Association Between Psychiatric Polygenic Scores, Healthcare Utilization and Comorbidity Burden

PurposeTo estimate the association of psychiatric polygenic scores (PGS) with healthcare utilization and comorbidity burden. MethodsObservational cohort study (N=118,882) of biobank participants 15+ years of age from three diverse healthcare systems. PGS derived for major depressive disorder (MDD), bipolar disorder, and schizophrenia, were tested for association with healthcare utilization (measured as frequency of emergency department (ED), inpatient (IP), and outpatient (OP) visits) and comorbidity burden (defined using Elixhauser and Charlson Comorbidity Indices). ResultsIndividual health records had a median EHR duration of 12 years. Those in the top decile of MDD PGS but without diagnosed MDD had significantly more ED visits (RR=1.22, 95% CI; 1.17, 1.29) compared to those in the bottom decile. Increases were also observed with IP and comorbidity burden. Among those diagnosed with depression and in the highest decile of the PGS, there was an increase in all utilization types (ED: RR=1.55, 95% CI 1.41, 1.72; OP: RR=1.16, 95% CI 1.09, 1.23; IP: RR=1.23, 95% CI 1.12, 1.36) post-diagnosis. A few statistically, however no clinically, significant results were observed with bipolar and schizophrenia PGS. ConclusionsMDD PGS is associated with increased utilization and comorbidity burden, even in the absence of a depression diagnosis. Following a diagnosis of depression, the MDD PGS was associated with further increases in utilization. These findings suggest that MDD PGS may serve as a biomarker of health outcomes in real-world settings.