A Three-Factor Model of Common Early-Onset Mental Disorders: Temperament, Adversity, and Dopamine

Iqbal, M., Cox, SML, Jaworska, N., etal. A three-factor model of common early-onset mental disorders: temperament, adversity, and dopamine. Neuropsychopharmacology. (2021). https://doi.org/10.1038/s41386-021-01187-z

Commentary

Although the mediating processes of mental disorders remain poorly understood, three factors have been explored.

These are externalizing characteristics of adolescence, early life adversity, and midbrain dopamine auto receptors. Combining these factors, a longitudinal study was conducted in youth. Cohort members were invited to participate based on their externalizing scores between the ages of 11 and 16. At age 18 (18.5 ± 0.6 years), 52 entry criteria were [ 18F] fariprid, completed a pediatric trauma questionnaire, and assessed with a DSM-5 structured clinical interview.

From these, the three-factor model identified those with a lifetime history of DSM-5 disorders with an overall accuracy of 90.4% (p = 2.4 × 10-5) and explained 91.5% of the area under the receiver operating characteristic curve.

It has been shown that targeting this externalizing disorder does not specifically produce a more powerful model than targeting all disorders. (p = 0.54)

When data from participants who developed their first disability during the three-year follow-up period were included, the model remained significant (p = 3.5 × 10-5).

The results suggest that a combination of temperament traits, childhood adversity, and poorly regulated dopamine transmission may prospectively predict this susceptibility and increase the risk of diverse and commonly comorbid early-onset psychiatric problems.