Most mental disorders originate in childhood, and once symptoms present, a variety of psychosocial and cognitive maladjustments may arise. Although early childhood problems are generally associated with later mental health impairments and psychopathology, pluripotent transdiagnostic trajectories may manifest. Possible predictors range from behavioral and neurobiological mechanisms, genetic predispositions, environmental and social factors, and psychopathological comorbidity. They may manifest in altered neurodevelopmental trajectories and need to be validated capitalizing on large-scale multi-modal epidemiological longitudinal cohorts. Moreover, clinical and etiological variability between patients with the same disorders represents a major obstacle to develop effective treatments. Hence, in order to achieve stratification of patient samples opening the avenue of adapting and optimizing treatment for the individual there is a need to integrate data from multi-dimensionally phenotyped clinical cohorts and cross-validate them with epidemiological cohort data. In the present review, we discuss these aspects in the context of externalizing and internalizing disorders summarizing the current state of knowledge, obstacles and pitfalls. Although a large number of studies has already increased our understanding on neuropsychobiological mechanisms of mental disorders it became also clear that this knowledge might only be the tip of the eisberg and that a large proportion still remains unknown. We discuss how the integration of different factors and methods may provide useful contributions to research and at the same time inform clinical practice by stratification algorithms for personalized stepped-care therapeutic and preventive interventions.

中文翻译：

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从精神病学的发展角度进行预测：我们能走多远？

大多数精神障碍起源于儿童时期，一旦出现症状，可能会出现各种社会心理和认知失调。尽管儿童早期问题通常与后来的心理健康障碍和精神病理学有关，但可能会出现多能性跨诊断轨迹。可能的预测因素包括行为和神经生物学机制、遗传倾向、环境和社会因素以及精神病理学共病。它们可能表现为改变的神经发育轨迹，需要利用大规模多模式流行病学纵向队列进行验证。此外，患有相同疾病的患者之间的临床和病因变异是开发有效治疗的主要障碍。因此，为了实现患者样本的分层，为个体适应和优化治疗开辟道路，需要整合来自多维表型临床队列的数据，并将其与流行病学队列数据进行交叉验证。在本综述中，我们在外化和内化障碍的背景下讨论这些方面，总结了知识、障碍和陷阱的当前状态。虽然大量的研究已经增加了我们对精神障碍的神经心理生物学机制的理解，但同样清楚的是，这些知识可能只是冰山一角，很大一部分仍然是未知的。