PAROXETINE, PROLONGED EXPOSURE, AND BIOLOGY IN PTSD

帕罗西汀、长期接触以及 PTSD 中的生物学

• 批准号: 2674480
• 负责人: RANDALL Dean MARSHALL
• 金额: $ 16.06万
• 依托单位: COLUMBIA UNIVERSITY HEALTH SCIENCES
• 依托单位国家: 美国
• 财政年份: 1997
• 资助国家: 美国
• 起止时间: 1997-04-01 至 2002-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/2674480
• 关键词: behavior test; behavioral /social science research tag; clinical chemistry; clinical research; clinical trials; cognition; cognitive behavior therapy; combination therapy; cortisol; human ecology; human subject; human therapy evaluation; mental disorder chemotherapy; mental disorder diagnosis; outcomes research; paroxetine; pharmacokinetics; posttraumatic stress disorder; social psychology

Posttraumatic Stress Disorder (PTSD) is a debilitating, often chronic disorder with serious psychiatric morbidity among civilians. The incidence in the U.S. is estimated at 1 % to 3%, although rates can be considerable higher in vulnerable populations. In traumatized groups such as rape and severe assault victims, the rate of PTSD can approach 50%. Little is known regarding effective pharmacologic and psychosocial treatment in civilians with PTSD, as the majority of research to date has been conducted in war veterans. This grant proposes a five year training and research program, which encompasses 3 major research domains of PTSD: pharmacologic treatment, psychosocial treatment, and biological correlates of clinical symptoms. Training would be accomplished in intensive supervision with the mentor (Michael Liebowitz, M.D.) and scientific advisors; course work; tutorials in major research centers; collaboration with established investigators; and original research projects. Five interrelated projects are proposed: 1) a double-blind, placebo-controlled, 12-week trial of paroxetine in PTSD; 2) development of a time-limited individual psychotherapy which integrates cognitive-behavioral and psychodynamic principles; 3) a systematic open trial of the integrated psychotherapy; 4) measurement of cortisol levels pre- and post-treatment in both clinical treatments; 5) assuming positive findings in #1 and #3, development of a clinical trial to assess the efficacy of paroxetine, pill- placebo, psychotherapy, and combined paroxetine and psychotherapy. It is hypothesized that both paroxetine and psychotherapy will be effective for PTSD, and that the combination might be superior to either treatment alone.

创伤后应激障碍(PTSD)是一种衰弱的，通常是慢性的 在平民中存在严重精神障碍和精神障碍。发病率 在美国，估计为1%至3%，尽管这一比率可能相当可观 在易受伤害的人群中更高。在遭受创伤的团体中，如强奸和 严重攻击受害者时，创伤后应激障碍的发生率可接近50%。 关于有效的药理学和心理社会作用，人们知之甚少 对患有创伤后应激障碍的平民的治疗，正如迄今为止的大多数研究所做的那样 是在退伍军人中进行的。这笔赠款建议进行为期五年的培训 和研究计划，包括创伤后应激障碍的三个主要研究领域： 药物治疗、心理社会治疗和生物相关性 临床症状。培训将以强化的形式完成 导师的监督(医学博士Michael Liebowitz)和科学性 导师；课程工作；主要研究中心的教程；协作 与成熟的调查人员合作；以及原创研究项目。五 相关项目被提出：1)双盲、安慰剂对照、 帕罗西汀治疗创伤后应激障碍的12周试验；2)开发一种有时间限制的 认知-行为和心理治疗相结合的个体心理治疗 心理动力学原理；3)整合性的系统开放试验 心理治疗；4)治疗前后皮质醇水平的测定 在两个临床治疗中；5)假设在#1和#3中有阳性结果， 一项临床试验的发展，以评估帕罗西汀，药片- 安慰剂、心理疗法以及帕罗西汀和心理疗法的结合。它是 假设帕罗西汀和心理疗法对 创伤后应激障碍，联合治疗可能比单独治疗更好。