"Large-scale genomics: a paradigm shift in psychiatry?”

The past decade has been one of unprecedented discovery in psychiatry. Large-scale genomic studies have identified hundreds of molecular risk factors and illuminated the genetic architectures of major psychiatric conditions. And yet with this knowledge has come a realization that these disorders are highly polygenic and that there is widespread pleiotropy of the risk alleles involved. These findings confirm long-held suspicions that our diagnostic categories do not describe biologically distinct conditions, and they pose fundamental challenges for the approaches to disease modeling that have helped us understand simpler Mendelian disorders. While progress has been immense, when and how will the promised impacts on clinical care be delivered?