Dr Jack Underwood
(he/him)
Welsh Clinical Academic Track (WCAT) Fellow
Overview
I am a Forensic Psychiatry Registrar on the Wales Clinical Academic Track, currently pending a PhD viva on a Wellcome Trust GW4-CAT Fellowship. My work looks at why co-occurring mental and physical health conditions are more common in autistic adults, using a mixture of epidemiological and statistical genetic techniques.
I have a further focus on genotype-phenotype variants in the CACNA1C gene, as part of a wider interest on modelling pathogenesis of neurodevelopmental disorders. As part of this I chair the Scientific Advisory Board for the Timothy Syndrome Alliance (TSA UK) charity, and co-lead on the TSA's CZI Rare As One grant award.
Publication
2024
- Wren, G., Flanagan, J., Underwood, J., Thompson, A., Humby, T. and Davies, W. 2024. Memory, mood and associated neuroanatomy in individuals with steroid sulfatase deficiency (X-linked ichthyosis). Genes, Brain and Behavior 23(3), article number: e12893. (10.1111/gbb.12893)
- Hunt, M., Underwood, J., Hubbard, L. and Hall, J. 2024. Risk of physical health comorbidities in autistic adults: a clinical nested cross-sectional study. BJPsych Open (10.1192/bjo.2024.777)
2023
- Christie, H., Hamilton-Giachritsis, C., McGuire, R., Bisson, J., Roberts, N. P., Underwood, J. and Halligan, S. 2023. Exploring the perceived impact of parental PTSD on parents and parenting behaviours – a qualitative study. Journal of Child and Family Studies 32, pp. 3378-3388. (10.1007/s10826-023-02614-z)
- Wren, G. et al. 2023. Characterising heart rhythm abnormalities associated with Xp22.31 deletion. Journal of Medical Genetics 60, pp. 636-643. (10.1136/jmg-2022-108862)
- Lynham, A. J. et al. 2023. DRAGON-Data: A platform and protocol for integrating genomic and phenotypic data across large psychiatric cohorts. BJPsych Open 9(2), article number: e32. (10.1192/bjo.2022.636)
- Levy, R., Timothy, K., Underwood, J., Hall, J., Bernstein, J. and Pasca, S. 2023. A cross-sectional study of the neuropsychiatric phenotype of CACNA1C-related disorder. Pediatric Neurology 138, pp. 101-106. (10.1016/j.pediatrneurol.2022.10.013)
2022
- Underwood, J., DelPozo-Banos, M., Frizzati, A., Rai, D., John, A. and Hall, J. 2022. Neurological and psychiatric disorders among autistic adults: a population healthcare record study. Psychological Medicine (10.1017/S0033291722002884)
- Underwood, J. F. G., DelPozo-Banos, M., Frizzati, A., John, A. and Hall, J. 2022. Evidence of increasing recorded diagnosis of autism spectrum disorders in Wales, UK – an e-cohort study. Autism 26(6), pp. 1499-1508. (10.1177/13623613211059674)
- Brcic, L., Wren, G., Underwood, J., Kirov, G. and Davies, W. 2022. Comorbid medical issues in X-linked ichthyosis [Letter]. JID Innovations 2(3), article number: 100109. (10.1016/j.xjidi.2022.100109)
2021
- Hoskins, M. D. et al. 2021. Pharmacological therapy for post-traumatic stress disorder: a systematic review and meta-analysis of monotherapy, augmentation and head-to-head approaches. European Journal of Psychotraumatology 12(1), article number: 1802920. (10.1080/20008198.2020.1802920)
- Hoskins, M. D. et al. 2021. Pharmacological-assisted psychotherapy for post-traumatic stress disorder: a systematic review and meta-analysis. European Journal of Psychotraumatology 12(1), article number: 1853379. (10.1080/20008198.2020.1853379)
2020
- Brcic, L., Underwood, J., Kendall, K., Caseras, X., Kirov, G. and Davies, W. 2020. Medical and neurobehavioural phenotypes in carriers of X-linked ichthyosis-associated genetic deletions in the UK Biobank. Journal of Medical Genetics 57(10), pp. 692-698. (10.1136/jmedgenet-2019-106676)
- Gubb, S., Brcic, L., Underwood, J., Kendall, K., Caseras, X., Kirov, G. and Davies, W. 2020. Medical and neurobehavioural phenotypes in male and female carriers of Xp22.31 duplications in the UK Biobank. Human Molecular Genetics 29(17), pp. 2872-2881. (10.1093/hmg/ddaa174)
2019
- Underwood, J., Kendall, K., Berrett, J., Lewis, C., Anney, R., Van den Bree, M. and Hall, J. 2019. Autism spectrum disorder diagnosis in adults: phenotype and genotype findings from a clinically derived cohort. British Journal of Psychiatry 215(5), pp. 647-653. (10.1192/bjp.2019.30)
- Underwood, J., Kendall, K., Berrett, J., Anney, R., Bree, M. V. D. and Hall, J. 2019. SA20COPY Number variants and polygenic risk scores in adults with autism spectrum disorder (ASD): results from the NCMH adult ASD cohort. European Neuropsychopharmacology 29(S4), pp. S1198-S1199. (10.1016/j.euroneuro.2018.08.242)
