Features of autism spectrum disorder, attention-deficit/hyperactivity disorder, learning disorders, intellectual disabilities, and communication and motor disorders usually emerge early in life and are associated with atypical neurodevelopment. These “neurodevelopmental conditions” are grouped together in the DSM-5 and ICD-11 to reflect their shared characteristics. Yet, reliance on categorical diagnoses poses significant challenges in both research and clinical settings (e.g., high co-occurrence, arbitrary diagnostic boundaries, high within-disorder heterogeneity). Taking a transdiagnostic dimensional approach provides a useful alternative for addressing these limitations, accounting for shared underpinnings across neurodevelopmental conditions, and characterizing their common co-occurrence and developmental continuity with other psychiatric conditions. Neurodevelopmental features have not been adequately considered in transdiagnostic psychiatric frameworks, although this would have fundamental implications for research and clinical practices. Growing evidence from studies on the structure of neurodevelopmental and other psychiatric conditions indicates that features of neurodevelopmental conditions cluster together, delineating a “neurodevelopmental spectrum” ranging from normative to impairing profiles. Studies on shared genetic underpinnings, overlapping cognitive and neural profiles, and similar developmental course and efficacy of support/treatment strategies indicate the validity of this neurodevelopmental spectrum. Further, characterizing this spectrum alongside other psychiatric dimensions has clinical utility, as it provides a fuller view of an individual's needs and strengths, and greater prognostic utility than diagnostic categories. Based on this compelling body of evidence, we argue that incorporating a new neurodevelopmental spectrum into transdiagnostic frameworks has considerable potential for transforming our understanding, classification, assessment, and clinical practices around neurodevelopmental and other psychiatric conditions.

中文翻译：

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神经发育状况在跨诊断精神病学框架中处于什么位置？纳入新的神经发育谱系


自闭症谱系障碍、注意力缺陷/多动障碍、学习障碍、智力障碍以及沟通和运动障碍的特征通常在生命早期出现，并与非典型神经发育有关。这些“神经发育状况”在 DSM-5 和 ICD-11 中被归为一组，以反映它们的共同特征。然而，依赖分类诊断在研究和临床环境中都构成了重大挑战（例如，高度共现、任意诊断边界、高疾病内异质性）。采用跨诊断维度方法为解决这些局限性提供了一种有用的替代方案，解释了神经发育状况的共同基础，并描述了它们与其他精神疾病的共同共现和发展连续性。跨诊断精神病学框架尚未充分考虑神经发育特征，尽管这将对研究和临床实践产生根本性影响。来自神经发育和其他精神疾病结构的研究越来越多的证据表明，神经发育状况的特征聚集在一起，描绘出从正常到损害的“神经发育谱”。关于共享遗传基础、重叠的认知和神经特征以及相似的发育过程和支持/治疗策略的疗效的研究表明这种神经发育谱的有效性。此外，将该谱系与其他精神病学维度一起表征具有临床效用，因为它提供了对个体需求和优势的更全面视图，并且比诊断类别具有更大的预后效用。 基于这些令人信服的证据，我们认为将新的神经发育谱纳入跨诊断框架具有相当大的潜力，可以改变我们对神经发育和其他精神病学疾病的理解、分类、评估和临床实践。