Psychosis: Early Detection, Intervention and Prevention

精神病：早期发现、干预和预防

• 批准号: 7017694
• 负责人: WILLIAM R MCFARLANE
• 金额: $ 87.18万
• 依托单位: MAINEHEALTH
• 依托单位国家: 美国
• 财政年份: 2003
• 资助国家: 美国
• 起止时间: 2003-03-01 至 2008-01-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7017694
• 关键词: adolescence (12-20); antipsychotic agents; behavioral /social science research tag; bipolar depression manic phase; clinical research; clinical trial phase I; community mental health services; dosage; early diagnosis; family structure /dynamics; human subject; major depression; mental disorder prevention; psychopharmacology; psychosis; psychotherapy; schizophrenia; young adult human (21-34)

DESCRIPTION (provided by applicant): The primary aim of this application is to conduct a randomized, controlled clinical trial of a specialized mental health service delivery system specifically developed for prodromal psychotic disorders. The intervention is Family-aided Assertive Community Treatment (FACT). The proposed study will be part of a larger program, Portland Identification and Early Referral (PIER), under foundation and Center for Mental Health Center sponsorship, that has established a population-based system of early detection for Greater Portland, Maine. Previous and present effort has educated and trained the community-at-large and all health, education and other professionals, with the result that referrals are occurring at the expected frequency. The principle strategy is to intervene early, prior to onset, in the course of the onset of psychotic disorders to arrest the development of psychotic symptoms and functional disability. The test treatment is a specialized combination of psychoeducational multifamily group and assertive community treatment. In pilot studies FACT has led to very low rates of conversion to psychosis and very high rates of engagement and retention in treatment, thereby decreasing the burden on the family and the community. The goal of the treatment is prevention of psychosis and disability. This study will assess experimentally the clinical effectiveness of this new type of mental health service. Other domains of outcome include cognitive dysfunction and functional disability. The project will support an EDIPFACT team of clinical staff with the ability to: a. foster detection of prodromal disorders in the Greater Portland community by general practitioners, guidance counselors, mental health professionals and the general public; b. accurately assess individuals at high risk for psychosis; c. reliably deliver an evidence-based psychosocial and, if indicated, pharmacological treatment package using standardized methodology. The research study will test, in a randomized controlled trial, the symptomatic and functional outcome of treatment in 96 subjects ages 12 to 35 identified by that system. It will allow the analysis of key social factors contributing to psychosis and their interaction with the treatment conditions and each other.

描述（由申请人提供）：本申请的主要目的是对专门针对前驱性精神病开发的专门心理健康服务提供系统进行随机、对照临床试验。干预措施是家庭辅助自信社区治疗（FACT）。拟议的研究将是一个更大的项目“波特兰识别和早期转诊”(PIER) 的一部分，该项目由基金会和心理健康中心赞助，该项目为缅因州大波特兰建立了一个基于人群的早期检测系统。 以前和现在的努力对整个社区以及所有卫生、教育和其他专业人员进行了教育和培训，结果是按预期频率进行转诊。原则策略是在精神病发作之前及早进行干预，以阻止精神病症状和功能障碍的发展。测试治疗是心理教育多家庭团体和自信社区治疗的专门结合。在试点研究中，FACT 导致精神病转化率非常低，治疗参与率和保留率非常高，从而减轻了家庭和社区的负担。治疗的目标是预防精神病和残疾。 这项研究将通过实验评估这种新型心理健康服务的临床有效性。其他结果领域包括认知功能障碍和功能障碍。该项目将支持 EDIPFACT 临床工作人员团队具备以下能力：促进全科医生、指导顾问、心理健康专业人员和公众对大波特兰社区前驱疾病的发现； b.准确评估精神病高危人群； c.使用标准化方法可靠地提供基于证据的心理社会治疗方案，如果有需要，还可以提供药物治疗方案。该研究将在一项随机对照试验中测试该系统确定的 96 名 12 至 35 岁受试者的治疗症状和功能结果。它将允许分析导致精神病的关键社会因素及其与治疗条件和彼此之间的相互作用。