1/2 Predicting Adult Outcomes in Bipolar Youth (PROBY)

1/2 预测双相情感障碍青少年的成年结局 (PROBY)

• 批准号: 10326340
• 负责人: BORIS BIRMAHER
• 金额: $ 47.55万
• 依托单位: UNIVERSITY OF PITTSBURGH AT PITTSBURGH
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-01-10 至 2023-12-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10326340
• 关键词: 3 year old; 7 year old; Address; Adolescence; Adult; Age; Anxiety Disorders; Attention deficit hyperactivity disorder; Bipolar Disorder; Cardiovascular Diseases; Cardiovascular system; Categories; Caucasians; Childhood; Clinical; Clinical assessments; Counseling; Data; Development; Dimensions; Discrimination; Disruptive Behavior Disorder; Early Intervention; Enrollment; Event; Exposure to; Family; Feeling suicidal; Female; Foundations; Future; Genetic; Goals; Heart Diseases; Impairment; Individual; Life; Literature; Malignant Neoplasms; Manic; Mathematics; Medical; Mental Depression; Mental disorders; Modeling; Moods; Multicenter Studies; National Institute of Mental Health; Onset of illness; Outcome; Patients; Pharmaceutical Preparations; Phenotype; Population; Positioning Attribute; Predictive Factor; Prevention; Prognosis; Prognostic Factor; Provider; Psychopathology; Reporting; Research; Risk; Risk Estimate; Risk Factors; Sample Size; Sampling; Schizophrenia; Site; Specific qualifier value; Specificity; Substance Use Disorder; Substance abuse problem; Suicide; Symptoms; Time; To specify; Universities; Work; Youth; base; biological research; cardiometabolism; childhood bipolar disorder; clinical care; clinical practice; clinical risk; clinically relevant; cognitive control; cognitive function; cohort; comorbidity; depressive symptoms; dosage; early onset; emerging adult; flexibility; follow-up; human old age (65+); individualized medicine; inflammatory marker; minimal risk; mood symptom; neuroimaging; novel; outcome prediction; personalized management; personalized predictions; prospective; protective factors; psychosocial; recruit; sex; suicidal behavior; suicidal risk; tool

Project Summary/Abstract The negative consequences of pediatric bipolar disorder (BP) are well documented, but the course, outcome, and prognostic factors of BP as youth transit into adulthood remain unknown. To answer these questions, the Predicting Adult Outcomes in BP Youth (PROBY), a multisite study (University of Pittsburgh, PI: B.Birmaher; Brown University, PIs: M.Keller/S.Yen; UCLA, PI: M.Strober), proposes: 1) to extend the prospective follow-up of the Course and Outcome of Bipolar Youth (COBY) cohort into adulthood, and 2) to use COBY data to build risk calculators to predict short-(2 years), intermediate-(5 years), and long-term (10 years) personalized mood course/outcome that capture transitions from adolescence through adulthood. We will study five key domains relevant for BP: 1) course of mood and non-mood disorders; 2) psychosocial functioning; 3) suicidality; 4) SUD; and 5) cognitive functioning. Risk calculation is an analytic approach that instead of group prediction, yields individualized estimates of risk for a specified event in a given patient, based on the presence of multiple risk factors. The risk calculators proposed in PROBY will have a true population impact by predicting BP outcomes, similar to those used in cardiovascular disease and cancer, but rarely applied in psychiatric disorders. The risk calculators will include well-established variables, in order to allow replication and clinical utility. Also, these variables are easily ascertained in clinical settings and are part of standard practice and thus, will be widely disseminable, and hold promise for utility in daily clinical practice. For example, results may be used to: counsel patients/families about long-term prognosis; individualize treatment by identifying patients likely to require prolonged treatments and those for whom medications may be reduced with minimal risk; and inform early intervention/prevention and clinical/biological research. To pursue the proposed study, 343 COBY subjects (BP-I=72.3%, BP-II=14.6%, BP-NOS=13.1%, mean age 26.3 (18.7–33.7), 47% female, 82% Caucasian, and on average, middle class), will have 2 additional clinical assessments over the five years of study. These subjects represent 77% of the original sample (n=446) enrolled between 2000 and 2006 at the three study sites. PROBY will continue to prospectively collect data on categorical and dimensional psychopathology, protective factors, psychosocial functioning (e.g., relationships, work, academics), cognitive functioning, inflammatory markers, cardiometabolic conditions, exposure to stressful/traumatic life events, and treatment (e.g., medication dosages, barriers). With 5 additional years of prospective observation, the mean age of the sample will be 31.3 years old (23.7–38.7). Thus, PROBY will be the first study with adequate sample size to answer questions about what happens to BP youth when they grow up. Furthermore, PROBY will be the first study to build risk calculators to predict outcome in key domains relevant for BP and validate these results using an independent adult BP sample (n=427) from the Collaborative Depression Study (CDS; R01 MH025416). These risk calculators have the potential to widely transform clinical care of BP.

