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.

临床评估策略组 早期患者的诊断更加复杂和不确定，但此阶段的治疗决策可能会产生重要后果（积极和消极）。年龄和发育问题使临床反应和不良反应（例如体重增加、性副作用和神经内分泌异常）的评估以及认知和神经影像数据的解释变得复杂。整个领域越来越认识到社会和角色（学术/职业）功能是成功的关键组成部分。 严重限制预后的疾病过程。因此，必须尽早识别功能缺陷并描述其发育过程，以制定最佳的早期干预措施。 依从性单位 坚持服药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。接受现实的挑战 对于青少年和年轻人来说，接受潜在的毁灭性疾病的影响以及接受服用（通常是侮辱性的）具有显着副作用的药物的必要性尤其困难。制定和测试针对这些人群的策略至关重要。此外，我们还必须解决添加的问题 疾病阶段的挑战，其中诊断仍存在相当大的不确定性。 不良反应科 早期精神病的不良反应的诊断、治疗和预防非常重要。首先，我们关注的人群从一开始就对药物抱有极大的不情愿/矛盾心理。其次，他们对代谢和内分泌的脆弱性及其后果 不良影响可能在重要方面与成人和慢性人群有所不同。第三，从年轻时开始长期药物治疗可能意味着大量长期接触这些药物。 尽管不良事件小组正在开展研究并分析各个年龄段的数据，但我们特别关注对患有精神障碍的青少年和年轻人的影响。 生物标志物单位 在这些人群中使用生物标志物所面临的挑战需要特别关注，并提供了独特的机会。在各种混杂因素发挥作用之前，检查生物标志物在疾病表现和治疗反应中的作用对于早期疾病特别有价值。在神经影像和认知方面，生物标志物部门在评估方面拥有特殊的专业知识，对发育中的大脑有特殊的考虑。