Population-Based Epidemiologic Research

基于人群的流行病学研究

• 批准号: 10011376
• 负责人: kathleen r merikangas
• 金额: $ 77.36万
• 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/10011376
• 关键词: 16 year old; Academic Medical Centers; Address; Adolescent; Adult; Affect; Age; Alcohols; Anxiety Disorders; Area; Attention; Australia; Behavior Disorders; Behavioral; Biochemical Genetics; Bipolar Disorder; Brain; Cardiovascular Diseases; Characteristics; Child; Child Mental Health; Child Rearing; Classification; Clinic; Clinical; Cohort Studies; Collaborations; Communities; Community Health; Comorbidity; Complement; Complex; Conflict (Psychology); Country; Data; Data Sources; Databases; Development; Disease; Eating Disorders; Emotional; Environment; Epidemiology; Etiology; Family; Family Study; Family history of; Feeling suicidal; First Degree Relative; Follow-Up Studies; Frequencies; Friendships; Funding; Future; Genetic; Genetic Research; Genetic Translation; Genetic study; Genomics; Goals; Headache; Health; Health behavior; Hypersomnolence; Individual; Institutes; Interview; Investigation; Ketamine; Link; Literature; Longitudinal Studies; Manic; Mental Depression; Mental Health; Mental disorders; Methodology; Migraine; Mind; Mission; Mood Disorders; Moods; Mothers; National Institute of Mental Health; Neurologic; New York; Outcome; Paper; Participant; Pathway interactions; Pattern; Pennsylvania; Perception; Personal Satisfaction; Philadelphia; Physical activity; Population; Population Genetics; Population Heterogeneity; Population Research; Population Study; Prevalence; Prevention; Primary Health Care; Prospective Studies; Psyche structure; Public Health; Published Comment; Publishing; Reporting; Research; Research Design; Research Personnel; Resources; Risk Factors; Sampling; Schools; Scopolamine; Siblings; Sleep; Sleeplessness; Social Functioning; Sports; Statistical Data Interpretation; Statistical Methods; Substance Use Disorder; Suicide attempt; Suicide prevention; Surveys; Switzerland; Symptoms; Translating; Universities; Work; Youth; adolescent substance use; aged; alcohol use disorder; base; cardiovascular risk factor; clinical care; cohesion; developmental genetics; disease classification; epidemiology study; farmer; genetic analysis; genetic epidemiology; improved; interest; knowledge base; meter; neighborhood disadvantage; offspring; pediatric department; peer; physical conditioning; population based; proband; programs; psychogenetics; psychological distress; psychosocial; respiratory; response; social; study population; young adult

We have continued to leverage the Adolescent Supplement of the National Comorbidity Survey's (NCS-A) rich information on risk factors to expand the scientific knowledge base that can be used to inform prevention efforts. We published a study of the association between engagement in regular physical activity and adolescent psychiatric disorders (He et al, 2018), and found that physical activity was associated with lower odds of mood disorder and psychological distress, but higher odds of alcohol use disorder and eating disorder. Importantly, some associations were observed only among adolescents who did or did not participate in organized sports. In collaboration with colleagues at Columbia and Johns Hopkins Universities, we published a methodological article that focused on school- and peer-level mechanisms linking neighborhood disadvantage to adolescent substance use and substance use disorder in the NCS-A (Rudolph et al, 2018). The purpose of this paper was to assist public health researchers in choosing between, and implementing, different statistical methods that can be used to study the pathways by which risk factors affect mental health. Additionally, in accordance with NIMH's recent focus on suicide prevention, we also conducted a study of social functioning, including characteristics of friendships, sibling relationships, family cohesion, and parenting style, and its association with suicidal thoughts and suicide attempts among adolescents in the NCS-A (Van Meter et al, 2019). This study took a unique approach by addressing these questions among adolescents with and without mental illness separately. We also investigated patterns of offspring-perceived family environment and their associations with parental bipolar disorder (BD) in a prospective study of adolescents age 12-21 from urban academic medical centers in the U.S. and Australia. We found that maternal BD was associated with offspring perceiving High Maternal Conflict. It may be helpful to support mothers with BD by addressing family functioning, with attention to offspring perceptions of their wellbeing, in clinical care and psychosocial settings (Stapp et al, 2019). We have also continued to study comorbidity between psychiatric disorders and other types of health conditions. In collaboration with researchers at the Mayo Clinic, we published the only nationally-representative study of the links between hypersomnolence and mental health among adolescents (Kolla et al, 2019). We found that adolescents with hypersomnolence were more likely to have behavioral disorders and eating disorders as well as insomnia. This