Treatment of Psychotic Disorders in Youth

描述(由申请人提供)：拟从事的职业的主要目标 开发活动的目的是提供扩展的知识库、技能 临床试验设计和分析，以及我需要的研究经验 成为一名独立调查员，专注于干预研究 患有精神障碍的儿童和青少年。这是一个稀缺的 精神病治疗方面的研究，特别是精神药理学 青年时期的精神障碍。我的主要兴趣是确定急性和长期的 特效性抗精神病药物对青少年精神分裂症的疗效和耐受性 精神分裂症谱系疾病。中期目标是开发更安全和 对儿童精神病的更有效的治疗。归根结底，这些技能和 在职业发展计划过程中获得的知识将增加 我能够利用干预研究的结果来推断 儿科精神病的病理生理学。在比赛中学到的技能 这一奖项的课程也将推广到严格的干预研究 其他严重的神经发育障碍，如自闭症。 我的职业发展计划包括：1)设计和指导课程 临床试验分析，2)儿童精神病学专家的教程 临床试验，在分析和调节临床的影响 试验，以及在儿童精神分裂症中，以及3)由 杰夫·利伯曼博士参与了对非典型抗精神病药物的评估 儿科精神病。我建议的指导性研究活动是1)a 多点随机对照试验(TEOSS，最近获得资助)，2 一项关于青壮年长期疗效的开放式前瞻性研究 抗精神病药物，以及3)新开发的抗精神病药物的试点研究。项目 1，TEOSS，比较了喹诺酮、利培酮和 奥氮平治疗精神分裂症和儿童青少年分裂情感性。 项目2检查精神病青年三年内的复发率 最初用不同的抗精神病药物治疗。项目3由试点项目组成 新开发的抗精神病药物包括齐拉西酮，阿立哌唑， 和安非他酮。协调项目？和3个TEOSS将允许我使用 许多相同的案件报告表格，相同的数据库系统，以及类似的 分析。此外，还可以对数据进行一般的比较 项目。这项职业发展计划和拟议的研究活动 将极大地促进我从一名临床医生过渡到少数几个 独立调查人员专注于对青少年的干预研究 精神病。

DESCRIPTION (provided by applicant): The primary objectives of the proposed career development activities are to provide the expanded knowledge base, skills in clinical trial design and analysis, and research experiences that I need to become an independent investigator with a focus on intervention research in children and adolescents with psychotic disorders. There is a dearth of research, particularly psychopharmacologic, on the treatment of psychotic disorders in youth. My primary interest is to determine the acute and long-term efficacy and tolerability of specific antipsychotics in youth with schizophrenia spectrum illnesses. Intermediate goals are to develop safer and more effective treatments for psychosis in children. Ultimately the skills and knowledge gained in the course of this career development program will increase my ability to use the results of intervention studies to make inferences about the pathophysiology of pediatric psychotic disorders. The skills gained in the course of this award will also Generalize to rigorous intervention studies in other severe neurodevelopmental disorders like autism. My career development plan includes 1) didactic courses in the design and analysis of clinical trials, 2) tutorials with experts in child psychiatry clinical trials, in the analysis and regulatory implications of clinical trials, and in childhood schizophrenia, and 3) research activities mentored by Dr. Jeff Lieberman involving the evaluation of atypical antipsychotics in pediatric psychosis. The mentored research activities that I propose are 1) a multisite, randomized, controlled trial (TEOSS, which was recently funded), 2) an open, prospective study of long-term outcome for youth treated with antipsychotics, and 3) pilot studies of newly developed antipsychotics. Project 1, TEOSS, compares the efficacy and tolerability of molindone, risperidone, and olanzapine in schizophrenia and schizoaffective in children and adolescents. Project 2 examines relapse incidence over three years in psychotic youth initially treated with different antipsychotics. Project 3 consists of pilot studies of newly developed antipsychotics including ziprasidone, aripiprazole, and iloperidone. Coordinating projects ? and 3 with TEOSS will'allow me to use many of the same case report forms, the same database systems, and similar analyses. Further, it will be possible to generally compare data between projects. This career development plan and the proposed research activities will greatly facilitate my transition from a clinician to one of the handful of independent investigators focused on intervention studies in youth with psychotic illnesses.