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1. Normative Modeling of Brain Morphometry in Clinical High Risk for Psychosis

Author

Haas, SS, Ge, R, Agartz, I, Amminger, GP, Andreassen, OA, Bachman, P, Baeza, I, Choi, S, Colibazzi, T, Cropley, VL, de la Fuente-Sandoval, C, Ebdrup, BH, Fortea, A, Fusar-Poli, P, Glenthoj, BY, Glenthoj, LB, Haut, KM, Hayes, RA, Heekeren, K, Hooker, CI, Hwang, WJ, Jahanshad, N, Kaess, M, Kasai, K, Katagiri, N, Kim, M, Kindler, J, Koike, S, Kristensen, TD, Kwon, JS, Lawrie, SM, Lebedeva, I, Lee, J, Lemmers-Jansen, ILJ, Lin, A, Ma, X, Mathalon, DH, McGuire, P, Michel, C, Mizrahi, R, Mizuno, M, Moller, P, Mora-Duran, R, Nelson, B, Nemoto, T, Nordentoft, M, Nordholm, D, Omelchenko, MA, Pantelis, C, Pariente, JC, Raghava, J, Reyes-Madrigal, F, Rossberg, JI, Rossler, W, Salisbury, DF, Sasabayashi, D, Schall, U, Smigielski, L, Sugranyes, G, Suzuki, M, Takahashi, T, Tamnes, CK, Theodoridou, A, Thomopoulos, SI, Thompson, PM, Tomyshev, AS, Uhlhaas, PJ, Vaernes, TG, van Amelsvoort, TAMJ, van Erp, TGM, Waltz, JA, Wenneberg, C, Westlye, LT, Wood, SJ, Zhou, JH, Hernaus, D, Jalbrzikowski, M, Kahn, RS, Corcoran, CM, Frangou, S, Haas, SS, Ge, R, Agartz, I, Amminger, GP, Andreassen, OA, Bachman, P, Baeza, I, Choi, S, Colibazzi, T, Cropley, VL, de la Fuente-Sandoval, C, Ebdrup, BH, Fortea, A, Fusar-Poli, P, Glenthoj, BY, Glenthoj, LB, Haut, KM, Hayes, RA, Heekeren, K, Hooker, CI, Hwang, WJ, Jahanshad, N, Kaess, M, Kasai, K, Katagiri, N, Kim, M, Kindler, J, Koike, S, Kristensen, TD, Kwon, JS, Lawrie, SM, Lebedeva, I, Lee, J, Lemmers-Jansen, ILJ, Lin, A, Ma, X, Mathalon, DH, McGuire, P, Michel, C, Mizrahi, R, Mizuno, M, Moller, P, Mora-Duran, R, Nelson, B, Nemoto, T, Nordentoft, M, Nordholm, D, Omelchenko, MA, Pantelis, C, Pariente, JC, Raghava, J, Reyes-Madrigal, F, Rossberg, JI, Rossler, W, Salisbury, DF, Sasabayashi, D, Schall, U, Smigielski, L, Sugranyes, G, Suzuki, M, Takahashi, T, Tamnes, CK, Theodoridou, A, Thomopoulos, SI, Thompson, PM, Tomyshev, AS, Uhlhaas, PJ, Vaernes, TG, van Amelsvoort, TAMJ, van Erp, TGM, Waltz, JA, Wenneberg, C, Westlye, LT, Wood, SJ, Zhou, JH, Hernaus, D, Jalbrzikowski, M, Kahn, RS, Corcoran, CM, and Frangou, S

