Psychiatric polygenic risk scores: Experience, hope for utility, and concerns among child and adolescent psychiatrists

•Child and adolescent psychiatrists (CAP) feel PRS have limited clinical utility.•CAP are optimistic future of PRS, but noted PRS are not yet ready for clinical use.•Some indicated patient/family requests for PRS testing would motivate them to order.•Concerns about misuse and misinterpretation of PRS were highly prevalent.•Several CAP noted the need for formal guidelines on PRS testing to aid clinicians. 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.