项目概要/摘要 小儿双相情感障碍 (BP) 的负面后果已有详细记录，但其病程、结果、 青少年进入成年后血压的影响和预后因素仍然未知。 预测 BP 青少年成人结局 (PROBY)，一项多地点研究（匹兹堡大学，PI：B.Birmaher； 布朗大学，PI：M.Keller/S.Yen；加州大学洛杉矶分校，PI：M.Strober），建议：1）延长前瞻性随访 双相情感障碍青年 (COBY) 队列进入成年期的过程和结果，以及 2) 使用 COBY 数据 构建风险计算器来预测短期（2 年）、中期（5 年）和长期（10 年）个性化 捕捉从青春期到成年过渡的情绪过程/结果我们将研究五个关键。 与 BP 相关的领域：1) 情绪和非情绪障碍的病程；2) 心理社会功能； 自杀倾向；4) SUD；以及 5) 风险计算是一种分析方法。 群体预测，根据给定患者特定事件的风险进行个性化估计 PROBY 中提出的风险计算器将对人口产生真正的影响。 预测血压结果，类似于心血管疾病和癌症中使用的方法，但很少应用于 精神疾病风险计算器将包括完善的变量，以便进行复制。 此外，这些变量在临床环境中很容易确定，并且是标准的一部分。 因此，它将被广泛传播，并有望在日常临床实践中发挥作用。 例如，结果可用于： 为患者/家属提供有关长期预后的建议； 可能需要长期治疗的患者并确定可以减少药物治疗的患者 以最小的风险；并为早期干预/预防和临床/生物学研究提供信息。 拟议的研究，343 名 COBY 受试者（BP-I=72.3%，BP-II=14.6%，BP-NOS=13.1%，平均年龄 26.3（18.7-33.7）， 47% 为女性，82% 为白人，平均为中产阶级），将进行 2 次额外的临床评估 这些受试者占 2000 年期间注册的原始样本 (n=446) 的 77%。 2006 年和 2006 年，PROBY 将继续前瞻性地收集有关分类和数据的数据。 心理维度的精神病理学、保护性心理因素、社会功能（例如人际关系、工作、学术）、 认知功能、炎症标志物、心脏代谢状况、压力/创伤性生活 事件和治疗（例如药物剂量、障碍）再进行 5 年的前瞻性观察， 样本的平均年龄为 31.3 岁（23.7-38.7），因此，PROBY 将是第一个研究。 足够的样本量可以回答有关 BP 青少年长大后会发生什么的问题。 PROBY 将是第一项建立风险计算器来预测与 BP 和相关关键领域结果的研究 使用来自协作抑郁症研究的独立成人血压样本 (n=427) 验证这些结果 （CDS；R01 MH025416）这些风险计算器有可能广泛改变 BP 的临床护理。

项目成果

A Risk Calculator to Predict the Individual Risk of Conversion From Subthreshold Bipolar Symptoms to Bipolar Disorder I or II in Youth.

风险计算器可预测青少年从阈下双相情感障碍症状转变为双相情感障碍 I 或 II 的个人风险。

• 发表时间: 2018
• 影响因子: 13.3
• 作者: Birmaher, Boris;Merranko, John A;Goldstein, Tina R;Gill, Mary Kay;Goldstein, Benjamin I;Hower, Heather;Yen, Shirley;Hafeman, Danella;Strober, Michael;Diler, Rasim S;Axelson, David;Ryan, Neal D;Keller, Martin B
• 通讯作者: Keller, Martin B

Validation of the youth mood recurrences risk calculator in an adult sample with bipolar disorder.

在双相情感障碍成人样本中验证青年情绪复发风险计算器。

• DOI: 10.1016/j.jad.2021.09.037
• 发表时间: 2021-09-01
• 期刊: Journal of affective disorders
• 影响因子: 6.6
• 作者: J. Fiedorowicz;J. Merranko;S. Iyengar;H. Hower;M. Gill;S. Yen;T. Goldstein;Michael Strober;D. Haf
• 通讯作者: D. Haf

Parsing cyclothymic disorder and other specified bipolar spectrum disorders in youth.

解析青少年的循环性障碍和其他特定的双相谱系障碍。

• 发表时间: 2018
• 影响因子: 6.6
• 作者: Van Meter, Anna;Goldstein, Benjamin I;Goldstein, Tina R;Yen, Shirley;Hower, Heather;Strober, Michael;Merranko, John A;Gill, Mary Kay;Diler, Rasim S;Axelson, David;Ryan, Neal D;Keller, Martin B;Birmaher, Boris
• 通讯作者: Birmaher, Boris

Higher socioeconomic status and less parental psychopathology improve prognosis in youths with bipolar disorder.

较高的社会经济地位和较少的父母精神病理学可改善双相情感障碍青少年的预后。

• 发表时间: 2022-04-01
• 影响因子: 6.6
• 作者: Diler, Rasim S;Merranko, John A;Hafeman, Danella;Goldstein, Tina R;Goldstein, Benjamin I;Hower, Heather;Gill, Mary Kay;Axelson, David A;Ryan, Neal;Strober, Michael;Keller, Martin B;Yen, Shirley;Hunt, Jeffrey I;Weinstock, Lauren M;Iyengar, Sa
• 通讯作者: Iyengar, Sa

The Effect of Traumatic Events on the Longitudinal Course and Outcomes of Youth with Bipolar Disorder.

创伤事件对患有双相情感障碍的青少年的纵向病程和结果的影响。

• 发表时间: 2020
• 影响因子: 6.6
• 作者: Andreu Pascual, Maria;Levenson, Jessica C;Merranko, John;Gill, Mary Kay;Hower, Heather;Yen, Shirley;Strober, Michael;Goldstein, Tina R;Goldstein, Benjamin I;Ryan, Neal D;Weinstock, Lauren M;Keller, Martin B;Axelson, David;Birmaher, Boris
• 通讯作者: Birmaher, Boris