Abstract

IMPORTANCE: The lack of robust neuroanatomical markers of psychosis risk has been traditionally attributed to heterogeneity. A complementary hypothesis is that variation in neuroanatomical measures in individuals at psychosis risk may be nested within the range observed in healthy individuals. OBJECTIVE: To quantify deviations from the normative range of neuroanatomical variation in individuals at clinical high risk for psychosis (CHR-P) and evaluate their overlap with healthy variation and their association with positive symptoms, cognition, and conversion to a psychotic disorder. DESIGN, SETTING, AND PARTICIPANTS: This case-control study used clinical-, IQ-, and neuroimaging software (FreeSurfer)-derived regional measures of cortical thickness (CT), cortical surface area (SA), and subcortical volume (SV) from 1340 individuals with CHR-P and 1237 healthy individuals pooled from 29 international sites participating in the Enhancing Neuroimaging Genetics Through Meta-analysis (ENIGMA) Clinical High Risk for Psychosis Working Group. Healthy individuals and individuals with CHR-P were matched on age and sex within each recruitment site. Data were analyzed between September 1, 2021, and November 30, 2022. MAIN OUTCOMES AND MEASURES: For each regional morphometric measure, deviation scores were computed as z scores indexing the degree of deviation from their normative means from a healthy reference population. Average deviation scores (ADS) were also calculated for regional CT, SA, and SV measures and globally across all measures. Regression analyses quantified the association of deviation scores with clinical severity and cognition, and 2-proportion z tests identified case-control differences in the proportion of individuals with infranormal (z < -1.96) or supranormal (z > 1.96) scores. RESULTS: Among 1340 individuals with CHR-P, 709 (52.91%) were male, and the mean (SD) age was 20.75 (4.74) years. Among 1237 healthy individuals, 684 (55.30%) were male, and the mean (SD

Published
2024

2. Abnormal asymmetries in subcortical brain volume in schizophrenia

Author

Okada, N, Fukunaga, M, Yamashita, F, Koshiyama, D, Yamamori, H, Ohi, K, Yasuda, Y, Fujimoto, M, Watanabe, Y, Yahata, N, Nemoto, K, Hibar, DP, van Erp, TGM, Fujino, H, Isobe, M, Isomura, S, Natsubori, T, Narita, H, Hashimoto, N, Miyata, J, Koike, S, Takahashi, T, Yamasue, H, Matsuo, K, Onitsuka, T, Iidaka, T, Kawasaki, Y, Yoshimura, R, Suzuki, M, Turner, JA, Takeda, M, Thompson, PM, Ozaki, N, Kasai, K, and Hashimoto, R

Subjects
Clinical Research, Mental Health, Brain Disorders, Neurosciences, Schizophrenia, Aetiology, 2.1 Biological and endogenous factors, Mental health, Adult, Amygdala, Basal Ganglia, Brain, Brain Mapping, Cohort Studies, Cross-Sectional Studies, Female, Functional Laterality, Hippocampus, Humans, Image Processing, Computer-Assisted, Magnetic Resonance Imaging, Male, Middle Aged, Psychiatric Status Rating Scales, Putamen, Thalamus, Biological Sciences, Medical and Health Sciences, Psychology and Cognitive Sciences, Psychiatry
Abstract

Subcortical structures, which include the basal ganglia and parts of the limbic system, have key roles in learning, motor control and emotion, but also contribute to higher-order executive functions. Prior studies have reported volumetric alterations in subcortical regions in schizophrenia. Reported results have sometimes been heterogeneous, and few large-scale investigations have been conducted. Moreover, few large-scale studies have assessed asymmetries of subcortical volumes in schizophrenia. Here, as a work completely independent of a study performed by the ENIGMA consortium, we conducted a large-scale multisite study of subcortical volumetric differences between patients with schizophrenia and controls. We also explored the laterality of subcortical regions to identify characteristic similarities and differences between them. T1-weighted images from 1680 healthy individuals and 884 patients with schizophrenia, obtained with 15 imaging protocols at 11 sites, were processed with FreeSurfer. Group differences were calculated for each protocol and meta-analyzed. Compared with controls, patients with schizophrenia demonstrated smaller bilateral hippocampus, amygdala, thalamus and accumbens volumes as well as intracranial volume, but larger bilateral caudate, putamen, pallidum and lateral ventricle volumes. We replicated the rank order of effect sizes for subcortical volumetric changes in schizophrenia reported by the ENIGMA consortium. Further, we revealed leftward asymmetry for thalamus, lateral ventricle, caudate and putamen volumes, and rightward asymmetry for amygdala and hippocampal volumes in both controls and patients with schizophrenia. Also, we demonstrated a schizophrenia-specific leftward asymmetry for pallidum volume. These findings suggest the possibility of aberrant laterality in neural pathways and connectivity patterns related to the pallidum in schizophrenia.

