时间: 2021-03
• 期刊: European journal of human genetics : EJHG
• 作者: Lázaro-Muñoz G;Torgerson L;Smith HS;Pereira S
• 通讯作者: Pereira S

Psychiatric genetics researchers' views on offering return of results to individual participants.

• DOI: 10.1002/ajmg.b.32682
• 发表时间: 2019-12
• 期刊: American journal of medical genetics. Part B, Neuropsychiatric genetics : the official publication of the International Society of Psychiatric Genetics
• 作者: Kostick KM;Brannan C;Pereira S;Lázaro-Muñoz G
• 通讯作者: Lázaro-Muñoz G

Return of results in a global survey of psychiatric genetics researchers: practices, attitudes, and knowledge.

• DOI: 10.1038/s41436-020-00986-x
• 发表时间: 2021-03
• 期刊: Genetics in medicine : official journal of the American College of Medical Genetics
• 作者: Lázaro-Muñoz G;Torgerson L;Pereira S
• 通讯作者: Pereira S

Integrating Genomics into Psychiatric Practice: Ethical and Legal Challenges for Clinicians.

将基因组学纳入精神病学实践：临床医生面临的道德和法律挑战。

• DOI: 10.1097/hrp.0000000000000203
• 发表时间: 2019
• 期刊: Harvard review of psychiatry
• 影响因子: 3.8
• 作者: Ward,EricT;Kostick,KristinM;Lázaro-Muñoz,Gabriel
• 通讯作者: Lázaro-Muñoz,Gabriel