2017
- Black, L. F. and Underwood, J. F. G. 2017. P.3.b.045 - Psychosis in Wilson’s disease: an unusual presentation of bipolar affective disorder. Presented at: 30th ECNP Congress 2017, Paris, France, 2-5 September 2017, Vol. 27. Vol. Supple. Elsevier pp. S915., (10.1016/S0924-977X(17)31627-9)
Cynadleddau
- Black, L. F. and Underwood, J. F. G. 2017. P.3.b.045 - Psychosis in Wilson’s disease: an unusual presentation of bipolar affective disorder. Presented at: 30th ECNP Congress 2017, Paris, France, 2-5 September 2017, Vol. 27. Vol. Supple. Elsevier pp. S915., (10.1016/S0924-977X(17)31627-9)
Erthyglau
- Wren, G., Flanagan, J., Underwood, J., Thompson, A., Humby, T. and Davies, W. 2024. Memory, mood and associated neuroanatomy in individuals with steroid sulfatase deficiency (X-linked ichthyosis). Genes, Brain and Behavior 23(3), article number: e12893. (10.1111/gbb.12893)
- Hunt, M., Underwood, J., Hubbard, L. and Hall, J. 2024. Risk of physical health comorbidities in autistic adults: a clinical nested cross-sectional study. BJPsych Open (10.1192/bjo.2024.777)
- Christie, H., Hamilton-Giachritsis, C., McGuire, R., Bisson, J., Roberts, N. P., Underwood, J. and Halligan, S. 2023. Exploring the perceived impact of parental PTSD on parents and parenting behaviours – a qualitative study. Journal of Child and Family Studies 32, pp. 3378-3388. (10.1007/s10826-023-02614-z)
- Wren, G. et al. 2023. Characterising heart rhythm abnormalities associated with Xp22.31 deletion. Journal of Medical Genetics 60, pp. 636-643. (10.1136/jmg-2022-108862)
- Lynham, A. J. et al. 2023. DRAGON-Data: A platform and protocol for integrating genomic and phenotypic data across large psychiatric cohorts. BJPsych Open 9(2), article number: e32. (10.1192/bjo.2022.636)
- Levy, R., Timothy, K., Underwood, J., Hall, J., Bernstein, J. and Pasca, S. 2023. A cross-sectional study of the neuropsychiatric phenotype of CACNA1C-related disorder. Pediatric Neurology 138, pp. 101-106. (10.1016/j.pediatrneurol.2022.10.013)
- Underwood, J., DelPozo-Banos, M., Frizzati, A., Rai, D., John, A. and Hall, J. 2022. Neurological and psychiatric disorders among autistic adults: a population healthcare record study. Psychological Medicine (10.1017/S0033291722002884)
- Underwood, J. F. G., DelPozo-Banos, M., Frizzati, A., John, A. and Hall, J. 2022. Evidence of increasing recorded diagnosis of autism spectrum disorders in Wales, UK – an e-cohort study. Autism 26(6), pp. 1499-1508. (10.1177/13623613211059674)
- Brcic, L., Wren, G., Underwood, J., Kirov, G. and Davies, W. 2022. Comorbid medical issues in X-linked ichthyosis [Letter]. JID Innovations 2(3), article number: 100109. (10.1016/j.xjidi.2022.100109)
- Hoskins, M. D. et al. 2021. Pharmacological therapy for post-traumatic stress disorder: a systematic review and meta-analysis of monotherapy, augmentation and head-to-head approaches. European Journal of Psychotraumatology 12(1), article number: 1802920. (10.1080/20008198.2020.1802920)
- Hoskins, M. D. et al. 2021. Pharmacological-assisted psychotherapy for post-traumatic stress disorder: a systematic review and meta-analysis. European Journal of Psychotraumatology 12(1), article number: 1853379. (10.1080/20008198.2020.1853379)
- Brcic, L., Underwood, J., Kendall, K., Caseras, X., Kirov, G. and Davies, W. 2020. Medical and neurobehavioural phenotypes in carriers of X-linked ichthyosis-associated genetic deletions in the UK Biobank. Journal of Medical Genetics 57(10), pp. 692-698. (10.1136/jmedgenet-2019-106676)
- Gubb, S., Brcic, L., Underwood, J., Kendall, K., Caseras, X., Kirov, G. and Davies, W. 2020. Medical and neurobehavioural phenotypes in male and female carriers of Xp22.31 duplications in the UK Biobank. Human Molecular Genetics 29(17), pp. 2872-2881. (10.1093/hmg/ddaa174)
- Underwood, J., Kendall, K., Berrett, J., Lewis, C., Anney, R., Van den Bree, M. and Hall, J. 2019. Autism spectrum disorder diagnosis in adults: phenotype and genotype findings from a clinically derived cohort. British Journal of Psychiatry 215(5), pp. 647-653. (10.1192/bjp.2019.30)
- Underwood, J., Kendall, K., Berrett, J., Anney, R., Bree, M. V. D. and Hall, J. 2019. SA20COPY Number variants and polygenic risk scores in adults with autism spectrum disorder (ASD): results from the NCMH adult ASD cohort. European Neuropsychopharmacology 29(S4), pp. S1198-S1199. (10.1016/j.euroneuro.2018.08.242)
