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HiTOP vs DSM: Utility for neural, cognitive, and treatment research in psychosis
The Hierarchical Taxonomy of Psychopathology (HiTOP) promises greater utility for mental health research than traditional nosologies have provided. However, few studies directly compared the utility of HiTOP and DSM, especially for understanding psychotic disorders. We investigated this question in the Suffolk County Mental Health Project, a longitudinal study of 628 patients with psychotic disorders who were followed for 20 years since first hospitalization. We compared the HiTOP model of psychotic disorders to DSM diagnoses in predicting future outcomes: neural function (panel of event-related potentials), performance on a neuropsychological battery, indices of real-world functioning (e.g., occupational, social, residential), and medications prescribed by community psychiatrists. HiTOP was more useful than DSM in predicting each outcome. In particular, present findings suggest that HiTOP can improve alignment between clinical phenotypes and neural measures, facilitating research on neural bases of psychotic disorders.