study contributes to our understanding of the complex interrelationships between sleep/wake function and mental health. We have also continued to work on the Philadelphia Neurodevelopmental Cohort Study and conducted a study of comorbidity of headache and migraine with other physical and mental health conditions in youth aged 8-21 (Lateef et al, 2019). We found that youth with migraine were more likely to have specific mental and physical conditions, including respiratory and neurologic conditions as well as anxiety, behavior, and mood disorders. An important aspect of our work is the ability to use population-based studies to inform psychiatric disorder definitions and classification. During the past year we worked with a team of researchers to combine data from 9 community studies in 5 countries, including the Zurich Cohort Study, to assess the validity of the definition of BD (Angst et al, 2019). Our results showed differences between groups in psychiatric disorder comorbidity, although no differences in family history of psychiatric disorder. This study contributes to the ongoing debate in the literature regarding the classification of unipolar mania among psychiatric disorders. In line with our branch's focus on genetic epidemiology, we published two articles pertaining to the future of genetic research in mental health. The first (Arguello et al, 2019) is a report by the Genomics Workgroup of the National Advisory Mental Health Council (NAMHC). This workgroup, convened by the NIMH, is comprised of geneticists and neuroscientists to advise the NAMHC and works to enhance the NIMH's psychiatric genetics research program, prioritize follow-up studies, and provide guidance in many areas relevant to genomics research. The purpose of this article is to assist researchers in creating the most scientifically rigorous and informative research designs possible to maximize progress gained from research funding. The second (Merikangas and Merikangas, 2019) is a commentary describing current challenges, and potential solutions, to the translation of genetic discovery to improve population mental health. This article, written for a wider audience and aims to bring the public health community up to date regarding large-scale population genetic research. Our branch's expertise in the conduct of family studies and statistical genetics has facilitated our collaboration with other researchers in these areas. First, using a community-based longitudinal study of 16-year-old probands who were followed through age 30, we identified clinical characteristics of alcohol use disorders among probands that were associated with the frequency of disorder among first-degree relatives (Farmer et al, 2018). Second, in collaboration with researchers from NIMH, Mount Sinai, Baylor, and Columbia University, we conducted a statistical analysis of the genetic contribution to response to two fast-acting depression treatments, ketamine and scopolamine (Guo et al, 2018). These activities fulfill our ongoing mission to serve the wider research community in using genetic study designs to improve population mental health. Public Health Impact: The investigation of risk factors during development, which the NCS-A makes possible, is extremely important in mental health because many cases of psychiatric disorder first arise during or prior to young adulthood and because brain development is implicated in the etiology of many psychiatric disorders. Our studies of physical activity and sleep in adolescents complement our family study work on the importance of behavioral rhythms in mental health and contribute to scientific understanding of psychiatric disorder etiology and opportunities for prevention. Our continuing mission to help identify the appropriate thresholds and boundaries for defining psychiatric disorders addresses an important current challenge in translating research to improvements in public health, as discussed in our recent commentary. Our branch also continues to serve the broader scientific community by promoting advancement in research questions, study design, and statistical analysis. Future Plans: A current issue in mental health research is the need for transdiagnostic approaches to studying mental illness and brain development. Toward this end, we have continued to be active in the ongoing Child Mind Institute's Healthy Brain Network (HBN) and plan to begin intensive analysis of collected data during the next reporting period. The HBN will serve as a resource for researchers in the field who wish to tackle transdiagnostic research questions related to mental health in children and youth. To further this goal, we have also recently begun work on establishing a Child Mental Health Research Database, which will serve a resource for researchers across the world who are interested in working with data related to youth mental health. We also expect to continue publishing population-based studies related the themes of 1) the intersection between physical and mental health, 2) the relation between health behaviors and psychiatric disorder, and 3) the influence of environmental and social exposures among children and youth.

