Psychosis: Early Detection, Intervention and Prevention

精神病：早期发现、干预和预防

• 批准号: 7232627
• 负责人: WILLIAM R MCFARLANE
• 金额: $ 87.23万
• 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 2010-01-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7232627
• 关键词: Address; Adolescent; Age; Characteristics; Childhood; Clinical; Clinical Trials; Clinical effectiveness; Cognitive; Communities; Condition; Contracts; Counseling; Detection; Development; Disease; Disease remission; Distress; Early Diagnosis; Early Intervention; Early identification; Education; Event; Expressed Emotion; Family; Family member; Fostering; Foundations; Frequencies; General Population; General Practitioners; Goals; Health Professional; Health education; Impaired cognition; Individual; Institution; Intervention; Knowledge; Lead; Life; Maine; Major Depressive Disorder; Mediating; Mental Health; Mental Health Services; Methodology; Mood Disorders; Nursing Staff; Outcome; Patients; Pharmacological Treatment; Phase; Physicians; Pilot Projects; Population; Prevention; Prevention intervention; Primary Health Care; Professional counselor; Psychotic Disorders; Randomized; Randomized Controlled Clinical Trials; Randomized Controlled Trials; Range; Rate; Recruitment Activity; Risk; Role; Schizophrenia; Social isolation; Stigmata; Symptoms; System; Testing; Training; Treatment outcome; base; burden of illness; design; disability; functional disability; functional outcomes; member; mental health center; outcome forecast; prevent; programs; psychoeducational; psychosocial; research study; social; social stigma; stressor

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精神病的专门精神卫生服务提供系统进行随机，对照临床试验。干预是家庭辅助社区待遇（事实）。拟议的研究将是一个大型计划，波特兰识别和早期推荐（PIER）的一部分，基金会和心理健康中心赞助中心，该计划已建立了基于人群的早期检测系统，可为缅因州的大波特兰市提供早期检测。 以前和现在的努力已经对整个社区以及所有健康，教育和其他专业人员进行了教育和培训，结果转介以预期的频率发生。原则策略是在精神疾病发作的过程中早点干预，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户家庭和自信社区治疗的专业组合。在试点研究中，事实导致转化为精神病的率非常低，并且在治疗中的参与度和保留率很高，从而减轻了家庭和社区的负担。治疗的目的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。结果的其他领域包括认知功能障碍和功能障碍。该项目将支持一支由临床人员组成的小组，具有以下能力：由全科波特兰社区中的前从业人员，指导顾问，精神卫生专业人员和公众促进检测到大波特兰社区的探测； b。准确评估患精神病高风险的人； c。可靠地提供基于证据的社会心理，并使用标准化方法提供药理治疗套件。该研究将在一项随机对照试验中测试，该系统的96名受试者的症状和功能结果是该系统确定的12至35名受试者。它将允许分析导致精神病及其与治疗条件的相互作用的关键社会因素。

项目成果

Change in neuropsychological functioning over one year in youth at clinical high risk for psychosis.

临床精神病高危青少年一年内神经心理功能的变化。

• DOI: 10.1016/j.schres.2013.01.017
• 发表时间: 2013
• 期刊: Schizophrenia research
• 影响因子: 4.5
• 作者: Woodberry,KristenA;McFarlane,WilliamR;Giuliano,AnthonyJ;Verdi,MaryB;Cook,WilliamL;Faraone,StephenV;Seidman,LarryJ
• 通讯作者: Seidman,LarryJ

Reduction in incidence of hospitalizations for psychotic episodes through early identification and intervention.

• DOI: 10.1176/appi.ps.201300336
• 发表时间: 2014-10
• 期刊: Psychiatric services (Washington, D.C.)
• 作者: McFarlane WR;Susser E;McCleary R;Verdi M;Lynch S;Williams D;McKeague IW
• 通讯作者: McKeague IW

Portland identification and early referral: a community-based system for identifying and treating youths at high risk of psychosis.

• DOI: 10.1176/appi.ps.61.5.512
• 发表时间: 2010-05
• 期刊: Psychiatric services (Washington, D.C.)
• 作者: McFarlane WR;Cook WL;Downing D;Verdi MB;Woodberry KA;Ruff A
• 通讯作者: Ruff A

Neuropsychological profiles in individuals at clinical high risk for psychosis: relationship to psychosis and intelligence.

• DOI: 10.1016/j.schres.2010.06.021
• 发表时间: 2010-11
• 期刊: SCHIZOPHRENIA RESEARCH
• 影响因子: 4.5
• 作者: Woodberry, Kristen A.;Seidman, Larry J.;Giuliano, Anthony J.;Verdi, Mary B.;Cook, William L.;McFarlane, William R.
• 通讯作者: McFarlane, William R.