Sankey diagram shows diagnosis switches.

Spoiler alert: not very. Switching between diagnoses is common, and patients often accumulate comorbidities.

We leverage 17 years of Electronic Health Record data from a psychiatric hospital to study diagnostic instability and illness trajectories. We delineate disease trajectories for >22,000 individuals treated for severe mental illness. These trajectories are diverse: they include both diagnostic switching and the accumulation of comorbidities. We also identify predictors of visit-to-visit diagnostic instability by combining structured data and NLP-features extracted from clinical notes. Resources like this set the stage for advancing large-scale genomic research in Colombia.

Check out our new preprint  on trajectories of severe mental illness, led by the amazing @juandelahozco