Psychiatry Consultation Liaison Service Research

精神科咨询联络服务研究

• 批准号: 8745750
• 负责人: Maryland Pao
• 金额: $ 46.52万
• 依托单位: NATIONAL INSTITUTE OF MENTAL HEALTH
• 依托单位国家: 美国
• 资助国家: 美国
• 起止时间: 至
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/8745750
• 关键词: AIDS/HIV problem; Acquired Immunodeficiency Syndrome; Address; Adolescent; Adolescent Medicine; Adult; Advance Care Planning; Advocate; Affect; Anxiety; Anxiety Disorders; Archives; Area; Behavioral; Bioethics; Bone Marrow Transplantation; Boston; Caregivers; Caring; Child; Childhood; Chronic; Chronic Disease; Clinical; Clinical Research; Clinical Services; Cognitive; Collaborations; Communities; Complex; Consent; Consultations; Development; Developmental Delay Disorders; Disease; Distress; District of Columbia; Enrollment; Evaluation; Extramural Activities; Faculty; Family; Feeling suicidal; Genes; Government; HIV; Health Professional; Health Services Research; Hepatitis; Hereditary Disease; Hospitals; Human Development; Informed Consent; Inpatients; Institutes; Institutional Review Boards; Intellectual functioning disability; Interest Group; Interferons; International; Intramural Research; Journals; Knowledge; Life; Literature; Malignant Neoplasms; Manuscripts; Medical; Medical center; Mental Depression; Mental Health; Mission; Mood Disorders; Names; National Heart, Lung, and Blood Institute; National Human Genome Research Institute; National Institute of Allergy and Infectious Disease; National Institute of Arthritis and Musculoskeletal and Skin Diseases; National Institute of Mental Health; National Institute of Neurological Disorders and Stroke; Neurocognitive; Neuropsychological Tests; Neuropsychology; Neurosciences; Nurses; Ohio; Outcome Measure; Palliative Care; Pamphlets; Paper; Parenting behavior; Parents; Patients; Pediatric Hospitals; Pediatric Oncology; Pediatrics; Peer Review; Phenotype; Physicians; Police; Population; Preparation; Prevention strategy; Process; Protocols documentation; Provider; Psychiatrist; Psychiatry; Psychologist; Psychophysiologic Disorders; Psychosomatic Medicine; Publications; Publishing; Rare Diseases; Research; Research Personnel; Research Project Grants; Research Subjects; Research Support; Resources; Role; Rotation; Services; Siblings; Social Workers; Staging; Suicide; Suicide prevention; Symptoms; Thermometers; Training; Training and Education; Translating; United States National Institutes of Health; Universities; Voice; Vulnerable Populations; Work; Youth; base; biopsychosocial; experience; graduate medical education; healthy volunteer; human subject protection; improved; instrument; meetings; member; methylmalonic aciduria; multidisciplinary; neurodevelopment; neuropsychiatry; neuropsychological; phase 2 study; posters; programs; psychologic; psychopharmacologic; psychosocial; public health ethics; review of reported cases; screening; suicidal behavior; symposium; tool; young adult

The NIMH Psychiatric Consultation Liaison Service (PCLS) provides important psychiatric services to the many constituencies of the NIH. While providing such services to the NIH Community, PCLS clinicians conduct research and collaborate with NIH investigators by providing expertise in the areas of psychiatric, neurocognitive, and psychosocial functioning in NIH research subjects who often have complex medical and neuropsychiatric symptoms. Patient-subjects enrolled in research trials in other Institutes/Centers at the NIH offer unparalleled opportunities to explore the roles of specific genes (e.g., monogenic diseases such as methylmalonic acidemia (MMA)) and specific therapies (e.g., interferon in hepatitis) in psychiatry and neurodevelopment. Psychosomatic medicine trainees on the PCLS are encouraged during their rotations to pursue research projects that result in publications in peer reviewed journals, including literature reviews, case reports and poster presentations at national conferences. Active NIH research collaborators include the CC Bioethics Department, NCI Pediatric Oncology Branch (POB), the NIAID HIV/AIDS Service, and the Smith-Magenis Research Team to name just a few. The PCLS Neuropsychology Consultation Service performs neuropsychological evaluations for neurocognitive phenotyping of medical disorders resulting in research collaborations with other Institutes such as NIAMS, NHGRI, NIAID, NHLBI, NINDS and others. The PCLS conducts collaborative research with the NCI POB and provides research support to the Pediatric Oncology Psychosocial Research Program which studies palliative care, psychopharmacologic management in pediatric oncology patients, sibling, parent and caregivers concerns, and screening for distress in bone marrow transplantation recipients as compared to other chronic diseases, among other topics. This active research program on psychiatric and psychosocial aspects of pediatric oncology care has led to several shared protocols including evaluation of a distress thermometer in pediatric medically ill