Structural brain alterations associated with suicidal thoughts and behaviors in young people: results from 21 international studies from the ENIGMA Suicidal Thoughts and Behaviours consortium
Molecular Psychiatry, vol. 27, pp. 4550–4560
Abstract
Identifying brain alterations associated with suicidal thoughts and behaviors (STBs) in young people is critical to understanding their development and improving 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. We performed analyses in three separate stages, in samples ranging from most to least homogeneous in terms of suicide assessment instrument and mental disorder. First, in a sample of 577 young people with mood disorders, in which STBs were assessed with the Columbia Suicide Severity Rating Scale (C-SSRS). Second, in a sample of young people with mood disorders, in which STB were assessed using different instruments, MRI metrics were compared among healthy controls without STBs (HC; N = 519), clinical controls with a mood disorder but without STBs (CC; N = 246) and young people with current suicidal ideation (N = 223). In separate analyses, MRI metrics were compared among HCs (N = 253), CCs (N = 217), and suicide attempters (N = 64). Third, in a larger transdiagnostic sample with various assessment instruments (HC = 606; CC = 419; Ideation = 289; HC = 253; CC = 432; Attempt=91). In the homogeneous C-SSRS sample, surface area of the frontal pole was lower in young people with mood disorders and a history of actual suicide attempts (N = 163) than those without a lifetime suicide attempt (N = 323; FDR-p = 0.035, Cohen's d = 0.34). No associations with suicidal ideation were found. When examining more heterogeneous samples, we did not observe significant associations. Lower frontal pole surface area may represent a vulnerability for a (non-interrupted and non-aborted) 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. laura.vanvelzen@unimelb.edu.au
Orygen, Parkville, VIC, Australia. laura.vanvelzen@unimelb.edu.au
Orygen, Parkville, VIC, Australia
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McGovern Institute for Brain Research · University of Cambridge · Massachusetts Institute of Technology · University of Birmingham
Affiliation as printed
Department of Psychiatry, University of Cambridge, Cambridge, UK
Institute for Mental Health, School of Psychology, University of Birmingham, Birmingham, UK
McGovern Institute for Brain Research, Massachusetts Institute of Technology, Cambridge, MA, USA
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Yale University · Jena University Hospital
Affiliation as printed
Department of Psychiatry and Psychotherapy, Jena University Hospital, Jena, Germany
Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
German Center for Mental Health, Halle-Jena-Magdeburg, Germany
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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, Melbourne, VIC, 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
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The University of Queensland · QIMR Berghofer Medical Research Institute · Institute for Molecular Bioscience
Affiliation as printed
Department of Genetics & Computational Biology, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
Institute for Molecular Bioscience, The University of Queensland, St Lucia, 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 Behavioral Sciences, University of Minnesota Medical School, Minneapolis, MN, 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, Kunming, China
Yunnan Province Clinical Research Center for Psychiatry, Kunming, 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 U1018, 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
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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 U1018, 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
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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, CSIC, University of Sevilla, Sevilla, Spain
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Affiliation as printed
Department of Psychiatry and Behavioral Sciences, University of Minnesota Medical School, 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
Department of Psychiatry, The University of Melbourne, Melbourne, VIC, 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, Melbourne, VIC, 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, Kunming, China
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Affiliation as printed
Brain and Mind Centre, University of Sydney, Camperdown, NSW, 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, NSW, Australia
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Philipps University of Marburg
Affiliation as printed
CMBB, Marburg, Germany
Core-Facility Brainimaging, Faculty of Medicine, University of Marburg, Marburg, Germany
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, Jena University Hospital, Jena, Germany
MOODS Team, CESP, INSERM U1018, Faculté de Médecine, Univ Paris-Saclay, Le Kremlin Bicêtre, 94275, France
McGill University, Department of Psychiatry, Montréal, QC, 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, Austin, TX, USA
Institute of Early Life Adversity Research, Dell Medical School, University of Texas at Austin, Austin, TX, USA
Mulva Clinic for Neuroscience, Dell Medical School, University of Texas at Austin, Austin, TX, USA
Waggoner Center for Alcohol and Addiction Research, University of Texas at Austin, Austin, TX, USA
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Affiliation as printed
Department of Psychology, Harvard University, Cambridge, MA, 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, Chapel Hill, NC, USA
Mental Health Risk and Resilience Research Program, RTI International, Research Triangle Park, NC, USA
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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, Houston, TX, USA
Louis A. Faillace, MD, Department of Psychiatry and Behavioral Sciences at McGovern Medical School, The University of Texas - Health Science Center at Houston, Houston, TX, 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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University of Pittsburgh · Center for the Neural Basis of Cognition
Affiliation as printed
Center for Neuroscience, University of Pittsburgh, Pittsburgh, PA, USA
Center for the Neural Basis of Cognition, University of Pittsburgh, Pittsburgh, PA, USA
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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, 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, Houston, TX, USA
Louis A. Faillace, MD, Department of Psychiatry and Behavioral Sciences at McGovern Medical School, The University of Texas - Health Science Center at Houston, Houston, TX, USA
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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, Chapel Hill, NC, 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, Houston, TX, USA
Louis A. Faillace, MD, Department of Psychiatry and Behavioral Sciences at McGovern Medical School, The University of Texas - Health Science Center at Houston, Houston, TX, USA
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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, TX, 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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Consejo Superior de Investigaciones Científicas · Marqués de Valdecilla University Hospital · Instituto de Investigación Marqués de Valdecilla · Instituto de Física de Cantabria
Affiliation as printed
Advanced Computing and e-Science, Instituto de Física de Cantabria (UC-CSIC), Santander, Spain
Department of Radiology, IDIVAL, Marqués de Valdecilla University Hospital, Santander, Spain
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Affiliation as printed
SoCAT Lab, Department of Psychiatry, School of Medicine, Ege University, Izmir, Turkey
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Nic J. A. van der Wee Aachen Department of Psychiatry, Leiden University Medical Center Leiden Institute for Brain and Cognition
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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Steven J. van der Werff Aachen Department of Psychiatry, Leiden University Medical Center Leiden Institute for Brain and Cognition
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, Leiden, The 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, Houston, TX, USA
Louis A. Faillace, MD, Department of Psychiatry and Behavioral Sciences at McGovern Medical School, The University of Texas - Health Science Center at Houston, Houston, TX, USA
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University of California, San Francisco
Affiliation as printed
Department of Psychiatry and Behavioral Sciences, Division of Child and Adolescent Psychiatry, Weill Institute for Neurosciences, UCSF, San Francisco, CA, 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 · 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
Child Study Center, Yale School of Medicine, New Haven, CT, USA
Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, CT, USA
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Anne‐Laura van Harmelen corresponding Aachen Leiden Institute for Brain and Cognition Social Security and Resilience Programme
Leiden University · University of Cambridge
Affiliation as printed
Department of Psychiatry, University of Cambridge, Cambridge, UK
Leiden Institute for Brain and Cognition, Leiden University, Leiden, The Netherlands
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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