Schizophrenia polygenic risk scores in youth mental health: preliminary associations with diagnosis, clinical stage and functioning

Journal article

BACKGROUND: The schizophrenia polygenic risk score (SCZ-PRS) is an emerging tool in psychiatry. AIMS: We aimed to evaluate the utility of SCZ-PRS in a young, transdiagnostic, clinical cohort. METHOD: SCZ-PRSs were calculated for young people who presented to early-intervention youth mental health clinics, including 158 patients of European ancestry, 113 of whom had longitudinal outcome data. We examined associations between SCZ-PRS and diagnosis, clinical stage and functioning at initial assessment, and new-onset psychotic disorder, clinical stage transition and functional course over time in contact with services. RESULTS: Compared with a control group, patients had elevated PRSs for schizophrenia, bipolar disorder and depression, but not for any non-psychiatric phenotype (for example cardiovascular disease). Higher SCZ-PRSs were elevated in participants with psychotic, bipolar, depressive, anxiety and other disorders. At initial assessment, overall SCZ-PRSs were associated with psychotic disorder (odds ratio (OR) per s.d. increase in SCZ-PRS was 1.68, 95% CI 1.08-2.59, P = 0.020), but not assignment as clinical stage 2+ (i.e. discrete, persistent or recurrent disorder) (OR = 0.90, 95% CI 0.64-1.26, P = 0.53) or functioning (R = 0.03, P = 0.76). Longitudinally, overall SCZ-PRSs were not significantly associated with new-onset psychotic disorder (OR = 0.84, 95% CI 0.34-2.03, P = 0.69), clinical stage transition (OR = 1.02, 95% CI 0.70-1.48, P = 0.92) or persistent functional impairment (OR = 0.84, 95% CI 0.52-1.38, P = 0.50). CONCLUSIONS: In this preliminary study, SCZ-PRSs were associated with psychotic disorder at initial assessment in a young, transdiagnostic, clinical cohort accessing early-intervention services. Larger clinical studies are needed to further evaluate the clinical utility of SCZ-PRSs, especially among individuals with high SCZ-PRS burden.

Authors: Crouse, JJ; Carpenter, JS; Iorfino, F; Lin, T; Ho, N

• Publication status: Published
• Peer review status: Peer reviewed
• Publisher: Cambridge University Press
• Journal: BJPsych Open
• Volume: 7
• Issue: 2
• Pages: e58-e58
• Article number: e58
• Publication date: 2021-02-22
• DOI: 10.1192/bjo.2021.14
• EISSN: 2056-4724
• ISSN: 2056-4724
• Language: English
• Keywords: Clinical psychology; Global Assessment of Functioning; Mood; Anxiety; Cohort; Internal medicine; Bipolar disorder; Schizophrenia (object-oriented programming); Odds ratio; Medicine; Psychiatry; Major depressive disorder; Depression (economics)