the disorder (7% based on PRS alone). While PRS are invaluable tools in research settings, the current BD PRS lack sufficient power to separate individuals into clinically meaningful risk categories, and therefore have no clinical utility at present87,88. PRS from this European BD meta-analysis yield higher R2 values in diverse ancestry samples than PRS based on any currently available BD GWAS within the same ancestry59. However, performance still greatly lags behind that in Europeans, with ~2% variance explained in East Asian samples and substantially less in admixed African American samples, likely due to differences in allele frequencies and LD structures, consistent with previous studies89,90. There is a pressing need for more and larger studies in other ancestry groups to ensure that any future clinical utility is broadly applicable. Exploiting the differences in LD structure between diverse ancestry samples will also assist in the fine-mapping of risk loci for BD.
