Professor Rachel Upthegrove MBBS, FRCPsych, PhD

School of Psychology
Professor of Psychiatry and Youth Mental Health
Consultant Psychiatrist Early Intervention in Psychosis

Contact details

Telephone: +44 (0)121 414 6241
Email: r.upthegrove@bham.ac.uk
Twitter: @RachelUTG

View my research portal

Address: School of Psychology
University of Birmingham
Edgbaston
Birmingham
B15 2TT
UK

Rachel is Professor of Psychiatry and Youth Mental Health at the University of Birmingham, and Consultant Psychiatrist in the Birmingham Early Intervention Services. Her research Interest is within the field of major mental illness; particularly schizophrenia and co-morbid depression in early phases of illness. Recent projects have developed the investigation of inflammatory models of psychosis and machine learning in prognostic indicators in early phases of developing mental ill health.

Qualifications

PhD Birmingham 2011
MPhil Birmingham 2001
FRCPsych 2017
MRCPsych 1999
MBBS University of London, Royal Free Hospital School of Medicine 1994

Biography

Rachel qualified from the Royal Free Hospital School of Medicine and after house officer and general medical SHO posts began training Psychiatry in Birmingham in the beginning of service developments for assertive community care. Rachel completed general and specialist adult psychiatry training working part time, whilst developing active research interests in Schizophrenia and First Episode Psychosis.

Postgraduate supervision

Carl Krynicki
Markella Griogoriou
Paris Lalousis
Rowena Jones
Margaret Hardiman
Emily Fisher

Research

Neuroimmunology and Psychosis: Immune dysfunction, particularly low-grate inflammation could be causally linked to psychosis: our evidence suggests inflammation is present prior to psychosis onset and is unrelated to medication effects. Recent trials of anti-inflammatory agents in psychosis have yielded mixed results. Current research projects aim to identify the stage of illness and phenotypic profile of patients with psychosis that is related to aberrant immune function. Thus future trials of novel or repurposed agents may be conducted with a refined, targeted approach.

Personalised Prognostic Tools for Early Psychosis Management. PRONIA EUFP7 funded PRONIA uses routine brain imaging and complementary data to optimise candidate biomarkers for the prediction and staging of psychoses and aim to generate a prognostic system that generalises well across different mental health services. We will also implement new multi-modal risk quantification tools to predict mental health-related disability in young help-seekers. The fusion of these tools with clinical knowledge will produce cybernetic prognostic services that accurately identify help-seekers at the highest risk of psychosis, poor functioning and suicide-related mortality. More information is available via the Pronia website.

Depression in Schizophrenia: NIHR and EU funded research has developed the evidence base for the frequency, importance and prognostic implications of depression in First Episode Psychosis, including that of poor functional outcomes and increased risk of completed suicide. Recent meta-analysis led by this group confirm that antidepressants are effective for patients with schizophrenia and depression. Current projects will develop the evidence base for preventative interventions and whether stopping depression developing in the early phases of psychosis can improve a range of outcomes.

Research Groups and Centres:

Other activities

NIHR CRN Specialty Lead for the West Midlands

Council Member of the British Association for Psychopharmacology

Deputy Editor for the British Journal of Psychiatry

Publications

Highlight publications

PRONIA Consortium, Lalousis, PA, Schmaal, L, Wood, S, Reniers, R, Barnes, N, Chisholm, K, Griffiths, L, Stainton, A, Wen, J, Hwang, G, Davatzikos, C, Wenzel, J, Kambeitz-Ilankovic, L, Andreou, C, Bonivento, C, Dannlowski, U, Ferro, A, Liechtenstein, T, Riecher-Rössler, A, Romer, G, Rosen, M, Bertolino, A, Borgwardt, S, Brambilla, P, Kambeitz, J, Lencer, R, Pantelis, C, Ruhrmann, S, Salokangas, RKR, Schultze-Lutter, F, Schmidt, A, Meisenzahl, EM, Koutsouleris, N, Dwyer, D & Upthegrove, R 2022, 'Neurobiologically based stratification of recent-onset depression and psychosis: identification of two distinct transdiagnostic phenotypes', Biological Psychiatry, vol. 92, no. 7, pp. 552-562. https://doi.org/10.1016/j.biopsych.2022.03.021

Upthegrove, R, Marwaha, S & Birchwood, M 2017, 'Depression and schizophrenia: cause, consequence or trans-diagnostic issue?', Schizophrenia bulletin, vol. 43, no. 2, pp. 240-244. https://doi.org/10.1093/schbul/sbw097

PIMS collaboration 2022, 'Inflammation and brain structure in schizophrenia and other neuropsychiatric disorders: A Mendelian randomization study', JAMA psychiatry, vol. 2022, no. 5, pp. 1-11. https://doi.org/10.1001/jamapsychiatry.2022.0407

