Transdiagnostic electrophysiological subtypes reveal brain-behavior dimensions in youth psychiatry

Conventional psychiatric diagnoses often fail to reflect the underlying neurobiological and behavioral complexity of mental health conditions. Here, we propose a transdiagnostic, data-driven framework for stratifying youth based on large-scale multisite electroencephalography (EEG) data from 1,707 individuals aged 5–18 years, including healthy controls and individuals diagnosed with attention-deficit/hyperactivity disorder (ADHD), autism spectrum disorder (ASD), anxiety disorders (ANX), and learning disabilities (LD), along with their common comorbidities. By applying normative modeling to quantify individual deviations from typical brain functional maturation, and integrating multidimensional EEG features across spectral, temporal, complexity, and dynamical domains via similarity network fusion clustering, we identified three robust neurophysiological biotypes. These biotypes showed distinct electrophysiological and behavioral profiles, and captured meaningful brain-behavior relationships. Our findings suggest that biologically informed subtypes capture meaningful neuropsychiatric heterogeneity in youth, challenging conventional diagnostic boundaries in psychiatric nosology.