Journal
INTERNATIONAL REVIEW OF PSYCHIATRY
Volume 34, Issue 7-8, Pages 663-675Publisher
TAYLOR & FRANCIS LTD
DOI: 10.1080/09540261.2022.2101352
Keywords
Polygenic risk score; genetics; schizophrenia; depression; environment; prediction; personalized medicine
Categories
Funding
- European Union FSEREACT-EU, PON Research and Innovation 2014-2020 [DM 1062/2021 [08-I-17631-1].]
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In recent years, the development of polygenic risk scores (PRSs) in psychiatry has been facilitated by the reduced costs and increased accessibility to large genome-wide association studies datasets. While PRS represent stable trait features with a normal distribution in the general population and are relatively easy to calculate in terms of time and costs, their real-world applicability is constrained by limitations such as low predictive power and lack of population diversity. Combining genomic and exposomic vulnerabilities with detailed clinical characterization is essential for personalized care in clinical psychiatry.
Over the last years, the decreased costs and enhanced accessibility to large genome-wide association studies datasets have laid the foundations for the development of polygenic risk scores (PRSs). A PRS is calculated on the weighted sum of single nucleotide polymorphisms and measures the individual genetic predisposition to develop a certain phenotype. An increasing number of studies have attempted to utilize the PRSs for risk stratification and prognostic evaluation. The present narrative review aims to discuss the potential clinical utility of PRSs in predicting outcomes and treatment response in psychiatry. After summarizing the evidence on major mental disorders, we have discussed the advantages and limitations of currently available PRSs. Although PRSs represent stable trait features with a normal distribution in the general population and can be relatively easily calculated in terms of time and costs, their real-world applicability is reduced by several limitations, such as low predictive power and lack of population diversity. Even with the rapid expansion of the psychiatric genetic knowledge base, pure genetic prediction in clinical psychiatry appears to be out of reach in the near future. Therefore, combining genomic and exposomic vulnerabilities for mental disorders with a detailed clinical characterization is needed to personalize care.
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