POLYGENIC RISK SCORES IN CHILD AND ADOLESCENT PSYCHIATRY: U.S. CLINICIANS’ PRACTICES, KNOWLEDGE, AND ATTITUDES

Objective: Psychiatric polygenic risk scores (PRS) have the potential to transform aspects of psychiatric care and prevention, but there are concerns about their implementation. We sought to assess child and adolescent psychiatrists' (CAP) experiences, perspectives, and potential uses of psychiatric PRS. Methods: A survey of 960 US-based practicing CAP. Results: Most respondents (54%) believed psychiatric PRS are currently at least slightly useful and 87% believed they will be so in five years. Yet, 77% rated their knowledge of PRS as poor or very poor. Ten percent have had a patient/family bring PRS to them, and 25% would request PRS if a patient/caregiver asked. Respondents endorsed different actions in response to a hypothetical child with a top 5th percentile psychiatric PRS but no diagnosis: 48% would increase prospective monitoring of symptoms, 42% would evaluate for current symptoms, and 4% would prescribe medications. Most respondents were concerned that high PRS results could lead to overtreatment and negatively impact patients' emotional well-being. Conclusion: Findings indicate emerging use of psychiatric PRS within child and adolescent psychiatry in the US. Thus, it is critical to examine the ethical and clinical challenges that PRS may generate and begin efforts to promote their informed and responsible use.

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Experience, Knowledge and Attitudes of Child Psychiatrists regarding Electroconvulsive Therapy in the Young

Australian & New Zealand Journal of Psychiatry ◽

10.3109/00048679709062680 ◽

1997 ◽

Vol 31 (5) ◽

pp. 676-681 ◽

Cited By ~ 20

Author(s):

Garry Walter ◽

Joseph M. Rey ◽

Jean Starling

Keyword(s):

New Zealand ◽

Young People ◽

Electroconvulsive Therapy ◽

Adolescent Psychiatry ◽

Child And Adolescent ◽

Child And Adolescent Psychiatry ◽

Knowledge And Attitudes ◽

Item Questionnaire ◽

Almost All ◽

Child Psychiatrists

Objective: To ascertain the experience, knowledge and attitudes of Australian and New Zealand child psychiatrists in relation to electroconvulsive therapy (ECT) in the young in order to determine whether they would be willing and able to provide an opinion if consulted about children or adolescents in whom ECT is proposed. Method: A 28-item questionnaire was posted to all members of the Faculty of Child and Adolescent Psychiatry living in Australia or New Zealand. Results: Eighty-three percent (n = 206) answered the questionnaire. Forty percent rated their knowledge about ECT in the young as nil or negligible. Having had patients treated with ECT was the best predictor of possessing some knowledge. Thirty-nine percent believed that ECT was unsafe in children compared to 17% for adolescents and 3% for adults. Almost all (92%) respondents believed child psychiatrists should be consulted in all cases of persons under 19 in whom ECT was recommended. The vast majority believed the Faculty or College should have guidelines relating to ECT use in this group and that it would be useful to have a national register of young persons treated with ECT. Conclusions: Child and adolescent psychiatrists wish to be involved in the process of ECT treatment in young people. At the same time, there are gaps in their knowledge. This will need to be remedied, particularly if formal guidelines advocating their involvement are introduced.

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