Tijdschr Psychiatr. 2025;67(8):460-463.
ABSTRACT
BACKGROUND: Based on current diagnostic criteria, it is possible that two individuals are diagnosed with depression despite little to no overlap in symptoms or diagnostic criteria. Psychiatric disorders are known for their heterogeneity, despite sharing many risk factors.
AIM: To discuss the role of heterogeneity and etiological stratification in psychiatric diagnosis, as well as the main risk factors that can play a trans-diagnostic and diagnosis-specific role.
METHOD: In the narrative review we focus on the aspects mostly discussed in the context of heterogeneity.
RESULTS: Genetic predisposition and environmental factors, including acute and chronic stress, as well as childhood trauma significantly contribute to the risk of psychiatric disorders and the observed heterogeneity. Nearly all psychiatric disorders have a complex genetic risk profile. This also means that the risk of a disorder often arises from the interaction between genetic predisposition and stress factors to which the individual has been exposed. We also describe heterogeneity within the life course, focusing on prodromes and chronicity.
CONCLUSION: Clinical heterogeneity reflects diversity in the etiology of psychiatric disorders and offers cues for etiological stratification, refined diagnostics, and more effective treatment options.
PMID:41147478
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