Morales-Munoz, I, Palmer, E, Mallikarjun, P, Marwaha, S & Upthegrove, R 2021, 'Persistent childhood and adolescent anxiety and risk for psychosis: a longitudinal birth cohort study', Biological Psychiatry. https://doi.org/10.1016/j.biopsych.2021.12.003

PRONIA Consortium 2020, 'The psychopathology and neuroanatomical markers of depression in early psychosis', Schizophrenia bulletin, vol. 2020, sbaa094. https://doi.org/10.1093/schbul/sbaa094

Recent publications

Article

Hoheisel, L, Kambeitz-Ilankovic, L, Wenzel, J, Haas, SS, Antonucci, LA, Ruef, A, Penzel, N, Schultze-Lutter, F, Lichtenstein, T, Rosen, M, Dwyer, DB, Salokangas, RKR, Lencer, R, Brambilla, P, Borgwardt, S, Wood, SJ, Upthegrove, R, Bertolino, A, Ruhrmann, S, Meisenzahl, E, Koutsouleris, N, Fink, GR, Daun, S & Kambeitz, J 2024, 'Alterations of Functional Connectivity Dynamics in Affective and Psychotic Disorders', Biological Psychiatry: Cognitive Neuroscience and Neuroimaging. https://doi.org/10.1016/j.bpsc.2024.02.013

Casetta, C, Santosh, P, Bayley, R, Bisson, J, Byford, S, Dixon, C, Drake, RJ, Elvins, R, Emsley, R, Fung, N, Hayes, D, Howes, O, James, A, James, K, Jones, R, Killaspy, H, Lennox, B, Marchant, L, McGuire, P, Oloyede, E, Rogdaki, M, Upthegrove, R, Walters, J, Egerton, A & MacCabe, JH 2024, 'CLEAR – clozapine in early psychosis: study protocol for a multi-centre, randomised controlled trial of clozapine vs other antipsychotics for young people with treatment resistant schizophrenia in real world settings', BMC Psychiatry, vol. 24, no. 1, 122. https://doi.org/10.1186/s12888-023-05397-1

Griffiths, K, Mellado, MR, Chung, R, Lally, J, McQueen, G, Sendt, K-V, Gillespie, A, Ibrahim, M, Richter, A, Shields, A, Ponsford, M, Jolles, S, Hodsoll, J, Pollak, TA, Upthegrove, R, Egerton, A & Maccabe, JH 2024, 'Changes in immunoglobulin levels during clozapine treatment in schizophrenia', Brain, Behavior, and Immunity, vol. 115, pp. 223-228. https://doi.org/10.1016/j.bbi.2023.10.001

Wenzel, J, Badde, L, Haas, SS, Bonivento, C, Van Rheenen, TE, Antonucci, LA, Ruef, A, Penzel, N, Rosen, M, Lichtenstein, T, Lalousis, PA, Paolini, M, Stainton, A, Dannlowski, U, Romer, G, Brambilla, P, Wood, SJ, Upthegrove, R, Borgwardt, S, Meisenzahl, E, Salokangas, RKR, Pantelis, C, Lencer, R, Bertolino, A, Kambeitz, J, Koutsouleris, N, Dwyer, DB, Kambeitz-Ilankovic, L & PRONIA Consortium 2024, 'Transdiagnostic subgroups of cognitive impairment in early affective and psychotic illness', Neuropsychopharmacology, vol. 49, no. 3, pp. 573-583. https://doi.org/10.1038/s41386-023-01729-7

Palmer, ER, Griffiths, SL, Watkins, B, Weetman, T, Ottridge, R, Patel, S, Woolley, R, Tearne, S, Au, P, Taylor, E, Sadiq, Z, Al-Janabi, H, Major, B, Marriott, C, Husain, N, Katshu, MZUH, Giacco, D, Barnes, NM, Walters, JTR, Barnes, TRE, Birchwood, M, Drake, R & Upthegrove, R 2023, 'Antidepressants for the prevention of depression following first-episode psychosis (ADEPP): study protocol for a multi-centre, double-blind, randomised controlled trial', Trials, vol. 24, no. 1, 646. https://doi.org/10.1186/s13063-023-07499-3

Betz, LT, Penzel, N, Rosen, M, Bhui, K, Upthegrove, R & Kambeitz, J 2023, 'Disentangling heterogeneity of psychosis expression in the general population: Sex-specific moderation effects of environmental risk factors on symptom networks', Psychological Medicine, vol. 53, no. 5, pp. 1860-1869. https://doi.org/10.1017/S0033291721003470

