Psychiatry Consultation Liaison Service Research

精神科咨询联络服务研究

• 批准号: 8158160
• 负责人: Maryland Pao
• 金额: $ 23.11万
• 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/8158160
• 关键词: Consultations; Health Services Research; Psychiatry

The Psychiatric Consultation Liaison Service (PCLS) serves an important integrative function in the NIH Clinical Center. Perceptive clinicians in the NIH intramural research program interact with the PCLS which leads to unique research collaborations in the areas of psychiatric and psychosocial research in the medically ill. Patient-subjects enrolled in research trials in other Institutes/Centers at the NIH offer unparalleled opportunities to explore the roles of specific genes (e.g., monogenic diseases) and specific therapies (e.g., interferon alpha in hepatitis) in psychiatry and neurodevelopment. PCLS Neuropsychology Consultations, initiated in October, 2008, continue to be an active service, performing about 250 neuropsychological evaluations per year. Two-thirds of these evaluations for neurocognitive phenotyping of medical disorders have been as a result of research collaborations between NIMH and other Institutes such as NIAMS, NHGRI, NIAID. NHLBI, NINDS and others. Recruitment for our suicide screen tool revalidation and suicide screening of medically ill children in a pediatric emergency room (Washington, D.C., Boston, Massachusetts, and Columbus, Ohio) is nearly completed. From a feasibility study of a single emergency department site, 6% of the 106 medical patients who were screened for suicide risk reported clinically significant suicidal ideation. In addition, 96% of the total patients (n = 156) stated that nurses should screen children for suicide risk in the pediatric emergency department. An evaluation of medical record data of a suicide screening tool found that 53% of children under the age of 12 presenting to the emergency department for psychiatric reasons screened positive for suicide risk. Collaboration with mental health and pediatric oncology clinicians has led to the development of a robust research program on psychiatric and psychosocial aspects of pediatric oncology care, culminating in the production of a handbook on psychological and psychiatric aspects of pediatric oncology care. Several protocols studying chronically ill youth are in data-collection phase, including evaluation of a "distress thermometer" in pediatric medically ill populations, characterization of "lone" parenting, and a new protocol on the experiences and needs of international families whose children are in research that is about to begin. In adult oncology, PCLS researchers worked with a multidisciplinary workgroup to redefine the classification of psychiatric events in oncology in clinical trials. An informed consent training video produced by the Clinical Research Advocates (CRAs) of the Human Subjects Protections (HSPU), in the Office of the Clinical Director, will be used for training in all the Graduate Medical Education clinical training programs at the NIH. The CRAs continues to provide training courses as well as present at national meetings on their experiences regarding implementing processes to standardize the evaluation and protection of vulnerable subjects in research. An exciting new NIH initiative spearheaded by the National Institute of Allergy and Infectious Diseases (NIAID) and the D.C. Department of Health (DOH) is the D.C. Partnership for HIV/AIDS Progress (DC PFAP). DC PFAP is designed to both enhance the availability of subspecialty care and to provide access to evidence-based clinical protocols and intramural research protocols. The NIMH PCLS team is an early partner in this important initiative. In conjuction with the D.C. government, local academic institutions, local community providers and HIV/AIDS patients, NIMH will assist in expanding knowledge on psychiatric and behavioral aspects of HIV/AIDS, specifically in D.C., and help to identify the most effective strategies for reducing the impact of psychiatric morbidity of HIV/AIDS in D.C. PCLS research has had a productive year with more than 25 posters, presentations or courses in the past year and the numerous publications listed below.

精神病学咨询联络服务 (PCLS) 在 NIH 临床中心发挥着重要的综合作用。 NIH 校内研究项目中富有洞察力的临床医生与 PCLS 互动，从而在医学疾病的精神病学和社会心理研究领域开展独特的研究合作。参加 NIH 其他研究所/中心的研究试验的患者受试者提供了无与伦比的机会来探索特定基因（例如，单基因疾病）和特定疗法（例如，肝炎中的干扰素 α）在精神病学和神经发育中的作用。 PCLS 神经心理学咨询于 2008 年 10 月启动，目前仍是一项积极的服务，每年进行约 250 次神经心理学评估。其中三分之二的医学疾病神经认知表型评估是 NIMH 与 NIAMS、NHGRI、NIAID 等其他研究所合作研究的结果。 NHLBI、NINDS 等。 我们在儿科急诊室（华盛顿特区、马萨诸塞州波士顿和俄亥俄州哥伦布）对自杀筛查工具进行重新验证和对患病儿童进行自杀筛查的招募工作已接近完成。根据对单个急诊科站点的可行性研究，接受自杀风险筛查的 106 名患者中有 6% 报告有临床上显着的自杀意念。此外，96% 的患者 (n = 156) 表示，护士应在儿科急诊科对儿童进行自杀风险筛查。对自杀筛查工具医疗记录数据的评估发现，因精神原因到急诊室就诊的 12 岁以下儿童中，53% 的自杀风险筛查结果呈阳性。 与心理健康和儿科肿瘤临床医生的合作导致了针对儿科肿瘤护理的精神病学和社会心理方面的强有力的研究计划的发展，最终编写了一本关于儿科肿瘤护理的心理和精神病学方面的手册。研究慢性病青少年的多项方案正处于数据收集阶段，包括对患有儿科疾病的人群的“痛苦温度计”进行评估、“孤独”养育的特征，以及一项关于儿童患有慢性疾病的国际家庭的经验和需求的新方案。即将开始的研究。在成人肿瘤学领域，PCLS 研究人员与多学科工作组合作，重新定义临床试验中肿瘤学精神事件的分类。 由临床主任办公室的人类受试者保护 (HSPU) 临床研究倡导者 (CRA) 制作的知情同意培训视频将用于 NIH 所有研究生医学教育临床培训项目的培训。 CRA 继续提供培训课程，并在全国会议上介绍其在实施标准化评估和保护研究中弱势受试者的流程方面的经验。 由国家过敏和传染病研究所 (NIAID) 和华盛顿特区卫生部 (DOH) 牵头的一项令人兴奋的 NIH 新举措是华盛顿特区艾滋病毒/艾滋病进展伙伴关系 (DC PFAP)。 DC PFAP 旨在提高亚专科护理的可用性，并提供基于证据的临床方案和校内研究方案。 NIMH PCLS 团队是这一重要计划的早期合作伙伴。 NIMH 将与华盛顿特区政府、当地学术机构、当地社区服务提供者和艾滋病毒/艾滋病患者合作，协助扩大有关艾滋病毒/艾滋病精神和行为方面的知识，特别是在华盛顿特区，并帮助确定减少艾滋病毒/艾滋病的最有效策略。华盛顿特区艾滋病毒/艾滋病精神发病率的影响 PCLS 研究取得了丰硕的一年，去年发布了超过 25 份海报、演示文稿或课程，以及下列众多出版物。