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） 精神病学遗传学研究人员最近发现了许多与精神分裂症相关的基因组位点。 精神分裂症，抑郁症，自闭症谱系障碍，双相情感障碍，注意力缺陷多动障碍， 和其他疾病。这些基因组位点的鉴定使得产生多基因 风险评分（PRS），以分层一个人的风险，不同的精神疾病相比， 一般人口。大多数精神疾病的发病年龄通常在儿童时期， 青春期和成年早期。在美国，多达20%的儿童和青少年患有 可诊断的精神障碍许多研究表明，早期干预可以改善临床结果， 然而，未经治疗的症状和病症的平均持续时间一般为数年。因此，在本发明中， 非常需要诸如减贫战略等工具来帮助改善儿童和青少年的识别 精神疾病的风险较高，以便采取措施可能预防或延迟发作 预防疾病，最大限度地减少发病率和自杀风险，或提供早期干预。 可靠的减贫战略在精神卫生保健和预防方面的前景是相当可观的， 潜在的道德和政策挑战。例如：哪些儿童和青少年，如果有的话，应该 测试;当，如果在所有，儿童和青少年应该进行测试;他们应该在哪里进行测试;应PRS 测试需要临床医生的命令，或者可以通过直接面向消费者的服务来完成;谁应该有 获取儿童和青少年的精神病PRS结果;应如何使用这些结果; 减贫战略成果对风险增加的儿童和青少年的影响;减贫战略高 影响父母/监护人的期望和养育子女的做法;生产者责任计划会否加剧或减少心理问题 健康耻辱和自我耻辱的那些被确定为处于较高的风险？ 这项研究的长期目标是制定道德上合理和安全的指导方针， 解决对儿童使用精神科减贫战略所带来的伦理和政策挑战的工具， 青少年。这一补充的目的是，作为实现这一目标的第一步， 以及青少年精神科医生的知识、实践、态度、期望和感知的益处和风险 使用精神病患者康复计划为了实现这一目标，我们将首先使用德尔菲技术与专家 儿童和青少年精神病学家制定“儿童和青少年精神病学调查中的PRS”。然后我们 将对儿童和青少年精神科医生进行调查，并检查结果的相关性。下 步骤包括开发R 01应用程序，以更全面地审查道德原则， 道德上合理的指导方针，以促进儿童和青少年负责任地使用精神病PRS。

项目成果

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.

精神病遗传学研究人员对向个人参与者提供结果回报的看法。

• 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

Screening embryos for polygenic conditions and traits: ethical considerations for an emerging technology.

• DOI: 10.1038/s41436-020-01019-3
• 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;Pereira S;Carmi S;Lencz T
• 通讯作者: Lencz T

Could Genetic Enhancement Really Lead to Obsolescence?

基因增强真的会导致衰老吗？

• DOI: 10.1080/15265161.2019.1618962
• 发表时间: 2019
• 期刊: The American journal of bioethics : AJOB
• 作者: Zuk,Peter;Kostick,KristinM;Lázaro-Muñoz,Gabriel
• 通讯作者: Lázaro-Muñoz,Gabriel