我们继续利用国家合并症调查青少年补充资料 (NCS-A) 中有关风险因素的丰富信息来扩大可用于为预防工作提供信息的科学知识库。我们发表了一项关于定期进行体力活动与青少年精神疾病之间关系的研究（He et al, 2018），发现体力活动与情绪障碍和心理困扰的几率较低相关，但与酒精使用障碍和心理困扰的几率较高相关。饮食失调。重要的是，一些关联仅在参加或不参加有组织的体育运动的青少年中观察到。我们与哥伦比亚大学和约翰·霍普金斯大学的同事合作，发表了一篇方法论文章，重点关注学校和同伴层面的机制，将邻里劣势与 NCS-A 中的青少年药物使用和药物使用障碍联系起来（Rudolph 等人，2018）。本文的目的是帮助公共卫生研究人员选择和实施不同的统计方法，这些方法可用于研究风险因素影响心理健康的途径。此外，根据 NIMH 最近对自杀预防的关注，我们还开展了一项关于 NCS 青少年的社会功能的研究，包括友谊、兄弟姐妹关系、家庭凝聚力和养育方式的特征，及其与自杀想法和自杀企图的关系。 -A（Van Meter 等人，2019）。这项研究采取了独特的方法，分别解决了患有和没有精神疾病的青少年的这些问题。 我们还在一项针对美国和澳大利亚城市学术医疗中心 12-21 岁青少年的前瞻性研究中调查了后代感知的家庭环境模式及其与父母双相情感障碍 (BD) 的关联。我们发现，母亲双相情感障碍与后代感知高度母亲冲突有关。在临床护理和心理社会环境中，通过解决家庭功能问题、关注后代对其健康的看法，可能有助于支持患有双相情感障碍的母亲（Stapp 等人，2019）。 我们还继续研究精神疾病和其他类型的健康状况之间的共病。我们与梅奥诊所的研究人员合作，发表了关于青少年嗜睡与心理健康之间联系的唯一具有全国代表性的研究（Kolla 等人，2019）。我们发现，患有嗜睡症的青少年更有可能出现行为障碍、饮食失调以及失眠。这项研究有助于我们理解睡眠/觉醒功能与心理健康之间复杂的相互关系。我们还继续开展费城神经发育队列研究，并对 8-21 岁青少年的头痛和偏头痛与其他身心健康状况的共病进行了研究（Lateef 等人，2019）。我们发现患有偏头痛的青少年更有可能出现特定的精神和身体状况，包括呼吸系统和神经系统疾病以及焦虑、行为和情绪障碍。 我们工作的一个重要方面是能够利用基于人群的研究来了解精神疾病的定义和分类。在过去的一年里，我们与一组研究人员合作，结合了 5 个国家的 9 项社区研究的数据，包括苏黎世队列研究，以评估 BD 定义的有效性（Angst 等人，2019）。我们的结果显示，尽管精神疾病家族史没有差异，但各组之间的精神疾病合并症存在差异。这项研究促进了文献中关于精神疾病中单相躁狂分类的持续争论。 根据我们部门对遗传流行病学的关注，我们发表了两篇有关心理健康遗传研究未来的文章。第一份报告（Arguello 等人，2019 年）是国家心理健康咨询委员会 (NAMHC) 基因组学工作组的一份报告。该工作组由 NIMH 召集，由遗传学家和神经科学家组成，为 NAMHC 提供建议，并致力于加强 NIMH 的精神遗传学研究计划，优先考虑后续研究，并在与基因组学研究相关的许多领域提供指导。本文的目的是帮助研究人员创建最科学、最严格、信息最丰富的研究设计，以最大限度地利用研究经费取得进展。第二篇（Merikangas 和 Merikangas，2019）是一篇评论，描述了将基因发现转化为改善人群心理健康的当前挑战和潜在解决方案。本文是为更广泛的读者撰写的，旨在让公共卫生界了解大规模群体遗传学研究的最新情况。 我们分支机构在进行家庭研究和统计遗传学方面的专业知识促进了我们与这些领域的其他研究人员的合作。首先，通过对 16 岁先证者进行一项以社区为基础的纵向研究，并随访至 30 岁，我们确定了先证者中酒精使用障碍的临床特征，这些特征与一级亲属中酒精使用障碍的频率相关（Farmer 等人） ，2018）。其次，我们与 NIMH、西奈山、贝勒和哥伦比亚大学的研究人员合作，对两种速效抑郁症治疗药物氯胺酮和东莨菪碱的反应的遗传贡献进行了统计分析（Guo 等，2018）。这些活动履行了我们持续不断的使命，即为更广泛的研究界服务，利用基因研究设计改善人群心理健康。 公共卫生影响： NCS-A 使得对发育过程中危险因素的调查成为可能，这对于心理健康极为重要，因为许多精神疾病病例首先出现在青年期期间或之前，而且因为大脑发育与许多精神疾病的病因有关。我们对青少年身体活动和睡眠的研究补充了我们关于行为节律在心理健康中的重要性的家庭研究工作，并有助于科学理解精神疾病的病因和预防机会。正如我们最近的评论中所讨论的，我们的持续使命是帮助确定定义精神疾病的适当阈值和界限，解决当前将研究转化为改善公共卫生的重要挑战。我们的分支机构还通过促进研究问题、研究设计和统计分析的进步，继续为更广泛的科学界服务。 未来计划： 心理健康研究当前的一个问题是需要跨诊断方法来研究精神疾病和大脑发育。为此，我们继续积极参与正在进行的儿童心理研究所的健康大脑网络 (HBN)，并计划在下一个报告期内开始对收集的数据进行深入分析。 HBN 将为该领域希望解决与儿童和青少年心理健康相关的跨诊断研究问题的研究人员提供资源。为了进一步实现这一目标，我们最近还开始建立儿童心理健康研究数据库，该数据库将为世界各地有兴趣处理青少年心理健康相关数据的研究人员提供资源。我们还期望继续发表与以下主题相关的基于人口的研究：1）身体和心理健康之间的交叉点，2）健康行为与精神疾病之间的关系，以及3）环境和社会暴露对儿童和青少年的影响。