Griffiths, SL, Bogatsu, T, Longhi, M, Butler, E, Alexander, B, Bandawar, M, Everard, L, Jones, PB, Fowler, D, Hodgekins, J, Amos, T, Freemantle, N, McCrone, P, Singh, SP, Birchwood, M & Upthegrove, R 2023, 'Five-year illness trajectories across racial groups in the UK following a first episode psychosis', Social Psychiatry and Psychiatric Epidemiology, vol. 58, no. 4, pp. 569-579. https://doi.org/10.1007/s00127-023-02428-w

Morales-Muñoz, I, Mallikarjun, PK, Chandan, JS, Thayakaran, R, Upthegrove, R & Marwaha, S 2023, 'Impact of anxiety and depression across childhood and adolescence on adverse outcomes in young adulthood: a UK birth cohort study', British Journal of Psychiatry , pp. 1-9. https://doi.org/10.1192/bjp.2023.23

Lalousis, PA, Schmaal, L, Wood, S, Reniers, R, Cropley, VL, Watson, A, Pantelis, C, Suckling, J, Barnes, N, Pariante, CM, Jones, P, Joyce, E, Barnes, TRE, Lawrie, SM, Husain, N, Dazzan, P, Deakin, B, Weickert, CS & Upthegrove, R 2023, 'Inflammatory subgroups of schizophrenia and their association with brain structure: A semi-supervised machine learning examination of heterogeneity', Brain, Behavior, and Immunity, vol. 113, pp. 166-175. https://doi.org/10.1016/j.bbi.2023.06.023

Herniman, SE, Wood, SJ, Khandaker, G, Dazzan, P, Pariante, CM, Barnes, NM, Krynicki, CR, Nikkheslat, N, Vincent, RC, Roberts, A, Giordano, A, Watson, A, Suckling, J, Barnes, TRE, Husain, N, Jones, PB, Joyce, E, Lawrie, SM, Lewis, S, Deakin, B & Upthegrove, R 2023, 'Network analysis of inflammation and symptoms in recent onset schizophrenia and the influence of minocycline during a clinical trial', Translational Psychiatry, vol. 13, no. 1, 297. https://doi.org/10.1038/s41398-023-02570-8

Altaweel, N, Upthegrove, R, Surtees, A, Durdurak, B & Marwaha, S 2023, 'Personality traits as risk factors for relapse or recurrence in major depression: a systematic review', Frontiers in Psychiatry, vol. 14, 1176355. https://doi.org/10.3389/fpsyt.2023.1176355

Osimo, EF, Perry, BI, Mallikarjun, P, Prichard, M, Lewis, J, Katunda, A, Murray , GK, Perez, J, Jones, P, Cardinal, RN, Howes, OD, Upthegrove, R & Khandaker, G 2023, 'Predicting treatment resistance from first-episode psychosis using routinely collected clinical information', Nature Mental Health, vol. 1, pp. 25-35. https://doi.org/10.1038/s44220-022-00001-z

Foley, EM, Griffiths, L, Murray, A, Rogers, J, Corsi-Zuelli, F, Hickinbotham, H, Warwick, E, Wilson, M, Kaser, M, Murray , GK, Deakin, B, Jadon, D, Suckling, J, Barnes, N, Upthegrove, R & Khandaker, GM 2023, 'Protocol for the Psychosis Immune Mechanism Stratified Medicine (PIMS) trial: a randomised double-blind placebo-controlled trial of single-dose tocilizumab in patients with psychosis', BMJ open, vol. 13, no. 3, e067944. https://doi.org/10.1136/bmjopen-2022-067944

Comment/debate

Jauhar, S, Arnone, D, Baldwin, DS, Bloomfield, M, Browning, M, Cleare, AJ, Corlett, P, Deakin, JFW, Erritzoe, D, Fu, C, Fusar-Poli, P, Goodwin, GM, Hayes, J, Howard, R, Howes, OD, Juruena, MF, Lam, RW, Lawrie, SM, McAllister-Williams, H, Marwaha, S, Matuskey, D, McCutcheon, RA, Nutt, DJ, Pariante, C, Pillinger, T, Radhakrishnan, R, Rucker, J, Selvaraj, S, Stokes, P, Upthegrove, R, Yalin, N, Yatham, L, Young, AH, Zahn, R & Cowen, PJ 2023, 'A leaky umbrella has little value: evidence clearly indicates the serotonin system is implicated in depression', Molecular Psychiatry, vol. 28, no. 8, pp. 3149-3152. https://doi.org/10.1038/s41380-023-02095-y

Review article

Marwaha, S, Palmer, E, Suppes, T, Cons, E, Young, AH & Upthegrove, R 2023, 'Novel and emerging treatments for major depression', The Lancet, vol. 401, no. 10371, pp. 141-153. https://doi.org/10.1016/S0140-6736(22)02080-3

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