Structural brain alterations associated with suicidal thoughts and behaviors in young people: results across 21 international studies from the ENIGMA Suicidal Thoughts and Behaviours consortium
Abstract
Abstract Objective Identifying brain differences associated with suicidal thoughts and behaviors (STBs) in young people is critical to understanding their development and generating effective approaches to early intervention and prevention. The ENIGMA Suicidal Thoughts and Behaviours (ENIGMA-STB) consortium analyzed neuroimaging data harmonized across sites to examine brain morphology associated with STBs in youth. Methods First, we examined associations among regional brain structure and STBs, which were assessed in six samples of youth with mood disorders, using the Columbia Suicide Severity Rating Scale (C-SSRS; N =577). Second, we combined this sample with a larger sample (total 21 sites) in which STBs were assessed using various instruments. MRI metrics were compared among healthy controls without STBs (HC; N =688), clinical controls without STBs (CC; N =648), and young people with psychiatric diagnoses and current suicidal ideation ( N =406). In separate analyses, MRI metrics were compared among HCs ( N =335), CCs ( N =768), and suicide attempters ( N =254). Results In the homogeneous C-SSRS sample, surface area of the frontal pole was lower in young people with mood disorders and history of actual suicide attempts ( N =163) than those without ( N =394; FDR- p <.001; Cohen’s d =.334). When expanding to more clinically heterogeneous samples, we also found lower surface area of the frontal pole in those with a history of suicide attempts (Cohen’s d =.22). Conclusions Lower frontal pole surface area may represent a vulnerability for a suicide attempt; however, more research is needed to understand the nature of its relationship to suicide risk.
Authors 78
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Laura S. van Velzen corresponding
The University of Melbourne · Orygen
Affiliation as printed
Centre for Youth Mental Health, University of Melbourne, Melbourne, VIC, Australia
Orygen, Parkville, VIC, Australia
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McGovern Institute for Brain Research · King's College London · University of Cambridge · Massachusetts Institute of Technology
Affiliation as printed
Department of Forensic and Neurodevelopmental Science; Institute of Psychiatry, Psychology, and Neuroscience; King’s College London, London, UK
Department of Psychiatry, University of Cambridge, Cambridge, UK
McGovern Institute for Brain Research, Massachusetts Institute of Technology, Cambridge, MA, USA
Department of Forensic and Neurodevelopmental Science
Institute of Psychiatry, Psychology, and Neuroscience
King's College London, London, UK
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Yale University · Jena University Hospital
Affiliation as printed
Center for Intervention and Research on adaptive and maladaptive brain circuits underlying mental health (CIRC), Jena, Germany
Department of Psychiatry and Psychotherapy, University Hospital Jena, Jena, Germany
Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
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Yale University · University of Oxford
Affiliation as printed
Department of Psychiatry, University of Oxford, Oxford, UK
Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
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Affiliation as printed
Centre for Youth Mental Health, University of Melbourne, Melbourne, VIC, Australia
Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne, Victoria, Australia
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The University of Melbourne · Orygen
Affiliation as printed
Centre for Youth Mental Health, University of Melbourne, Melbourne, VIC, Australia
Orygen, Parkville, VIC, Australia
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University of Southern California
Affiliation as printed
Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Marina del Rey, CA, USA
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University of Southern California · King's College London
Affiliation as printed
Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Marina del Rey, CA, USA
Social Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, UK
Social Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
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The University of Queensland · QIMR Berghofer Medical Research Institute
Affiliation as printed
Department of Genetics & Computational Biology, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
School of Biomedical Sciences, Faculty of Medicine, University of Queensland, Brisbane, QLD, Australia
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University of Southern California
Affiliation as printed
Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Marina del Rey, CA, USA
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Affiliation as printed
Laboratory of Neuropsychiatry, IRCCS Santa Lucia Foundation, Rome, Italy
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Universidad de Cantabria · Centro de Investigación Biomédica en Red de Salud Mental · Marqués de Valdecilla University Hospital · Instituto de Investigación Marqués de Valdecilla
Affiliation as printed
Centro Investigación Biomédica en Red de Salud Mental (CIBERSAM), Sevilla, Spain
Department of Psychiatry, Marqués de Valdecilla University Hospital, IDIVAL, School of Medicine, University of Cantabria, Santander, Spain
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Affiliation as printed
Laboratory of Neuropsychiatry, IRCCS Santa Lucia Foundation, Rome, Italy