populations, characterization of "lone" parenting and a protocol to understand the experiences and needs of international families whose children are in research all of which resulted in recent publications. The PCLS research group provides mental health consultation on a number of educational brochures and booklets and recently developed "Voicing My Choices," an advance care planning guide for adolescents and young adults. Over 9000 copies of "Voicing My Choices" has been distributed nationally and internationally. It has been translated into Spanish and Italian. The PCLS group is also studying assessment instruments of mood and anxiety disorders for adolescents and young adult (AYA) healthy volunteers and AYA with cancer. The PCLS research team has taken a central role in NIMH's collaboration with NIAID and the District of Columbia (DC) in establishing an interdisciplinary, cross-institutional research collaborative effort with local investigators (see list of extramural collaborators), the DC-NIH Partnership for AIDS Progress (DC PFAP), to enhance knowledge of the biopsychosocial mental health aspects of HIV/AIDS. PCLS staff are working with DC Government leaders, clinical providers and administration, and community groups to identify gaps in services and knowledge to develop related research opportunities. PCLS researchers have co-founded and co-chaired the DC CFAR "Mental Health and Neuroscience" Scientific Interest Group which includes more than 30 investigators from DC based universities and meets monthly to discuss research collaborations. PCLS researchers have also co-founded and co-chaired the intramural NeuroHIV Interest Group Steering Committee, which meets monthly and oversees and coordinates five intramural research protocols at various stages of development; two protocols were co-authored and are co-led by PCLS researchers while all five receive substantial logistical support from PCLS, including neuropsychological testing and mental health screening which are among the key outcome measures for all these protocols. The PCLS research group continues to describe the processes involved in developing adequate programs for the protection of healthy volunteers as well as vulnerable subjects while conducting cutting-edge research. An informed consent training video produced by the Clinical Research Advocates (CRAs) of the Human Subjects Protections Unit (HSPU), in the Office of the Clinical Director, is now being used for training in all the Graduate Medical Education programs at the NIH as well as throughout the CC. The CRAs continue to provide training courses as well as present at national meetings on their experiences regarding implementing processes to standardize the evaluation and protection of vulnerable subjects in research. They continue to serve on the Ability to Consent Assessment Team (ACAT) with the CC Bioethics department and are utilized frequently throughout the Clinical Center to provide additional safeguards to vulnerable subjects. The PCLS also provides mental health consultation to the National Institute for Child Human Development (NICHD), and assigns a mental health professional to serve on the NICHD IRB. PCLS faculty regularly serve as reviewers for peer reviewed journals in mental health, psychosomatic medicine, pediatrics, neuropsychology, ethics, and public health. The PCLS research group is involved in several timely research projects that align with NIMH's mission to improve suicide prevention strategies. Three suicide screening projects address suicide screening in the medical setting. This past year we concluded a multisite study of pediatric EDs at Children's National Medical Center, Boston Children's Hospital and Nationwide Children's Hospital in Columbus, Ohio led by the PCLS group. A four-item screening instrument was developed, the ASQ (Ask Suicide-Screening Questions), and has been published by Archives of Pediatrics and Adolescent Medicine (now JAMA Pediatrics). To address the issue of suicidality in hospital settings, the PCLS research group created a suicide screening instrument and educational program to assist nurses on inpatient medical units with suicide assessment. The Ask Suicide-Screening Questions to Everyone in Medical Settings (asQem) Quality Improvement Project was initiated in January 2012 and was published in Psychosomatics in 2013. The third project involves an international collaboration and is focused on developing a suicide screening tool for youth with developmental delay and adults with intellectual disabilities. Phase 2 of this study was completed in July 2013 with the first manuscript in preparation. Due to the PCLS's expertise in this area of research, PCLS members have presented in-services to physicians, nurses and NIH police around the NIH CC on the topic of suicide prevention. The PCLS research team had a productive year with more than a dozen posters, more than 20 papers and numerous presentations and educational courses in the past year.