Published
2016

4. Aberrant attentive and inattentive brain activity to auditory negative words, and its relation to persecutory delusion in patients with schizophrenia

Author

Iwashiro N, Takano Y, Natsubori T, Aoki Y, Yahata N, Gonoi W, Kunimatsu A, Abe O, Kasai K, and Yamasue H

Subjects
Auditory perception, Inferior frontal gyrus, Emotion, Language, fMRI, Psychosis, Neurosciences. Biological psychiatry. Neuropsychiatry, RC321-571, Neurology. Diseases of the nervous system, RC346-429
Abstract

Norichika Iwashiro,1 Yosuke Takano,1 Tatsunobu Natsubori,1 Yuta Aoki,1 Noriaki Yahata,1,2 Wataru Gonoi,3 Akira Kunimatsu,3 Osamu Abe,3 Kiyoto Kasai,1 Hidenori Yamasue4 1Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan; 2Department of Molecular Imaging and Theranostics, National Institute of Radiological Sciences, National Institutes for Quantum and Radiological Science and Technology, Chiba-city, Chiba, Japan; 3Department of Radiology, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Japan; 4Department of Psychiatry, Hamamatsu University School of Medicine, Higashi-ku, Hamamatsu City, Japan Background and purpose: Previous research has suggested that deficits in emotion recognition are involved in the pathogenesis of persecutory delusion in schizophrenia. Although disruption in auditory and language processing is crucial in the pathophysiology of schizophrenia, the neural basis for the deficits in emotion recognition of auditorily presented language stimuli and its relation to persecutory delusion have not yet been clarified. Patients and methods: The current functional magnetic resonance imaging study used a dichotic listening task for 15 patients with schizophrenia and 23 healthy controls matched for age, sex, parental socioeconomic background, handedness, dexterous ear, and intelligence quotient. The participants completed a word recognition task on the attended side in which a word with emotionally valenced content (negative/neutral) was presented to one ear and a different neutral word was presented to the other ear. Participants selectively attended to either ear. Results: The whole brain analysis detected the aberrant neural activity in the right inferior frontal gyrus in the patients with schizophrenia compared to that in the controls (P

Published
2019

9. Being Praised for Prosocial Behaviors Longitudinally Reduces Depressive Symptoms in Early Adolescents: A Population-Based Cohort Study

Author

Nagaoka, D., primary, Tomoshige, N., additional, Ando, S., additional, Morita, M., additional, Kiyono, T., additional, Kanata, S., additional, Fujikawa, S., additional, Endo, K., additional, Yamasaki, S., additional, Fukuda, M., additional, Nishida, A., additional, Hiraiwa-Hasegawa, M., additional, and Kasai, K., additional

Published
2023
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13. Crystal structure of the neutralizing nanobody P86 against SARS-CoV-2

Author

Maeda, R., primary, Fujita, J., additional, Konishi, Y., additional, Kazuma, Y., additional, Yamazaki, H., additional, Anzai, I., additional, Yamaguchi, K., additional, Kasai, K., additional, Nagata, K., additional, Yamaoka, Y., additional, Miyakawa, K., additional, Ryo, A., additional, Shirakawa, K., additional, Makino, F., additional, Matsuura, Y., additional, Inoue, T., additional, Imura, A., additional, Namba, K., additional, and Takaori-Kondo, A., additional

Published
2022
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14. Cryo-EM structure of the SARS-CoV-2 spike protein (2-up RBD) bound to neutralizing nanobodies P86

Author

Maeda, R., primary, Fujita, J., additional, Konishi, Y., additional, Kazuma, Y., additional, Yamazaki, H., additional, Anzai, I., additional, Yamaguchi, K., additional, Kasai, K., additional, Nagata, K., additional, Yamaoka, Y., additional, Miyakawa, K., additional, Ryo, A., additional, Shirakawa, K., additional, Makino, F., additional, Matsuura, Y., additional, Inoue, T., additional, Imura, A., additional, Namba, K., additional, and Takaori-Kondo, A., additional

Published
2022
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15. Neuroanatomical heterogeneity and homogeneity in individuals at clinical high risk for psychosis

