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medRxiv

Clinical trajectories and genetic architecture across the neurological–psychiatric boundary

The study compared disease-trajectory embeddings from Delphi-2M, a transformer trained only on the health records of about 400,000 UK Biobank participants, with genome-wide genetic correlations for 19 neurological and psychiatric disorders, finding moderate convergence across the 171 disorder pairs (Mantel r = 0.33, p < 1×10⁻⁴), with both measures keeping sixteen disorders closer to their own diagnostic category and making the same three exceptions — multiple sclerosis, migraine, and essential tremor sat closer on average to psychiatric disorders — so clinical trajectories and genetic architecture draw the same boundary and break it in the same places.