Professor Rachel Upthegrove MBBS, FRCPsych, PhD

Professor Rachel Upthegrove

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

Contact details

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

Wannan, CMJ, Nelson, B, Addington, J, Allott, K, Anticevic, A, Arango, C, Baker, JT, Bearden, CE, Billah, T, Bouix, S, Broome, MR, Buccilli, K, Cadenhead, KS, Calkins, ME, Cannon, TD, Cecci, G, Chen, EYH, Cho, KIK, Choi, J, Clark, SR, Coleman, MJ, Conus, P, Corcoran, CM, Cornblatt, BA, Diaz-Caneja, CM, Dwyer, D, Ebdrup, BH, Ellman, LM, Fusar-Poli, P, Galindo, L, Gaspar, PA, Gerber, C, Glenthøj, LB, Glynn, R, Harms, MP, Horton, LE, Kahn, RS, Kambeitz, J, Kambeitz-Ilankovic, L, Kane, JM, Kapur, T, Keshavan, MS, Kim, SW, Koutsouleris, N, Kubicki, M, Kwon, JS, Langbein, K, Lewandowski, KE, Light, GA, Mamah, D, Marcy, PJ, Mathalon, DH, McGorry, PD, Mittal, VA, Nordentoft, M, Nunez, A, Pasternak, O, Pearlson, GD, Perez, J, Perkins, DO, Powers, AR, Roalf, DR, Sabb, FW, Schiffman, J, Shah, JL, Smesny, S, Spark, J, Stone, WS, Strauss, GP, Tamayo, Z, Torous, J, Upthegrove, R, Vangel, M, Verma, S, Wang, J, Rossum, IWV, Wolf, DH, Wolff, P, Wood, SJ, Yung, AR, Agurto, C, Alvarez-Jimenez, M, Amminger, P, Armando, M, Asgari-Targhi, A, Cahill, J, Carrión, RE, Castro, E, Cetin-Karayumak, S, Mallar Chakravarty, M, Cho, YT, Cotter, D, D'Alfonso, S, Ennis, M, Fadnavis, S, Fonteneau, C, Gao, C, Gupta, T, Gur, RE, Gur, RC, Hamilton, HK, Hoftman, GD, Jacobs, GR, Jarcho, J, Ji, JL, Kohler, CG, Lalousis, PA, Lavoie, S, Lepage, M, Liebenthal, E, Mervis, J, Murty, V, Nicholas, SC, Ning, L, Penzel, N, Poldrack, R, Polosecki, P, Pratt, DN, Rabin, R, Rahimi Eichi, H, Rathi, Y, Reichenberg, A, Reinen, J, Rogers, J, Ruiz-Yu, B, Scott, I, Seitz-Holland, J, Srihari, VH, Srivastava, A, Thompson, A, Turetsky, BI, Walsh, BC, Whitford, T, Wigman, JTW, Yao, B, Yuen, HP, Ahmed, U, Byun, AJS, Chung, Y, Do, K, Hendricks, L, Huynh, K, Jeffries, C, Lane, E, Langholm, C, Lin, E, Mantua, V, Santorelli, G, Ruparel, K, Zoupou, E, Adasme, T, Addamo, L, Adery, L, Ali, M, Auther, A, Aversa, S, Baek, SH, Bates, K, Bathery, A, Bayer, JMM, Beedham, R, Bilgrami, Z, Birch, S, Bonoldi, I, Borders, O, Borgatti, R, Brown, L, Bruna, A, Carrington, H, Castillo-Passi, RI, Chen, J, Cheng, N, Ching, AE, Clifford, C, Colton, BL, Contreras, P, Corral, S, Damiani, S, Done, M, Estradé, A, Etuka, BA, Formica, M, Furlan, R, Geljic, M, Germano, C, Getachew, R, Goncalves, M, Haidar, A, Hartmann, J, Jo, A, John, O, Kerins, S, Kerr, M, Kesselring, I, Kim, H, Kim, N, Kinney, K, Krcmar, M, Kotler, E, Lafanechere, M, Lee, C, Llerena, J, Markiewicz, C, Matnejl, P, Maturana, A, Mavambu, A, Mayol-Troncoso, R, McDonnell, A, McGowan, A, McLaughlin, D, McIlhenny, R, McQueen, B, Mebrahtu, Y, Mensi, M, Hui, CLM, Suen, YN, Wong, SMY, Morrell, N, Omar, M, Partridge, A, Phassouliotis, C, Pichiecchio, A, Politi, P, Porter, C, Provenzani, U, Prunier, N, Raj, J, Ray, S, Rayner, V, Reyes, M, Reynolds, K, Rush, S, Salinas, C, Shetty, J, Snowball, C, Tod, S, Turra-Fariña, G, Valle, D, Veale, S, Whitson, S, Wickham, A, Youn, S, Zamorano, F, Zavaglia, E, Zinberg, J, Woods, SW & Shenton, ME 2024, 'Accelerating Medicines Partnership® Schizophrenia (AMP® SCZ): Rationale and Study Design of the Largest Global Prospective Cohort Study of Clinical High Risk for Psychosis', Schizophrenia bulletin, vol. 50, no. 3, pp. 496-512. https://doi.org/10.1093/schbul/sbae011