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Affiliation as printed
Department of Psychiatry and Behavioural Sciences, University of Minnesota Medical School, USA
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University of Münster · University Hospital Münster
Affiliation as printed
University Clinic for Radiology, University of Münster, Münster, Germany
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Boys Town National Research Hospital
Affiliation as printed
Center for Neurobehavioral Research, Boys Town National Research Hospital, Boys Town, NE, USA
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Boys Town National Research Hospital
Affiliation as printed
Center for Neurobehavioral Research, Boys Town National Research Hospital, Boys Town, NE, USA
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Philipps University of Marburg
Affiliation as printed
CMBB, Marburg, Germany
Department of Psychiatry and Psychotherapy, Marburg University, Marburg, Germany
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Kunming Medical University · First Affiliated Hospital of Kunming Medical University
Affiliation as printed
Department of Psychiatry, First Affiliated Hospital of Kunming Medical College, China
Yunnan Province Clinical Research Center for Psychiatry, China
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Inserm · Université Paris-Saclay · Assistance Publique – Hôpitaux de Paris · Centre de recherche en Epidémiologie et Santé des Populations · Bicêtre Hospital
Affiliation as printed
MOODS Team, CESP, INSERM, Faculté de Médecine, Univ Paris-Saclay, Le Kremlin Bicêtre, 94275, France
Service Hospitalo-Universitaire de Psychiatrie de Bicêtre, Hôpitaux Universitaires Paris-Saclay, Assistance Publique-Hôpitaux de Paris, Hôpital de Bicêtre, Le Kremlin Bicêtre, F-94275, France
Service Hospitalo-Universitaire de Psychiatrie de Bicêtre, Hôpitaux Universitaires Paris-Saclay, Assistance Publique-Hôpitaux de Paris, Hôpital de Bicêtre, Le Kremlin Bicêtre, F-945, France
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Affiliation as printed
Department of Biomedical Sciences, Florida State University, Tallahassee, FL, USA
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Inserm · Université Paris-Saclay · Assistance Publique – Hôpitaux de Paris · Centre de recherche en Epidémiologie et Santé des Populations · Bicêtre Hospital
Affiliation as printed
MOODS Team, CESP, INSERM, Faculté de Médecine, Univ Paris-Saclay, Le Kremlin Bicêtre, 94275, France
Service Hospitalo-Universitaire de Psychiatrie de Bicêtre, Hôpitaux Universitaires Paris-Saclay, Assistance Publique-Hôpitaux de Paris, Hôpital de Bicêtre, Le Kremlin Bicêtre, F-94275, France
Service Hospitalo-Universitaire de Psychiatrie de Bicêtre, Hôpitaux Universitaires Paris-Saclay, Assistance Publique-Hôpitaux de Paris, Hôpital de Bicêtre, Le Kremlin Bicêtre, F-945, France
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Centre National de la Recherche Scientifique · Institut national de recherche en sciences et technologies du numérique · Inserm · The University of Queensland · Sorbonne Université · Institut du Cerveau · ARAMIS: Algorithmes, modèles et méthodes pour les images et les signaux du cerveau humain sain et pathologique · Institute for Molecular Bioscience
Affiliation as printed
Institute for Molecular Bioscience, The University of Queensland, St Lucia, QLD, Australia
Paris Brain Institute (ICM), Inserm (U1127), CNRS (UMR 7225), Sorbonne University, Inria Paris (Aramis project-team), Paris, France
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Centro de Investigación Biomédica en Red de Salud Mental · Instituto de Biomedicina de Sevilla · Hospital Universitario Virgen del Rocío · Universidad de Sevilla
Affiliation as printed
Centro Investigación Biomédica en Red de Salud Mental (CIBERSAM), Sevilla, Spain
Virgen del Rocío University Hospital, IBiS, University of Sevilla, Sevilla, Spain
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Affiliation as printed
Department of Psychiatry and Behavioural Sciences, University of Minnesota Medical School, USA
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Affiliation as printed
Institute for Translational Psychiatry, University of Münster, Münster, Germany
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Affiliation as printed
Department of Psychiatry, The University of Melbourne, Victoria, Australia
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Affiliation as printed
Institute for Translational Psychiatry, University of Münster, Münster, Germany
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UNSW Sydney · Neuroscience Research Australia
Affiliation as printed
Neuroscience Research Australia, Randwick, NSW, Australia
School of Medical Sciences, University of New South Wales, Kensington, NSW, Australia
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Affiliation as printed
SoCAT Lab, Department of Psychiatry, School of Medicine, Ege University, Izmir, Turkey
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Affiliation as printed
Department of Psychology, Stanford University, Stanford, CA, USA
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Affiliation as printed
Institute for Translational Psychiatry, University of Münster, Münster, Germany
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Affiliation as printed
Institute for Translational Psychiatry, University of Münster, Münster, Germany
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Affiliation as printed
Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne, Victoria, Australia
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Kunming Medical University · First Affiliated Hospital of Kunming Medical University
Affiliation as printed
