Work

The clinical value of pharmacogenomics in the pharmacotherapy of common psychiatric disorders: a macroscopic analysis based on real-world data

Year: 2026

Type: article

Abstract: BACKGROUND: Pharmacogenomic (PGx) testing holds promise for personalized psychiatry, but its clinical utility in real-world inpatient settings remains inadequately established. Using real-world data, this study investigated whether PGx testing is associated with improved treatment outcomes in hospitalized patients with schizophrenia (SCZ), major depressive disorder (MDD), and bipolar disorder (BD). METHODS: A retrospective cohort study was conducted, enrolling inpatients with SCZ, MDD, and BD from January 2022 to March 2024. Patients were divided into a PGx group or a treatment-as-usual (TAU) group based on whether they received PGx testing. The primary outcomes were disease-specific scale scores (PANSS for SCZ; HAMD/HAMA for MDD; YMRS/HAMD for BD). Demographic characteristics, length of hospital stay, and hospitalization costs were also compared between the two groups. RESULTS: In total, 3,942 patients were included (SCZ: 1,328; MDD: 1,143; BD: 1,471). Linear mixed model analyses revealed significant negative interaction effects between PGx testing and treatment duration across all three disorders (SCZ-PANSS: -0.86, p < 0.001; MDD-HAMD: -0.49, p < 0.001; MDD-HAMA: -0.32, p < 0.001; BD-YMRS: -0.25, p = 0.025; BD-HAMD: -0.39, p < 0.001). This indicates that symptom improvement over time was significantly faster in the PGx group. Furthermore, for MDD and BD, the PGx group had more severe baseline symptoms (MDD: HAMD score 2.77 points higher, p < 0.001; HAMA score 1.79 points higher, p < 0.001. BD: HAMD score 2.16 points higher, p < 0.001) and higher hospitalization costs (MDD: ¥8,730.06 higher, p < 0.001; BD: ¥2,902.78 higher, p = 0.025). Additionally, MDD patients in the PGx group had a significantly longer hospital stay (mean difference: 4.25 days, p = 0.02). CONCLUSION: In the real-world inpatient setting, PGx testing was associated with a steeper slope of clinical symptom improvement in patients with SCZ, MDD, and BD. It is important to note that PGx testing was used more often for patients with more severe baseline conditions who also required more healthcare resources. Nevertheless, PGx may help optimize treatment regimens and enhance therapeutic efficiency. Overall, these findings provide practical evidence supporting PGx as a useful clinical decision-support tool for hospitalized psychiatric patients. CLINICAL TRIAL NUMBER: Not applicable. This study is a retrospective observational study using real-world clinical data and did not involve a prospective intervention requiring trial registration.

Source: BMC Psychiatry

DOI: 10.1186/s12888-026-08198-4