TREATMENT OF ADOLESCENT SUICIDE ATTEMPTERS (TASA)

青少年自杀未遂者的治疗 (TASA)

• 批准号: 7605721
• 负责人: BARBARA Jane COFFEY
• 金额: $ 0.28万
• 依托单位: NEW YORK UNIVERSITY SCHOOL OF MEDICINE
• 依托单位国家: 美国
• 财政年份: 2007
• 资助国家: 美国
• 起止时间: 2007-04-01 至 2008-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7605721
• 关键词: Adolescent; Adult; Aggressive behavior; Agitation; Anxiety; Behavior Therapy; Cessation of life; Clinical; Cognitive Therapy; Computer Retrieval of Information on Scientific Projects Database; Conflict (Psychology); DSM-IV; Depressed mood; Depressive disorder; Drug Combinations; Drug toxicity; Dysthymic Disorder; End Point; Evaluation; Event; Family; Family member; Feasibility Studies; Feeling hopeless; Feeling suicidal; Functional disorder; Funding; Grant; Impulsivity; Institution; Intervention; Lithium; Masks; Measures; Medical; Monitor; National Institute of Mental Health; Numbers; Outcome Measure; Play; Procedures; Randomized; Rate; Research; Research Personnel; Resources; Role; Safety; Selective Serotonin Reuptake Inhibitor; Severities; Source; Suicide; Suicide attempt; Supplementation; Time; Training; Treatment Protocols; United States National Institutes of Health; Week; children' s depression rating scale; comparative; day; density; depressive symptoms; follow-up; ideation; programs; single episode major depressive disorder; size; social; suicidal

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. This is a feasibility study of the comparative efficacy of different forms of therapy for depressed adolescent suicide attempters. The comparators are: 1) medical management (MM), typically an selective serotonin reuptake inhibitor (SSRI) with possible lithium supplementation; 2) a cognitive behavior therapy (CBT) program for up to 22 sessions; or 3) MM+CBT over a 6-month treatment regimen and a year follow-up. A total of 120 adolescents with a current DSM-IV Major Depressive Episode, or Dysthymic Disorder, and a suicide attempt within the past 45 days will be randomized to the 3 groups. The study will help validate outcome measures and monitoring procedures, including safety. It will also help provide between-group standardized effect size estimates needed to plan a larger trial. The primary endpoint will be the time to first occurrence of a suicidal event. Secondary endpoints include the following: the severity of suicidal ideation, measured by the Beck Scale; the rate and density of suicidal events and ideation, measured by the Suicide Severity Rating Scale; the rate of agitation and suicidal ideation; the severity of depressive symptoms, measured by the revised Child Depression Rating Scale; and (exploratory aims) the levels of hopelessness, aggression, impulsivity, anxiety, family conflict and social dysfunction. Some of these assessments are made by an independent evaluator at 6-week intervals during the interventions. A psychotherapist will monitor systemic functions (clinical rating, SAEs) virtually weekly, as well as assess possible drug toxicity. None of the proposed therapies have been shown to be effective in adolescents. In adults, the maximal benefit provided by any of the treatments alone is 60% at best. Combinations of drug and behavior therapy have shown synergy in the treatment of adult depressive disorders. Approach: This is a multicenter NIMH study which the PI played a role in developing. It includes a number of "safety" features, including an ombudsman to protect the vulnerable adolescent and a Masked Suicide Evaluation Board. There are procedures for educating family members to decrease suicide potential, and procedures for handling suicide events and deaths. There is training for psychopharmacologists and independent evaluators.

该副本是利用众多研究子项目之一 由NIH/NCRR资助的中心赠款提供的资源。子弹和 调查员（PI）可能已经从其他NIH来源获得了主要资金， 因此，可以在其他清晰的条目中表示。列出的机构是 对于中心，这不一定是调查员的机构。 这是一项可行性研究，该研究对不同形式的青少年自杀式疗法的比较疗效的比较疗效。比较器是：1）医疗管理（MM），通常是选择性羟色胺再摄取抑制剂（SSRI），并可能补充锂； 2）最多22个会议的认知行为疗法（CBT）计划；或3）在6个月的治疗方案和一年的随访中，MM+CBT。 在过去45天内，共有120名患有当前DSM-IV重大抑郁发作或心脏病障碍的青少年和自杀未遂将被随机分为3组。 该研究将有助于验证结果指标和监测程序，包括安全。 它还将有助于提供规划更大试验所需的组间标准化效果估计。 主要终点将是首次发生自杀事件的时间。 次要终点包括以下内容：以贝克量表来衡量的自杀意念的严重程度；自杀事件和构想的速度和密度，通过自杀严重程度量表来衡量；躁动和自杀念头的速度；抑郁症状的严重程度，通过修订后的儿童抑郁评分量表来衡量； （探索性的目的）绝望，侵略性，冲动，焦虑，家庭冲突和社会功能障碍的水平。这些评估中的一些是由独立评估者在干预期间以6周的间隔进行的。 心理治疗师几乎每周都会监测系统性功能（临床评级，SAE），并评估可能的药物毒性。 尚未证明建议的疗法在青少年中有效。在成年人中，仅任何治疗方法提供的最大益处最多为60％。药物和行为疗法的组合已表明在治疗成人抑郁症方面的协同作用。 方法：这是一项多中心NIMH研究，PI在发展中发挥了作用。 它包括许多“安全”功能，包括申诉专员，以保护脆弱的青少年和蒙面自杀评估委员会。 有一些程序可以教育家庭成员降低自杀潜力，以及处理自杀事件和死亡的程序。有针对心理药理学家和独立评估者的培训。