Are polygenic scores for psychiatric and substance use outcomes "ready" for clinical application? Current state and next steps

Despite drastic advances in psychiatric genetics, comparatively little attention has focused on the translation of those discoveries into real-world impact. This paper reviews the processes and considerations for integrating new techniques into clinical practice and provides an overview of areas of medicine where polygenic scores (PGS) are already being incorporated. We evaluate current PGS across three areas of psychiatry (depression, substance use disorders, and schizophrenia) against the criteria used by the National Electronic Medical Records and Genomics consortium to select PGS to study in a clinical context, finding that the PGS for psychiatric conditions are comparable to the PGS being implemented in clinical practice for other medical conditions. We conclude by discussing next steps for evaluating psychiatric PGS for clinical implementation including ethical issues that must be considered, and the need for more research on clinical utility to evaluate whether and how PGS can be used to improve behavioral health outcomes.