Author

Baldwin, H, Radua, J, Antoniades, M, Haas, SS, Frangou, S, Agartz, I, Allen, P, Andreassen, OA, Atkinson, K, Bachman, P, Baeza, I, Bartholomeusz, CF, Chee, MWL, Colibazzi, T, Cooper, RE, Corcoran, CM, Cropley, VL, Ebdrup, BH, Fortea, A, Glenthoj, LB, Hamilton, HK, Haut, KM, Hayes, RA, He, Y, Heekeren, K, Kaess, M, Kasai, K, Katagiri, N, Kim, M, Kindler, J, Klaunig, MJ, Koike, S, Koppel, A, Kristensen, TD, Bin Kwak, Y, Kwon, JS, Lawrie, SM, Lebedeva, I, Lee, J, Lin, A, Loewy, RL, Mathalon, DH, Michel, C, Mizrahi, R, Moller, P, Nelson, B, Nemoto, T, Nordholm, D, Omelchenko, MA, Pantelis, C, Raghava, JM, Rossberg, J, Roessler, W, Salisbury, DF, Sasabayashi, D, Schall, U, Smigielski, L, Sugranyes, G, Suzuki, M, Takahashi, T, Tamnes, CK, Tang, J, Theodoridou, A, Thomopoulos, S, Tomyshev, AS, Uhlhaas, PJ, Vaernes, TG, van Amelsvoort, TAMJ, Van Erp, TGM, Waltz, JA, Westlye, LT, Wood, SJ, Zhou, JH, McGuire, P, Thompson, PM, Jalbrzikowski, M, Hernaus, D, Fusar-Poli, P, Baldwin, H, Radua, J, Antoniades, M, Haas, SS, Frangou, S, Agartz, I, Allen, P, Andreassen, OA, Atkinson, K, Bachman, P, Baeza, I, Bartholomeusz, CF, Chee, MWL, Colibazzi, T, Cooper, RE, Corcoran, CM, Cropley, VL, Ebdrup, BH, Fortea, A, Glenthoj, LB, Hamilton, HK, Haut, KM, Hayes, RA, He, Y, Heekeren, K, Kaess, M, Kasai, K, Katagiri, N, Kim, M, Kindler, J, Klaunig, MJ, Koike, S, Koppel, A, Kristensen, TD, Bin Kwak, Y, Kwon, JS, Lawrie, SM, Lebedeva, I, Lee, J, Lin, A, Loewy, RL, Mathalon, DH, Michel, C, Mizrahi, R, Moller, P, Nelson, B, Nemoto, T, Nordholm, D, Omelchenko, MA, Pantelis, C, Raghava, JM, Rossberg, J, Roessler, W, Salisbury, DF, Sasabayashi, D, Schall, U, Smigielski, L, Sugranyes, G, Suzuki, M, Takahashi, T, Tamnes, CK, Tang, J, Theodoridou, A, Thomopoulos, S, Tomyshev, AS, Uhlhaas, PJ, Vaernes, TG, van Amelsvoort, TAMJ, Van Erp, TGM, Waltz, JA, Westlye, LT, Wood, SJ, Zhou, JH, McGuire, P, Thompson, PM, Jalbrzikowski, M, Hernaus, D, and Fusar-Poli, P