Department of Psychiatry, First Affiliated Hospital of Kunming Medical College, China
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Affiliation as printed
Brain and Mind Centre, University of Sydney, Camperdown, Australia
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University of California, San Francisco
Affiliation as printed
Department of Psychiatry and Behavioral Sciences, University of California San Francisco, San Francisco, CA, USA
Weill Institute for Neurosciences, University of California San Francisco, San Francisco, CA, USA
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Affiliation as printed
Brain and Mind Centre, University of Sydney, Camperdown, Australia
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Philipps University of Marburg
Affiliation as printed
CMBB, Marburg, Germany
Core-Facility Brainimaging, Faculty of Medicine, University of Marburg
Department of Psychiatry and Psychotherapy, Marburg University, Marburg, Germany
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Inserm · Université Paris Cité · Université Paris-Saclay · Centre de recherche en Epidémiologie et Santé des Populations · Centre Hospitalier Universitaire de Nîmes · Jena University Hospital · GHU Paris psychiatrie & neurosciences · McGill University
Affiliation as printed
Academic Hospital (CHU) Nîmes, France
Department of Psychiatry and Psychotherapy, University Hospital Jena, Jena, Germany
MOODS Team, CESP, INSERM, Faculté de Médecine, Univ Paris-Saclay, Le Kremlin Bicêtre, 94275, France
McGill University, Department of psychiatry, Montréal, Canada
Université de Paris & GHU Paris Psychiatrie et Neurosciences, Paris, France
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Philipps University of Marburg
Affiliation as printed
CMBB, Marburg, Germany
Department of Psychiatry and Psychotherapy, Marburg University, Marburg, Germany
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Affiliation as printed
University of Minnesota, Department of Psychology, Minneapolis, MN, USA
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Affiliation as printed
Institute for Translational Psychiatry, University of Münster, Münster, Germany
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Affiliation as printed
Institute for Translational Psychiatry, University of Münster, Münster, Germany
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The University of Texas at Austin
Affiliation as printed
Department of Psychiatry and Behavioral Sciences, Dell Medical School, University of Texas at Austin, USA
Institute of Early Life Adversity Research, Dell Medical School, University of Texas at Austin, USA
Mulva Clinic for Neuroscience, Dell Medical School, University of Texas at Austin, USA
Waggoner Center for Alcohol and Addiction Research, University of Texas at Austin, USA
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Affiliation as printed
Department of Psychology, Harvard University, USA
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Affiliation as printed
Institute for Translational Neuroscience, University of Münster, Münster, Germany
Institute for Translational Psychiatry, University of Münster, Münster, Germany
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University of North Carolina at Chapel Hill · RTI International
Affiliation as printed
Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, USA
Mental Health Risk and Resilience Research Program, RTI International, Research Triangle Park, NC
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Affiliation as printed
School of Psychiatry, University of New South Wales, Kensington, NSW, Australia
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The University of Texas Health Science Center at Houston
Affiliation as printed
Center Of Excellence On Mood Disorders, The University of Texas - Health Science Center at Houston
Louis A. Faillace, MD, Department of Psychiatry and Behavioral Sciences at McGovern Medical School, The University of Texas - Health Science Center at Houston
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Philipps University of Marburg
Affiliation as printed
CMBB, Marburg, Germany
Department of Psychiatry and Psychotherapy, Marburg University, Marburg, Germany
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University of Pittsburgh · Center for the Neural Basis of Cognition
Affiliation as printed
Center for Neuroscience, University of Pittsburgh, Pittsburgh, PA
Center for the Neural Basis of Cognition, University of Pittsburgh, Pittsburgh, PA
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Neuroscience Research Australia
Affiliation as printed
Neuroscience Research Australia, Randwick, NSW, Australia
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Philipps University of Marburg
Affiliation as printed
CMBB, Marburg, Germany
Department of Psychiatry and Psychotherapy, Marburg University, Marburg, Germany
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Affiliation as printed
Laboratory of Neuropsychiatry, IRCCS Santa Lucia Foundation, Rome, Italy
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Philipps University of Marburg
Affiliation as printed
CMBB, Marburg, Germany
Department of Psychiatry and Psychotherapy, Marburg University, Marburg, Germany
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Affiliation as printed
School of Psychiatry, University of New South Wales, Kensington, NSW, Australia
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University of Münster · University Hospital Münster
Affiliation as printed
Department of Child & Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital Münster
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The University of Texas Health Science Center at Houston
