ArticlePsychological medicine2025
The broad structure of psychopathology in the All of Us Research Program.
Article in Psychological medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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Abstract
backgroundGiven substantial comorbidity among, and considerable heterogeneity within, psychiatric diagnoses, researchers have suggested alternative systems for classifying psychopathology. The Hierarchical Taxonomy of Psychopathology (HiTOP) is a recently proposed framework for understanding mental disorders based on how symptoms and diagnoses tend to cluster across individuals. While the model is grounded in existing research and supported by recent meta-analytic evidence, its structure has not yet been directly tested using large, representative clinical datasets. In this study, we used electronic health record (EHR) data to examine the overall organization of mental disorders as proposed by HiTOP, with the goal of informing future research on biological and environmental risk factors as well as important life outcomes.
methodsData were drawn from the
resultsA model identifying six broad and correlated dimensions - Fear, Distress, Externalizing, Substance Use, Thought Problems, and Neurodevelopmental Disorders - provided the best fit to the data. This structure was highly consistent across analyses and showed strong split-half replicability and meaningful associations with relevant clinical and demographic characteristics.
conclusionsThese findings support a 6-factor model of psychopathology that broadly resembles major dimensions in the HiTOP framework. By addressing key gaps in the literature, this study advances our understanding of the structure and correlates of mental disorders. The results offer a foundation for more nuanced investigations into the etiology, progression, and treatment of mental health conditions.
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