Abstract

Individuals at Clinical High Risk for Psychosis (CHR-P) demonstrate heterogeneity in clinical profiles and outcome features. However, the extent of neuroanatomical heterogeneity in the CHR-P state is largely undetermined. We aimed to quantify the neuroanatomical heterogeneity in structural magnetic resonance imaging measures of cortical surface area (SA), cortical thickness (CT), subcortical volume (SV), and intracranial volume (ICV) in CHR-P individuals compared with healthy controls (HC), and in relation to subsequent transition to a first episode of psychosis. The ENIGMA CHR-P consortium applied a harmonised analysis to neuroimaging data across 29 international sites, including 1579 CHR-P individuals and 1243 HC, offering the largest pooled CHR-P neuroimaging dataset to date. Regional heterogeneity was indexed with the Variability Ratio (VR) and Coefficient of Variation (CV) ratio applied at the group level. Personalised estimates of heterogeneity of SA, CT and SV brain profiles were indexed with the novel Person-Based Similarity Index (PBSI), with two complementary applications. First, to assess the extent of within-diagnosis similarity or divergence of neuroanatomical profiles between individuals. Second, using a normative modelling approach, to assess the 'normativeness' of neuroanatomical profiles in individuals at CHR-P. CHR-P individuals demonstrated no greater regional heterogeneity after applying FDR corrections. However, PBSI scores indicated significantly greater neuroanatomical divergence in global SA, CT and SV profiles in CHR-P individuals compared with HC. Normative PBSI analysis identified 11 CHR-P individuals (0.70%) with marked deviation (>1.5 SD) in SA, 118 (7.47%) in CT and 161 (10.20%) in SV. Psychosis transition was not significantly associated with any measure of heterogeneity. Overall, our examination of neuroanatomical heterogeneity within the CHR-P state indicated greater divergence in neuroanatomical profiles at an individual level, irre

Published
2022

25. Association of Structural Magnetic Resonance Imaging Measures With Psychosis Onset in Individuals at Clinical High Risk for Developing Psychosis: An ENIGMA Working Group Mega-analysis

Author

ENIGMA Clinical High Risk for Psychosis Working Group, Jalbrzikowski M, Hayes RA, Wood SJ, Nordholm D, Zhou JH, Fusar-Poli P, Uhlhaas PJ, Takahashi T, Sugranyes G, Kwak YB, Mathalon DH, Katagiri N, Hooker CI, Smigielski L, Colibazzi T, Esther Via Virgili, Tang J, Koike S, Rasser PE, Michel C, Lebedeva I, Hegelstad WTV, de la Fuente-Sandoval C, Waltz JA, Mizrahi R, Corcoran CM, Resch F, Tamnes CK, Haas SS, Lemmers-Jansen ILJ, Agartz I, Allen P, Amminger GP, Andreassen OA, Atkinson K, Bachman P, Baeza I, Baldwin H, Bartholomeusz CF, Borgwardt S, Catalano S, Chee MWL, Chen X, Cho KIK, Cooper RE, Cropley VL, Dolz M, Ebdrup BH, Fortea A, Glenthøj LB, Glenthøj BY, de Haan L, Hamilton HK, Harris MA, Haut KM, He Y, Heekeren K, Heinz A, Hubl D, Hwang WJ, Kaess M, Kasai K, Kim M, Kindler J, Klaunig MJ, Koppel A, Kristensen TD, Kwon JS, Lawrie SM, Lee J, León-Ortiz P, Lin A, Loewy RL, Ma X, McGorry P, McGuire P, Mizuno M, Møller P, Moncada-Habib T, Muñoz Samons D, Nelson B, Nemoto T, Nordentoft M, Omelchenko MA, Oppedal K, Ouyang L, Pantelis C, Pariente JC, Raghava JM, Reyes-Madrigal F, Roach BJ, Røssberg JI, Rössler W, Salisbury DF, Sasabayashi D, Schall U, Schiffman J, Schlagenhauf F, Schmidt A, Sørensen ME, Suzuki M, Theodoridou A, Tomyshev AS, Tor J, Værnes TG, Velakoulis D, Venegoni GD, Vinogradov S, Wenneberg C, Westlye LT, Yamasue H, Yuan L, Yung AR, van Amelsvoort TAMJ, Turner JA, van Erp TGM, Thompson PM, and Hernaus D

