Project 1 ACISR

项目1 ACISR

基本信息

批准号：
8110777
负责人：
CHRISTOPH U CORRELL
金额：
$ 7.66万
依托单位：
FEINSTEIN INSTITUTE FOR MEDICAL RESEARCH
依托单位国家：
美国
项目类别：
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/8110777
关键词：
Adherence Adolescent Adverse effects American Anti-Anxiety Agents Antidepressive Agents Antipsychotic Agents Area Attenuated Biological Process Brain Chronic Clinical Research Data Development Developmental Delay Disorders Disease Early identification Early treatment Fluoxetine General Population Generations Goals Incidence Incipient Schizophrenia Individual Intervention Intervention Studies Lead Longitudinal Studies Masks Mediating Medicine Mood stabilizers Neurodevelopmental Disorder Outcome Patients Personal Satisfaction Pharmaceutical Preparations Phase Physicians Pilot Projects Prevalence Prevention Preventive Intervention Psychotic Disorders Randomized Recurrent disease Relapse Research Retrospective Studies Risk Role Safety Sampling Schizophrenia Severities Symptoms Time Wood material Work aged aripiprazole base clinically relevant cohort design first episode schizophrenia functional decline functional outcomes gray matter high risk hypnotic improved functioning open label prevent prodromal psychosis programs protective effect psychopharmacologic symptomatic improvement treatment response

项目摘要

Early Recognition and Prevention During the Psychotic Prodrome. After more than five decades of increasingly refined psychopharmacologic developments, schizophrenia has remained one of the most severe and disabling disorders in medicine. Since interventions after a first schizophrenia episode have not been able to alter the generally chronic and relapsing disease course (Robinson et al. 2004), eariy intervention and prevention of schizophrenia are a vital goal. Initial, retrospective studies that demonstrated presence of a symptomatic prepsychotic illness phase of clinically relevant severity and duration (Hafner et al. 1999) provided the practical basis for early identification efforts. Several lines of evidence further supported the potential utility of eariy interventions for the schizophrenia prodrome. These include an increasing appreciation that schizophrenia is a neurodevelopmental disorder characterized by early developmental delays and problems, and that is further associated with a significant functional decline and brain morphological changes (Correll and Kane 2004; Sawa and Snyder, 2002; Woods 1998). Moreover, the duration of untreated psychosis (Marshall et al. 2005), and number of relapses have been associated with decreased grey matter and worse functional outcomes, even after controlling for potentially relevant confounders (Perkins et al. 2005). Importantly, brain morphological changes have also been demonstrated during the transition from prodromal psychosis to full blown psychosis (Pantelis et al. 2003), suggesting that early intervention may be a potential vehicle to effectively interrupt biological processes involved in the development of psychosis and its adverse functional consequences. Prodromal schizophrenia research conducted over the past ten years at our Center and others has further consolidated the evidence that eariy identification and intervention studies during the schizophrenia prodrome are possible. Eariy recognition programs have identified high risk samples with conversion rates to psychosis between 10 and 40% over one to two years (Yung et al. 2008). In the largest study to date by the North American Prodromal Longitudinal Study (NAPLS) group of which Dr. Cornblatt at our Center is one of the PIs, a conversion rate of 35.3% over 2.5 years was reportecl (Cannon et al. 2008). These conversion rates to psychosis are 10-40 times the prevalence rate observed in the general population and far greater than the expected incidence rate during such a brief time period (Eaton 1999).

精神病前期期间的早期识别和预防。经过五十多年的精神病学发展，精神分裂症仍然是医学中最严重，最残疾的疾病之一。由于第一次精神分裂症发作后的干预措施无法改变通常的慢性和复发性疾病病程（Robinson等，2004），因此，Eariy的干预和预防精神分裂症是至关重要的目标。最初的回顾性研究表明，存在临床相关严重性和持续时间的有症状性心理疾病阶段（Hafner等，1999）为早期识别工作提供了实际的基础。几条证据进一步支持了精神分裂症前代的耳部干预措施的潜在效用。这些包括越来越多的赞赏精神分裂症是一种以早期发育延迟和问题为特征的神经发育障碍，这进一步与功能下降和脑形态变化有关（Correll和Correll and Correll和凯恩（Kane）2004; Sawa和Snyder，2002年；伍兹1998）。此外，即使在控制潜在的相关混杂因素（Perkins etal。2005）之后，未经治疗的精神病的持续时间（Marshall等，2005）以及复发的数量也与灰质减少和功能性结果较差有关。重要的是，在从前驱精神病到完全爆破精神病的过渡过程中，脑形态变化也已证明（Pantelis等，2003），这表明早期干预可能是有效中断精神病发展及其不良功能后果的潜在工具。在过去的十年中，在我们中心进行的前驱精神分裂症研究进一步巩固了证据表明，在精神分裂症前途期间，可以鉴定和干预研究。 Eariy识别计划已经确定了一到两年内将精神病转化率转化为10％至40％的高风险样本（Yung等，2008）。在迄今为止由北美前驱纵向研究（NAPLS）组的最大研究中，我们中心的Cornblatt博士是PIS之一，在2。5年内的转化率为35.3％（Cannon等人，2008年）。这些对精神病的转化率是普通人群中观察到的患病率的10-40倍，远大于此短时间内的预期发病率（Eaton 1999）。