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

Lalousis, PA, Malaviya, A, Khatibi, A, Saberi, M, Kambeitz-Ilankovic, L, Haas, SS, Wood, SJ, Barnes, NM, Rogers, J, Chisholm, K, Bertolino, A, Borgwardt, S, Brambilla, P, Kambeitz, J, Lencer, R, Pantelis, C, Ruhrmann, S, Salokangas, RKR, Schultze-Lutter, F, Schmidt, A, Meisenzahl, E, Dwyer, D, Koutsouleris, N, Upthegrove, R, Griffiths, SL & PRONIA Consortium 2024, 'Anhedonia as a potential transdiagnostic phenotype with immune-related changes in recent onset mental health disorders', Biological Psychiatry. https://doi.org/10.1016/j.biopsych.2024.05.019

Birdi, GK, Wong, G, Upthegrove, R, Higgs, S, Walsh, A, Ahern, A, Allen, K, Howe, J, Habib, H, Nixon, K, Oduola, S & Maidment, I 2024, 'A Realist Evaluation of Social Care Practitioners’ Experiences With and Understanding of Applied Healthcare Research', Inquiry : The Journal of Health Care Organization, Provision, and Financing, vol. 61. https://doi.org/10.1177/00469580241248130

Tse, W, Khandaker, GM, Zhou, H, Luo, H, Yan, WC, Siu, MW, Poon, LT, Lee, EHM, Zhang, Q, Upthegrove, R, Osimo, EF, Perry, BI & Chan, SKW 2024, 'Assessing the generalisability of the psychosis metabolic risk calculator (PsyMetRiC) for young people with first-episode psychosis with validation in a Hong Kong Chinese Han population: a 4-year follow-up study', The Lancet Regional Health - Western Pacific, vol. 47, 101089. https://doi.org/10.1016/j.lanwpc.2024.101089

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

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

Dunleavy, C, Elsworthy, RJ, Wood, SJ, Allott, K, Spencer, F, Upthegrove, R & Aldred, S 2024, 'Exercise4Psychosis: A randomised control trial assessing the effect of moderate-to-vigorous exercise on inflammatory biomarkers and negative symptom profiles in men with first-episode psychosis', Brain, Behavior, and Immunity, vol. 120, pp. 379-390. https://doi.org/10.1016/j.bbi.2024.06.017

Altaweel, N, Upthegrove, R & Marwaha, S 2024, 'Personality traits and change in depression status at 18 months: Findings from a British Psychiatric Morbidity Survey', Journal of Affective Disorders, vol. 367, pp. 157-163. https://doi.org/10.1016/j.jad.2024.08.190

Morales-Munoz, I, Marwaha, S, Upthegrove, R & Cropley, V 2024, 'Role of Inflammation in Short Sleep Duration Across Childhood and Psychosis in Young Adulthood', JAMA psychiatry, vol. 81, no. 8, pp. 825-833. https://doi.org/10.1001/jamapsychiatry.2024.0796

Palmer, ER, Morales-Muñoz, I, Perry, BI, Marwaha, S, Warwick, E, Rogers, JC & Upthegrove, R 2024, 'Trajectories of Inflammation in Youth and Risk of Mental and Cardiometabolic Disorders in Adulthood', JAMA psychiatry. https://doi.org/10.1001/jamapsychiatry.2024.2193

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

Metry, Y, Mcmullan, C, Upthegrove, R, Belli, A, Gomes, RSM, Blanch, RJ & Ahmed, Z 2024, 'Understanding how traumatic brain injury-related changes in fluid biomarkers affect quality of life outcomes in veterans: a prospective observational trial protocol (UNTANGLE)', BMJ open, vol. 14, no. 8, e084818. https://doi.org/10.1136/bmjopen-2024-084818

Comment/debate

ISARIC4C Investigators, COVID-CNS Consortium, Michael, BD, Dunai, C, Needham, EJ, Tharmaratnam, K, Williams, R, Huang, Y, Boardman, SA, Clark, JJ, Sharma, P, Subramaniam, K, Wood, GK, Collie, C, Digby, R, Ren, A, Norton, E, Leibowitz, M, Ebrahimi, S, Fower, A, Fox, H, Tato, E, Ellul, MA, Sunderland, G, Held, M, Hetherington, C, Egbe, FN, Palmos, A, Stirrups, K, Grundmann, A, Chiollaz, AC, Sanchez, JC, Stewart, JP, Griffiths, M, Solomon, T, Breen, G, Coles, AJ, Kingston, N, Bradley, JR, Chinnery, PF, Cavanagh, J, Irani, SR, Vincent, A, Baillie, JK, Openshaw, PJ, Semple, MG, Taams, LS & Menon, DK 2024, 'Author Correction: Para-infectious brain injury in COVID-19 persists at follow-up despite attenuated cytokine and autoantibody responses', Nature Communications, vol. 15, no. 1, 2918. https://doi.org/10.1038/s41467-024-47320-6

Letter

PHOSP-COVID Collaborative Group, ISARIC investigators, Jackson, T, Broome, M, McArdle, P, Moss, P, Thickett, D, Upthegrove, R, Wraith, D, Aldera, EL, Green, C & McGee, K 2024, 'Large-scale phenotyping of patients with long COVID post-hospitalization reveals mechanistic subtypes of disease', Nature Immunology, vol. 25, no. 4, pp. 607-621. https://doi.org/10.1038/s41590-024-01778-0

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