Abstract

IMPORTANCE: The ENIGMA clinical high risk (CHR) for psychosis initiative, the largest pooled neuroimaging sample of individuals at CHR to date, aims to discover robust neurobiological markers of psychosis risk. OBJECTIVE: To investigate baseline structural neuroimaging differences between individuals at CHR and healthy controls as well as between participants at CHR who later developed a psychotic disorder (CHR-PS+) and those who did not (CHR-PS-). DESIGN, SETTING, AND PARTICIPANTS: In this case-control study, baseline T1-weighted magnetic resonance imaging (MRI) data were pooled from 31 international sites participating in the ENIGMA Clinical High Risk for Psychosis Working Group. CHR status was assessed using the Comprehensive Assessment of At-Risk Mental States or Structured Interview for Prodromal Syndromes. MRI scans were processed using harmonized protocols and analyzed within a mega-analysis and meta-analysis framework from January to October 2020. MAIN OUTCOMES AND MEASURES: Measures of regional cortical thickness (CT), surface area, and subcortical volumes were extracted from T1-weighted MRI scans. Independent variables were group (CHR group vs control group) and conversion status (CHR-PS+ group vs CHR-PS- group vs control group). RESULTS: Of the 3169 included participants, 1428 (45.1%) were female, and the mean (SD; range) age was 21.1 (4.9; 9.5-39.9) years. This study included 1792 individuals at CHR and 1377 healthy controls. Using longitudinal clinical information, 253 in the CHR-PS+ group, 1234 in the CHR-PS- group, and 305 at CHR without follow-up data were identified. Compared with healthy controls, individuals at CHR exhibited widespread lower CT measures (mean [range] Cohen d = -0.13 [-0.17 to -0.09]), but not surface area or subcortical volume. Lower CT measures in the fusiform, superior temporal, and paracentral regions were associated with psychosis conversion (mean Cohen d = -0.22; 95% CI, -0.35 to 0.10). Among healthy controls, compared with those in the CHR-PS+ group, age showed a stronger negative association with left fusiform CT measures (F = 9.8; P < .001; q < .001) and left paracentral CT measures (F = 5.9; P = .005; q = .02). Effect sizes representing lower CT associated with psychosis conversion resembled patterns of CT differences observed in ENIGMA studies of schizophrenia (? = 0.35; 95% CI, 0.12 to 0.55; P = .004) and individuals with 22q11.2 microdeletion syndrome and a psychotic disorder diagnosis (? = 0.43; 95% CI, 0.20 to 0.61; P = .001). CONCLUSIONS AND RELEVANCE: This study provides evidence for widespread subtle, lower CT measures in individuals at CHR. The pattern of CT measure differences in those in the CHR-PS+ group was similar to those reported in other large-scale investigations of psychosis. Additionally, a subset of these regions displayed abnormal age associations. Widespread disruptions in CT coupled with abnormal age associations in those at CHR may point to disruptions in postnatal brain developmental processes.

Published
2021

26. Association of Structural Magnetic Resonance Imaging Measures with Psychosis Onset in Individuals at Clinical High Risk for Developing Psychosis: An ENIGMA Working Group Mega-analysis

