Clinical Assessment Strategies Unit (Research Methods Core)

临床评估策略单元（研究方法核心）

• 批准号: 8110771
• 负责人: BARBARA A. CORNBLATT
• 金额: $ 14.89万
• 依托单位: FEINSTEIN INSTITUTE FOR MEDICAL RESEARCH
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-07-27 至 2015-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8110771
• 关键词: Address; Adherence; Adolescent; Adult; Adverse effects; Adverse event; Age; Attention; Biological Markers; Brain; Chronic; Clinical; Clinical assessments; Cognition; Cognitive; Complex; Data; Data Analyses; Detection; Development; Diagnosis; Doctor of Medicine; Doctor of Philosophy; Endocrine; Exposure to; Goals; Hospitals; Intervention; Measures; Mental disorders; Metabolic; Mind; National Institute of Mental Health; Neurosecretory Systems; Occupational; Outcome; Patients; Pharmaceutical Preparations; Pharmacotherapy; Phase; Play; Population; Prevention; Procedures; Process; Psychopathology; Psychotic Disorders; Recommendation; Research Methodology; Role; Schools; Social Development; Staging; Strategic Planning; Testing; Weight Gain; functional disability; improved; infrastructure development; neuroimaging; novel; outcome forecast; response; tool; treatment response; young adult

Clinical Assessment Strategies Unit Diagnosis in eariy phase patients is more complex and uncertain, yet treatment decisions at this stage can have important consequences (both positive and negative). Age and developmental issues complicate the assessment of clinical response and adverse effects (e.g. weight gain, sexual side effects and neuroendocrine abnormalities), as well as the interpretation of cognitive and neuroimaging data. Recognition has increased throughout the field that social and role (academic/occupational) functioning are critical components of the illness process that severely limit prognosis. It is, therefore, essential to identify functional deficits and characterize their developmental course as eariy as possible to develop optimum eariy interventions. Adherence Unit Adherence in medication-taking as well as following overall treatment recommendations is a critical variable in treatment response and outcome (particulariy long term). The challenges of accepting the reality and implications of a potentially devastating illness, as well as accepting the need to take (often stigmatizing) medication with significant adverse effects are particulariy difficult for adolescents and young adults. It is critical to develop and test strategies with these populations in mind. In addition, we must address the added challenge of illness phases in which there can remain considerable uncertainly as to the diagnosis. Adverse Effects Unit The diagnosis, management and prevention of adverse effects in eariy phase psychosis is enormously important. First, the populations in which we are focusing have enormous reluctance/ambivalence about medication from the outset. Second, their vulnerabilities to and the consequences of metabolic and endocrine adverse effects might differ in important ways from adult and more chronic populations. Third, long-term pharmacotherapy beginning at a young age likely means considerable chronic exposure to these medications. Although the Adverse Events Unit is conducting studies and analyzing data across the age range, we have a particular focus on the implications for adolescents and young adults with psychotic disorders. Biomarkers Unit The challenges in using biomarkers in these populations require special attention and provide unique opportunities. The potential to examine the role of biomarkers in illness presentation and treatment response is particulariy valuable in eariy phase illness before a variety of confounding factors may come into play. In neuroimaging and cognition, there are special considerations for the developing brain that the Biomarkers Unit has special expertise in assessing.

Clinical Assessment Strategies Unit 耳阶段患者的诊断更加复杂和不确定，但是在此阶段的治疗决策可能会带来重要的后果（正面和阴性）。年龄和发育问题使评估临床反应和不良影响（例如体重增加，性副作用和神经内分泌异常）以及认知和神经成像数据的解释变得复杂。 Recognition has increased throughout the field that social and role (academic/occupational) functioning are critical components of the illness process that severely limit prognosis.因此，必须识别功能不足并表征其发育过程尽可能地发育，以发展最佳的耳朵干预措施。 Adherence Unit 遵守药物治疗以及遵循总体治疗建议是治疗反应和结果（尤其是长期）的关键变量。 The challenges of accepting the reality and 潜在的毁灭性疾病的意义，以及接受对青少年和年轻人服用（通常是污名化）具有重大不良影响的（经常污名化）药物的需求。 It is critical to develop and test strategies with these populations in mind. In addition, we must address the added challenge of illness phases in which there can remain considerable uncertainly as to the diagnosis. Adverse Effects Unit The diagnosis, management and prevention of adverse effects in eariy phase psychosis is enormously important. First, the populations in which we are focusing have enormous reluctance/ambivalence about medication from the outset. Second, their vulnerabilities to and the consequences of metabolic and endocrine adverse effects might differ in important ways from adult and more chronic populations. Third, long-term pharmacotherapy beginning at a young age likely means considerable chronic exposure to these medications. 尽管不良事件单位正在进行研究和分析整个年龄范围内的数据，但我们特别关注对患有精神疾病的青少年和年轻人的影响。 生物标志物单元 在这些人群中使用生物标志物的挑战需要特别注意并提供独特的机会。在各种混杂因素可能发挥作用之前，研究生物标志物在疾病表现和治疗反应中的作用在疾病中特别有价值。在神经影像学和认知中，对发展中的大脑有特殊的考虑，即生物标志物单元在评估方面具有特殊的专业知识。