How to embrace transdiagnostic concepts when neurodevelopmental disorders become harbingers of adult psychopathology?

Excerpt

Neurodevelopmental disorders are less prevalent than adult-onset mental health issues, but are associated with poor outcomes and low quality of life. Furthermore, neurodevelopmental psychopathology may become comorbid to or predisposing for psychotic, affective, or substance use disorders. Collectively, obsessive compulsive disorder (OCD), attention deficit hyperactivity disorder (ADHD), and autism spectrum disorders (ASD) may exert shared and distinct pathways to other psychopathology. For example, OCD, ADHD, and ASD have specific abnormalities of psychomotor behaviors [1]. Likewise, neurodevelopmental disorders show overlaps between other physiological measures or dimensions of psychopathology, e.g. reduced cognitive control or impulsiveness. Furthermore, transdiagnostic psychopharmacological strategies have been applied to some of these disorders, such as OCD and ADHD. Phenomenological and behavioral similarities suggested common pathobiology. However, a recent large-scale ENIGMA meta-analysis failed to demonstrate shared differences between control subjects and ADHD, ASD, or OCD patients [2]. Instead, specific cortical (ASD) and subcortical (ADHD) abnormalities were substantiated. Thus, despite some commonalities, the differences between the neurodevelopmental disorders are critical for psychiatry. …