Research
Autism is a life-long neurodevelopmental condition which affects ~1% of people. Mental health problems are more common in autistic people, but we don't understand why. My PhD looks at this, and what effects genetics or lifestyle have on the mental health of autistic adults. I examine the effects of existing quantified polygenic risk for mental health disorders (PGS) in the autistic population, alongside associations within hospital and general practice record data on subsequent mental health difficulties. To undertake this I have identified and co-produced assessments in a cohort of autistic adults from the National Centre for Mental Health (NCMH) Database, as well as autistic people within a large dataset of anonymised healthcare records (SAIL) and a longitudinal population sample (ALSPAC).
For these projects I am supervised by Prof Jeremy Hall (Cardiff), Dr Ric Anney (Cardiff), and Prof Dheeraj Rai (Bristol University, Population Health Sciences).
I have a further thread of research interest in the phenotype-genotype relationship of CACNA1C variants, aiming to establish phenotypic features associated with gene variants across loci in this gene. My particular focus is on neurodevelopmental disorders within this context, and modelling how changes in this gene result in these features. To examine this I have compiled an international case series of individuals with CACNA1C and their families, with deep phenotyping and cell lines (where available). I lead the Scientific Advisory Board for the Timothy Syndrome Alliance charity, and have organised and hosted conferences and events for the charity. We were awarded grant funding for a public engagement film in 2021, further funding in 2022 for international translation of conferences, and won the 2022 Gene People Awards Best Research Partnership.
Teaching
I teach on several Cardiff and Swansea University courses, at the undergraduate and postgraduate level.
For the Medicine MBBCh course, I lecture on neuroanatomy and provide small group teaching on personality disorders and communication skills. I am a formative and summative psychiatry ISCE examiner. I have supervised intercalating student projects on the Psychology in Medicine BSc course. I supervise SSC projects, including wet and dry lab work.
I have provided data and supervision for student case studies on the MSc in Applied Bioinformatics and Genomics. I have also supervised dissertation projects on the MSc in Psychiatry, and the Doctorate in Clinical Psychology.
Biography
I am a Forensic Psychiatry Registrar on the Wales Clinical Academic Track, recently back into clinical training at ST5 level and pending my PhD viva on a Wellcome Trust GW4-CAT Fellowship. I undertook Core Psychiatry Training and the Foundation Programme in South Wales, after graduating from Medicine (BMBS) at Peninsula College of Medicine and Dentistry. I have been a member of the Royal College of Psychiatrists since 2018.
Honours and awards
2024 - Chan Zuckerberg Initiative Rare As One Grant - as Chair of TSA Scientific Advisory Board
2022 – Gene People Awards - Best Research Partnership - Winner, with Timothy Syndrome Alliance
2019 – Wellcome Trust GW4-CAT Clinical Academic Training Fellowship
2018 – Wellcome Trust ISSF Clinical Primer Award
2018 – RCPsych International Congress Travel Bursary
2018 – European Psychiatric Association Congress Travel Grant
2016 – Cardiff MRC Centre Clinical Academic Mentorship Scheme
Professional memberships
Member of the Royal College of Psychiatrists (MRCPsych)
Registered with the General Medical Council (7414226)
Committees and reviewing
I have peer reviewed multiple publications for a variety of journals, including: JAMA Psychiatry, The British Journal of Psychiatry (BJPsych), BJPsych Bulletin, BJPsych Open, Research in Developmental Disorders, Biological Psychiatry, Advances in Autism, Research in Autism Spectrum Disorders.
Through the Wellcome Gatsby Neuroscience initiative I was involved in the promotion of Neuroscience for the Royal College of Psychiatrists, initially as Neuroscience Trainee Editor for TrOn and later the RCPsych Neuroscience Champion for Wales.
I have further experience of commissioning and clinical governance through a number of committees, including the Welsh Government Autism and Neurodiversity Clinical Advisory Group.