Meta Mesh Ontology for Cross-Domain Mental Health Knowledge Integration: Development and Evaluation Study

Psychiatric diagnostic practice faces persistent challenges in adequately capturing the complexity, heterogeneity, and dynamic nature of mental disorders. Conventional categorical classification systems such as the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) and the International Classification of Diseases, 11th Revision (ICD-11) rely on rigid symptom-based criteria that often fail to represent multifactorial etiologies, dimensional symptom profiles, and high rates of comorbidity. Although dimensional models, domain-specific ontologies, and alternative taxonomies have been developed to address these limitations, they are typically applied in isolation, resulting in fragmented knowledge representations and limited interoperability. This lack of semantic integration hampers data harmonization and cross-domain analysis.

The objective of this work is to develop and present the Meta Mesh Ontology (MMO) and its Core Domain Framework (CDF) as an integrative approach for mapping heterogeneous psychiatric knowledge bases and evaluating ontology structure, logical consistency, and specified retrieval and inference behavior.

We designed a modular ontology architecture grounded in the Basic Formal Ontology to ensure structural and semantic consistency across biological, psychological, and social domains. Existing psychiatric frameworks and ontologies-including dimensional models, diagnostic taxonomies, and socioenvironmental knowledge systems-were systematically analyzed and represented through domain modules using a documented alignment and mapping procedure. The MMO was implemented using formal semantic web standards, including the Web Ontology Language and the Resource Description Framework (RDF), and aligned with established biomedical ontologies and informatics standards to support explicit mappings and modular extensions across domains. Evaluation used 2 MMO and CDF metric sets and 10 module metric sets to quantify ontology size, semantic alignments, external integration, and dataset readiness. We also assessed Web Ontology Language 2 Description Logic (OWL 2 DL) conformance, logical consistency, and 11 competency questions (including 1 entailment test) and 4 negative controls, in an outpatient scenario with 50 variables.

The MMO provides a shared semantic framework for representing links among heterogeneous psychiatric knowledge sources. Its modular design allows domain-specific subontologies to be incorporated under a common architecture. MMO and CDF comprised 2238 triples, 208 classes, 28 properties, 3 individuals, and 103 alignments (100 external) across 5 frameworks. The 10 modules added 967 triples and 171 alignments (116 external), with 21 integrations and complete label coverage (54/54 resources). The ontology resources conformed to OWL 2 DL; HermiT (Information Systems Group) detected no logical inconsistency, and all 11 competency questions and 4 negative controls produced the expected results. All 50 variables were linked to at least 1 CDF anchor, and 47 had an explicit Simple Knowledge Organization System (SKOS) mapping.

The MMO provides a modular foundation for representing links among diverse psychiatric knowledge systems and data modalities. The current evaluation characterizes its structure, mappings, and behavior in the specified tests. Further research should assess mapping validity, governed clinical data, operational performance, and clinical utility.