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Chunk #24 — Discussion

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Using polygenic scores for identifying individuals at increased risk of substance use disorders in clinical and population samples.
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In an exploratory approach, we chose a series of more restrictive thresholds to divide the PRS distribution. The odds of having an AUD were statistically indistinguishable across each of the thresholds in both COGA and FT12. Even though the point estimates increased in some cases, the confidence intervals around these estimates were relatively large and they did not differ significantly. Additionally, there were only a small number of individuals in the severe category in FT12 and we urge caution in interpreting these estimates. Finally, the top 5% of the continuum for each PRS reported elevated rates of other SUD criteria (cannabis, cocaine, opioid, and nicotine use disorders) compared to the bottom 95%. The RISK PC PRS was most associated with higher mean levels of SUD criteria, suggesting that risk for externalizing may be particularly useful in identifying individuals at risk for multiple SUDs.