Pervasively thinner neocortex as a transdiagnostic feature of general psychopathology

Abstract

Objective: Neuroimaging research has revealed that structural brainalterations arecommonacrossbroaddiagnosticfamilies of disorders rather than specific to a single psychiatric disorder. Suchoverlapinthestructural braincorrelatesofmentaldisorders mirrors already well-documented phenotypic comorbidity of psychiatric symptoms and diagnoses, which can be indexed by a general psychopathology or p factor. The authors hypothesized that if general psychopathology drives the convergence of structural alterations common across disorders, then 1) there shouldbe fewassociationsuniquetoanyonediagnostic family of disorders, and 2) associations with the p factor should overlap with those for the broader diagnostic families. Methods: Analyses were conducted on structural MRI and psychopathology data collected from 861 members of the population-representative Dunedin Multidisciplinary Health and Development Study at age 45. Results: Study members with high scores across three broad diagnostic families of disorders (externalizing, internalizing, thought disorder) exhibited highly overlapping patterns of reduced global and widely distributed parcel-wise neocortical thickness. Study members with high p factor scores exhibited patterns of reduced global and parcel-wise neocortical thickness nearly identical to those associated with the three broad diagnostic families. Conclusions: A pattern of pervasively reduced neocortical thickness appears to be common across all formsof mental disorders and may represent a transdiagnostic feature of general psychopathology. As has been documented with regard to symptoms and diagnoses, the underlying brain structural correlates of mental disorders may not exhibit specificity, and the continued pursuit of such specific correlates may limit progress toward more effective strategies for etiological understanding, prevention, and intervention.