Affiliation as printed
Center Of Excellence On Mood Disorders, The University of Texas - Health Science Center at Houston
Louis A. Faillace, MD, Department of Psychiatry and Behavioral Sciences at McGovern Medical School, The University of Texas - Health Science Center at Houston
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University of North Carolina at Chapel Hill
Affiliation as printed
Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, USA
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The University of Texas Health Science Center at Houston
Affiliation as printed
Center Of Excellence On Mood Disorders, The University of Texas - Health Science Center at Houston
Louis A. Faillace, MD, Department of Psychiatry and Behavioral Sciences at McGovern Medical School, The University of Texas - Health Science Center at Houston
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Baylor College of Medicine · Fondazione Santa Lucia
Affiliation as printed
Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, Texas, USA
Laboratory of Neuropsychiatry, IRCCS Santa Lucia Foundation, Rome, Italy
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Philipps University of Marburg
Affiliation as printed
CMBB, Marburg, Germany
Department of Psychiatry and Psychotherapy, Marburg University, Marburg, Germany
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University of Pittsburgh · Stanford University
Affiliation as printed
Department of Psychology, Stanford University, Stanford, CA, USA
Department of Psychology, University of Pittsburgh, Pittsburgh, PA, USA
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Centro de Investigación Biomédica en Red de Salud Mental · Marqués de Valdecilla University Hospital · Instituto de Investigación Marqués de Valdecilla
Affiliation as printed
Centro Investigación Biomédica en Red de Salud Mental (CIBERSAM), Sevilla, Spain
Department of Radiology. Marqués de Valdecilla University Hospital, Valdecilla Biomedical Research Institute IDIVAL, Spain
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Affiliation as printed
SoCAT Lab, Department of Psychiatry, School of Medicine, Ege University, Izmir, Turkey
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Leiden University · Leiden University Medical Center
Affiliation as printed
Department of Psychiatry, Leiden University Medical Center, Leiden, the Netherlands
Leiden Institute for Brain and Cognition. Leiden University. Leiden, the Netherlands
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Leiden University · Leiden University Medical Center
Affiliation as printed
Department of Psychiatry, Leiden University Medical Center, Leiden, the Netherlands
Leiden Institute for Brain and Cognition. Leiden University. Leiden, the Netherlands
Leids Universitair Behandel- en Expertise Centrum, Leiden, the Netherlands
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Robert R. J. M. Vermeiren Aachen
Leiden University Medical Center
Affiliation as printed
Child and Adolescent Psychiatry Leiden University Medical Center, Leiden, the Netherlands
Youz: child and adolescent psychiatry, Netherlands
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Affiliation as printed
Institute for Translational Psychiatry, University of Münster, Münster, Germany
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The University of Texas Health Science Center at Houston
Affiliation as printed
Center Of Excellence On Mood Disorders, The University of Texas - Health Science Center at Houston
Louis A. Faillace, MD, Department of Psychiatry and Behavioral Sciences at McGovern Medical School, The University of Texas - Health Science Center at Houston
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University of California, San Francisco · University of California San Francisco Medical Center
Affiliation as printed
Department of Psychiatry and Behavioral Sciences, Division of Child and Adolescent Psychiatry, Weill Institute for Neurosciences, UCSF, USA
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University of Southern California
Affiliation as printed
Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Marina del Rey, CA, USA
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The University of Queensland · University of California, San Francisco · QIMR Berghofer Medical Research Institute · Global Brain Health Institute
Affiliation as printed
Department of Genetics & Computational Biology, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
Global Brain Health Institute, University of California, San Francisco, San Francisco, CA, USA
School of Biomedical Sciences, Faculty of Medicine, University of Queensland, Brisbane, QLD, Australia
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University of Southern California
Affiliation as printed
Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Marina del Rey, CA, USA
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Affiliation as printed
Child Study Center, Yale School of Medicine, USA
Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
Department of Radiology and Biomedical Imaging, Yale School of Medicine, USA
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Leiden University · University of Cambridge
Affiliation as printed
Department of Psychiatry, University of Cambridge, Cambridge, UK
Social Security and Resilience Programme, Education and Child Studies, Leiden University, Leiden, the Netherlands
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The University of Melbourne · Orygen
Affiliation as printed
Centre for Youth Mental Health, University of Melbourne, Melbourne, VIC, Australia
Orygen, Parkville, VIC, Australia
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