Conceptualizing mental disorders as deviations from normative functioning

作者：André F. Marquand, Seyed Mostafa Kia, Mariam Zabihi, Thomas Wolfers, Jan K. Buitelaar, Christian F. Beckmann · 发表于：Molecular Psychiatry · 年份：2019 · DOI：10.1038/s41380-019-0441-1 · 被引用次数：470 · 研究领域：Mental Health and Psychiatry、Mental Health Treatment and Access、Schizophrenia research and treatment

Normative models are a class of emerging statistical techniques useful for understanding the heterogeneous biology underlying psychiatric disorders at the level of the individual participant. Analogous to normative growth charts used in paediatric medicine for plotting child development in terms of height or weight as a function of age, normative models chart variation in clinical cohorts in terms of mappings between quantitative biological measures and clinically relevant variables. An emerging body of literature has demonstrated that such techniques are excellent tools for parsing the heterogeneity in clinical cohorts by providing statistical inferences at the level of the individual participant with respect to the normative range. Here, we provide a unifying review of the theory and application of normative modelling for understanding the biological and clinical heterogeneity underlying mental disorders. We first provide a statistically grounded yet non-technical overview of the conceptual underpinnings of normative modelling and propose a conceptual framework to link the many different methodological approaches that have been proposed for this purpose. We survey the literature employing these techniques, focusing principally on applications of normative modelling to quantitative neuroimaging-based biomarkers in psychiatry and, finally, we provide methodological considerations and recommendations to guide future applications of these techniques. We show that normative mode...