NIMH 精神病学咨询联络服务 (PCLS) 为 NIH 的众多选区提供重要的精神病学服务。在向 NIH 社区提供此类服务的同时，PCLS 临床医生通过为经常具有复杂医学和神经精神症状的 NIH 研究对象提供精神病学、神经认知和心理社会功能领域的专业知识，开展研究并与 NIH 研究人员合作。参加 NIH 其他研究所/中心的研究试验的患者受试者提供了无与伦比的机会来探索特定基因（例如甲基丙二酸血症 (MMA) 等单基因疾病）和特定疗法（例如肝炎中的干扰素）在精神病学中的作用和神经发育。 PCLS 的心身医学实习生被鼓励在轮换期间从事研究项目，并在同行评审期刊上发表论文，包括文献综述、病例报告和在全国会议上的海报展示。 NIH 活跃的研究合作者包括 CC 生物伦理学部、NCI 儿科肿瘤科 (POB)、NIAID HIV/AIDS 服务中心和 Smith-Magenis 研究团队等。 PCLS 神经心理学咨询服务对医学疾病的神经认知表型进行神经心理学评估，从而与 NIAMS、NHGRI、NIAID、NHLBI、NINDS 等其他机构进行研究合作。 PCLS 与 NCI POB 开展合作研究，并为儿科肿瘤心理社会研究项目提供研究支持，该项目研究姑息治疗、儿科肿瘤患者的心理药理学管理、兄弟姐妹、父母和护理人员的担忧，以及骨髓移植受者的痛苦筛查其他慢性疾病等主题。这项关于儿科肿瘤护理的精神病学和社会心理方面的积极研究计划已形成了若干共享方案，包括对儿科疾病人群的痛苦温度计进行评估、“孤独”养育的特征以及了解国际家庭的经历和需求的方案。儿童正在接受研究，所有这些研究都导致了最近的出版物。 PCLS 研究小组通过许多教育手册和小册子提供心理健康咨询，并最近开发了“表达我的选择”，这是针对青少​​年和年轻人的预先护理计划指南。 《表达我的选择》已在国内外发行超过 9000 册。它已被翻译成西班牙语和意大利语。 PCLS 小组还在研究针对青少年和青年 (AYA) 健康志愿者以及患有癌症的 AYA 的情绪和焦虑障碍的评估工具。 PCLS 研究团队在 NIMH 与 NIAID 和哥伦比亚特区 (DC) 的合作中发挥了核心作用，与当地研究人员建立了跨学科、跨机构的研究合作努力（参见校外合作者名单），DC-NIH 合作伙伴关系艾滋病进展 (DC PFAP)，旨在增强对艾滋病毒/艾滋病生物心理社会心理健康方面的了解。 PCLS 工作人员正在与华盛顿特区政府领导人、临床提供者和行政部门以及社区团体合作，以确定服务和知识方面的差距，以开发相关的研究机会。 PCLS 研究人员共同创立并共同主持了 DC CFAR“心理健康和神经科学”科学兴趣小组，该小组由来自 DC 大学的 30 多名研究人员组成，每月举行一次会议讨论研究合作。 PCLS 研究人员还共同创立并共同主持了校内 NeuroHIV 兴趣小组指导委员会，该委员会每月举行一次会议，监督和协调处于不同发展阶段的五项校内研究方案；两项协议由 PCLS 研究人员共同撰写和领导，而所有五个协议均获得 PCLS 的大力后勤支持，包括神经心理学测试和心理健康筛查，这是所有这些协议的关键结果衡量标准之一。 PCLS 研究小组继续描述在进行前沿研究的同时制定适当的计划以保护健康志愿者和弱势受试者的过程。由临床主任办公室的人类受试者保护单位 (HSPU) 的临床研究倡导者 (CRA) 制作的知情同意培训视频现在也用于 NIH 的所有研究生医学教育项目的培训与整个 CC 一样。 CRA 继续提供培训课程，并在全国会议上介绍其实施流程的经验，以标准化研究中弱势受试者的评估和保护。他们继续在 CC 生物伦理学部门的同意能力评估小组 (ACAT) 中任职，并在整个临床中心经常使用，为弱势受试者提供额外的保障。 PCLS 还向国家儿童人类发展研究所 (NICHD) 提供心理健康咨询，并指派一名心理健康专业人员在 NICHD IRB 中服务。 PCLS 教师定期担任心理健康、心身医学、儿科、神经心理学、伦理学和公共卫生领域同行评审期刊的审稿人。 PCLS 研究小组参与了几个及时的研究项目，这些项目与 NIMH 改善自杀预防策略的使命相一致。 三个自杀筛查项目致力于医疗环境中的自杀筛查。去年，我们在 PCLS 小组的领导下，完成了一项针对国家儿童医疗中心、波士顿儿童医院和俄亥俄州哥伦布市全国儿童医院儿科急诊室的多中心研究。开发了四项筛查工具 ASQ（询问自杀筛查问题），并已由儿科和青少年医学档案馆（现为 JAMA 儿科）出版。为了解决医院环境中的自杀问题，PCLS 研究小组创建了自杀筛查工具和教育计划，以协助住院医疗单位的护士进行自杀评估。 向医疗机构中的每个人提出自杀筛查问题 (asQem) 质量改进项目于 2012 年 1 月启动，并于 2013 年在《心身学》上发表。第三个项目涉及国际合作，重点是为发育障碍青少年开发自杀筛查工具。延迟和智力障碍的成年人。这项研究的第二阶段于 2013 年 7 月完成，第一份手稿正在准备中。由于 PCLS 在这一研究领域的专业知识，PCLS 成员向 NIH CC 周围的医生、护士和 NIH 警察介绍了预防自杀的主题。 PCLS 研究团队度过了富有成效的一年，在过去的一年里发布了十几张海报、20 多篇论文以及大量的演示和教育课程。