Child and adolescent psychiatrists' use, attitudes, and understanding of genetic testing and pharmacogenetics in clinical practice.

The purpose of this study was to report current practices and attitudes of child and adolescent psychiatrists (CAP) regarding diagnostic genetic and pharmacogenetic (PGx) testing. We surveyed 958 US-based practicing CAP. 54.9% of respondents indicated that they had ordered/referred for a genetic test in the past 12 months. 87% of respondents agreed that it is their role to discuss genetic information regarding psychiatric conditions with their patients; however, 45% rated their knowledge of genetic testing practice guidelines as poor/very poor. The most ordered test was PGx (32.2%), followed by chromosomal microarray (23.0%). 73.4% reported that PGx is at least slightly useful in child and adolescent psychiatry. Most (62.8%) were asked by a patient/family to order PGx in the past 12 months and 41.7% reported they would order PGx in response to a family request. Those who ordered a PGx test were more likely to have been asked by a patient/family and to work in private practice. 13.8% of respondents agreed/strongly agreed that a PGx test can predict the effectiveness of specific antidepressants. Some respondents also indicated they would make clinical changes based on PGx information even if a medication was currently effective and there were no side effects. Genetic testing has become routine clinical care in child and adolescent psychiatry. Despite this, many providers rate their associated knowledge as poor/very poor. Patient requests were associated with ordering practices and providers misinterpretation of PGx may be leading to unnecessary changes in clinical management. There is need for further education and support for clinicians.
Competing Interests: Declaration of Competing Interest Dr. Soda receives grant support from NIH. Dr. Merner reports no financial relationships with commercial interests. Dr. Small receives grant support from NIH. Ms. Torgerson reports no financial relationships with commercial interests. Ms. Muñoz reports no financial relationships with commercial interests. Dr Austin receives support from BC Mental Health and Substance Use Services, and grant funding from Genome BC/Genome Canada, and the Canadian Institutes of Health Research. They have consulted for 23andme. Dr. Storch is a consultant for Biohaven and Brainsway. He receives grant support from NIH, International OCD Foundation, and Ream Foundation. He owns stock valued under $5000 in Nview. He receives book royalties from Elsevier, Springer, Oxford, Guilford, American Psychological Association, Lawrence Erlbaum, and Jessica Kingsley. Dr. Pereira receives grant support from NIH. Dr. Lázaro-Muñoz receives grant support from NIH.
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