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


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出现在生命早期，并且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，对分类诊断的依赖在研究和临床环境中都带来了重大挑战（例如，高共现性、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存和发育连续性。神经发育特征在跨诊断精神病学框架中尚未得到充分考虑，尽管这将对研究和临床实践产生根本性影响。对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，神经发育疾病的特征聚集在一起，描绘出从正常到受损的“神经发育谱”。对共享遗传基础、重叠的认知和神经特征以及类似的发育过程和支持/治疗策略的功效的研究表明了这种神经发育谱的有效性。此外，将这一谱系与其他精神病学维度一起表征具有临床实用性，因为它可以更全面地了解个人的需求和优势，并且比诊断类别具有更大的预后实用性。 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巨大的潜力，可以改变我们对神经发育和其他精神疾病的理解、分类、评估和临床实践。