Author

Jalbrzikowski, M, Hayes, RA, Wood, SJ, Nordholm, D, Zhou, JH, Fusar-Poli, P, Uhlhaas, PJ, Takahashi, T, Sugranyes, G, Kwak, YB, Mathalon, DH, Katagiri, N, Hooker, CI, Smigielski, L, Colibazzi, T, Via, E, Tang, J, Koike, S, Rasser, PE, Michel, C, Lebedeva, I, Hegelstad, WTV, De La Fuente-Sandoval, C, Waltz, JA, Mizrahi, R, Corcoran, CM, Resch, F, Tamnes, CK, Haas, SS, Lemmers-Jansen, ILJ, Agartz, I, Allen, P, Amminger, GP, Andreassen, OA, Atkinson, K, Bachman, P, Baeza, I, Baldwin, H, Bartholomeusz, CF, Borgwardt, S, Catalano, S, Chee, MWL, Chen, X, Cho, KIK, Cooper, RE, Cropley, VL, Dolz, M, Ebdrup, BH, Fortea, A, Glenthøj, LB, Glenthøj, BY, De Haan, L, Hamilton, HK, Harris, MA, Haut, KM, He, Y, Heekeren, K, Heinz, A, Hubl, D, Hwang, WJ, Kaess, M, Kasai, K, Kim, M, Kindler, J, Klaunig, MJ, Koppel, A, Kristensen, TD, Kwon, JS, Lawrie, SM, Lee, J, León-Ortiz, P, Lin, A, Loewy, RL, Ma, X, McGorry, P, McGuire, P, Mizuno, M, Møller, P, Moncada-Habib, T, Muñoz-Samons, D, Nelson, B, Nemoto, T, Nordentoft, M, Omelchenko, MA, Oppedal, K, Ouyang, L, Pantelis, C, Pariente, JC, Raghava, JM, Reyes-Madrigal, F, Roach, BJ, Røssberg, JI, Rössler, W, Salisbury, DF, Sasabayashi, D, Schall, U, Schiffman, J, Schlagenhauf, F, Schmidt, A, Sørensen, ME, Yung, Alison, Jalbrzikowski, M, Hayes, RA, Wood, SJ, Nordholm, D, Zhou, JH, Fusar-Poli, P, Uhlhaas, PJ, Takahashi, T, Sugranyes, G, Kwak, YB, Mathalon, DH, Katagiri, N, Hooker, CI, Smigielski, L, Colibazzi, T, Via, E, Tang, J, Koike, S, Rasser, PE, Michel, C, Lebedeva, I, Hegelstad, WTV, De La Fuente-Sandoval, C, Waltz, JA, Mizrahi, R, Corcoran, CM, Resch, F, Tamnes, CK, Haas, SS, Lemmers-Jansen, ILJ, Agartz, I, Allen, P, Amminger, GP, Andreassen, OA, Atkinson, K, Bachman, P, Baeza, I, Baldwin, H, Bartholomeusz, CF, Borgwardt, S, Catalano, S, Chee, MWL, Chen, X, Cho, KIK, Cooper, RE, Cropley, VL, Dolz, M, Ebdrup, BH, Fortea, A, Glenthøj, LB, Glenthøj, BY, De Haan, L, Hamilton, HK, Harris, MA, Haut, KM, He, Y, Heekeren, K, Heinz, A, Hubl, D, Hwang, WJ, Kaess, M, Kasai, K, Kim, M, Kindler, J, Klaunig, MJ, Koppel, A, Kristensen, TD, Kwon, JS, Lawrie, SM, Lee, J, León-Ortiz, P, Lin, A, Loewy, RL, Ma, X, McGorry, P, McGuire, P, Mizuno, M, Møller, P, Moncada-Habib, T, Muñoz-Samons, D, Nelson, B, Nemoto, T, Nordentoft, M, Omelchenko, MA, Oppedal, K, Ouyang, L, Pantelis, C, Pariente, JC, Raghava, JM, Reyes-Madrigal, F, Roach, BJ, Røssberg, JI, Rössler, W, Salisbury, DF, Sasabayashi, D, Schall, U, Schiffman, J, Schlagenhauf, F, Schmidt, A, Sørensen, ME, and Yung, Alison

Published
2021

31. Responding to experienced and anticipated discrimination (READ): Anti -stigma training for medical students towards patients with mental illness - Study protocol for an international multisite non-randomised controlled study

Author

Deb T., Lempp H., Bakolis I., Vince T., Waugh W., Henderson C., Thornicroft G., Ando S., Yamaguchi S., Matsunaga A., Kondo S., Ichihashi K., Ojio Y., Ogawa M., Fujii C., Kasai K., Candelas A., Martin L., Jimenez A., Castaneda C., Hernandez C., De La Higuera J., Munoz-Negro J. E., Sola M., Garcia R., Gota J. M., Mula J. F., Lopez A., Oria A., Cervilla J. A., Bono A., Franco D., Gomez J., Jimenez C., Dorado R., Ingunza E., Marquez I., De La Vega D., Go-Cubillana P., Ouali U., Jouini L., Zgueb Y., Jomli R., Nacef F., Campbell M., Stein D., Harangozo J., Ojo T. M., Ogunwale A., Sowunmi A. O., Awhangansi S. S., Ogundapo D., Sodiya O. T., Fadipe B., Olagunju A. T., Erinfolami A. R., Ogunnubi P. O., Tomas C. C., Krupchanka D., Pascucci M., Bacle S. V., Colliez A., Sebbane D., Mengin A., Vidailhet P., Cazals C., Ucok A., Fiorillo A., Sampogna G., Savorani M., Del Vecchio V., Luciano M., Borriello G., Pocai B., Nwaubani P., James Y., Tocca A., Pattnaik R., Chilasagaram S., Wufang Z., Deb, T., Lempp, H., Bakolis, I., Vince, T., Waugh, W., Henderson, C., Thornicroft, G., Ando, S., Yamaguchi, S., Matsunaga, A., Kondo, S., Ichihashi, K., Ojio, Y., Ogawa, M., Fujii, C., Kasai, K., Candelas, A., Martin, L., Jimenez, A., Castaneda, C., Hernandez, C., De La Higuera, J., Munoz-Negro, J. E., Sola, M., Garcia, R., Gota, J. M., Mula, J. F., Lopez, A., Oria, A., Cervilla, J. A., Bono, A., Franco, D., Gomez, J., Jimenez, C., Dorado, R., Ingunza, E., Marquez, I., De La Vega, D., Go-Cubillana, P., Ouali, U., Jouini, L., Zgueb, Y., Jomli, R., Nacef, F., Campbell, M., Stein, D., Harangozo, J., Ojo, T. M., Ogunwale, A., Sowunmi, A. O., Awhangansi, S. S., Ogundapo, D., Sodiya, O. T., Fadipe, B., Olagunju, A. T., Erinfolami, A. R., Ogunnubi, P. O., Tomas, C. C., Krupchanka, D., Pascucci, M., Bacle, S. V., Colliez, A., Sebbane, D., Mengin, A., Vidailhet, P., Cazals, C., Ucok, A., Fiorillo, A., Sampogna, G., Savorani, M., Del Vecchio, V., Luciano, M., Borriello, G., Pocai, B., Nwaubani, P., James, Y., Tocca, A., Pattnaik, R., Chilasagaram, S., and Wufang, Z.

