# Polygenic Risk Scores in Child and Adolescent Psychiatry: Ethical, Clinical, and Legal Implications

> **NIH NIH R01** · BAYLOR COLLEGE OF MEDICINE · 2024 · $615,513

## Abstract

PROJECT SUMMARY
Recently, more than 500 genomic loci associated with various psychiatric disorders, including schizophrenia,
depression, and autism spectrum disorders, have been identified. This makes it possible to generate
polygenic risk scores (PRS) to stratify individuals by risk for different psychiatric disorders compared
to the general population. As a prediction tool, psychiatric PRS would likely be most valuable when
applied to individuals before the onset of illness. In about 75% of cases, the onset of psychiatric disorders
or prodromal features occurs by early adulthood making psychiatric PRS likely most useful for children and
adolescents. PRS have the potential to improve early identification, and lead to enhanced monitoring and
interventions to potentially prevent or delay onset, and minimize morbidity and risk for suicide, the second
leading cause of death in the U.S. in ages 10–24. Despite their promise, PRS could be especially perilous
in the context of psychiatry, and our preliminary work has found that PRS are already being used in
child and adolescent psychiatry. There is significant stigma around mental illness, and a history of misuse of
“predictors” of “undesirable” behaviors or mental illness in the US. Thus, psychiatric PRS could be another tool
used against patients with psychiatric disorders. Further, psychiatric PRS are arguably the first tool with the
capacity to generate risk predictions about psychiatric disorders for any individual and there are key legal gaps
in the protection of the privacy of this information and the prevention of genetic discrimination. To promote
responsible use of psychiatric PRS in children and adolescents, we will use a mixed-methods approach that
includes qualitative, quantitative, and legal analysis to: 1) give voice to stakeholders (i.e., patients,
parents/caregivers, clinicians) by examining their perspectives regarding whether psychiatric PRS should be
used and, if so, how; and 2) examine the legal and regulatory landscape to identify what safeguards may be
necessary. Although some of these gaps also apply to other genetic information, we will focus on identifying
potential policy solutions for the likely uses and misuses of psychiatric PRS against individuals with or at risk of
psychiatric disorders, almost 30% of the US population. The long-term goal of this research is to develop
ethically-justified and empirically-informed guidelines to address the ethical challenges raised by the use of
psychiatric PRS with children and adolescents. Building on our NIH-funded Child and Adolescent Psychiatric
Genetics Survey (CAPGS), which examined child and adolescent psychiatrists’ perspectives about PRS
(3R00HG008689-05S1), the objective of the current proposal is to use a mixed-methods design to examine:
1) challenges in the clinical use of psychiatric PRS, 2) key stakeholders’ perspectives on psychiatric PRS, and
3) gaps in legal protections against privacy violations and discrimination based ...

## Key facts

- **NIH application ID:** 10911771
- **Project number:** 5R01MH128676-04
- **Recipient organization:** BAYLOR COLLEGE OF MEDICINE
- **Principal Investigator:** Gabriel Lazaro-Munoz
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $615,513
- **Award type:** 5
- **Project period:** 2021-09-07 → 2026-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10911771

## Citation

> US National Institutes of Health, RePORTER application 10911771, Polygenic Risk Scores in Child and Adolescent Psychiatry: Ethical, Clinical, and Legal Implications (5R01MH128676-04). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10911771. Licensed CC0.

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