Subjects
Internationality, Students, Medical, Social Stigma, lcsh:Medicine, Social Sciences, INDIGO READ study group, Study Protocol, Statistical analyses, Discrimination, REDUCE PREJUDICE, SCALE, Schools, Medical, lcsh:LC8-6691, Mental Disorders, EDUCATION, General Medicine, Social Discrimination, Distress, HOSPITAL-CARE, Research Design, Mental Disorder, Psychology, INTERVENTIONS, Human, Education, Medical, Undergraduate, Medical education, medicine.medical_specialty, Evidence-based practice, Attitude of Health Personnel, 1302 Curriculum and Pedagogy, education, Developing country, EMPATHY, 1117 Public Health and Health Services, HEALTH-RELATED STIGMA, INTERGROUP CONTACT, PEOPLE, medicine, Humans, Education, Scientific Disciplines, Health professionals, lcsh:Special aspects of education, Public health, lcsh:R, Mental illness, medicine.disease, Education & Educational Research, Stigma, DEPRESSIVE DISORDER, Medical Informatics
Abstract

BackgroundStigma and discrimination are a significant public health concern and cause great distress to people with mental illness. Healthcare professionals have been identified as one source of this discrimination. In this article we describe the protocol of an international, multisite controlled study, evaluating the effectiveness of READ, an anti-stigma training for medical students towards patients with mental illness. READ aims to improve students’ ability to minimise perceived discriminatory behaviours and increase opportunities for patients, therefore developing the ability of future doctors to address and challenge mental illness related discrimination. READ includes components that medical education research has shown to be effective at improving attitudes, beliefs and understanding.Methods/designREAD training was developed using evidence based components associated with changes in stigma related outcomes. The study will take place in multiple international medical schools across high, middle and low income countries forming part of the INDIGO group network, with 25 sites in total. Students will be invited to participate via email from the lead researcher at each site during their psychiatry placement, and will be allocated to an intervention or a control arm according to their local teaching group at each site. READ training will be delivered solely to the intervention arm. Standardised measures will be used to assess students’ knowledge, attitudes and skills regarding discrimination in both the intervention and control groups, at baseline and at follow up immediately after the intervention. Statistical analyses of individual-level data will be conducted using random effects models accounting for clustering within sites to investigate changes in mean or percentages of each outcome, at baseline and immediately after the intervention.DiscussionThis is the first international study across high, middle and low income countries, which will evaluate the effectiveness of training for medical students to respond effectively to patients’ experiences and anticipation of discrimination. The results will promote implementation of manualised training that will help future doctors to reduce the impact of mental illness related discrimination on their patients. Limitations of the study are also discussed.

Published
2019
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