PTSD and nonadherence in pediatric transplant patients

描述（由申请人提供）：此申请NIMH指导 临床科学家发展奖（MCSDA）使用K-08机制是 题目是：“创伤后应激障碍和儿科移植患者的非依从性。“那 这项建议的目的是检查创伤后应激障碍的症状 儿童移植受者的创伤后应激障碍（PTSD），并调查其 与不依从药物治疗和不良医疗结果的关系。 儿科移植受者的不依从性很常见， 致命的因此，研究风险因素非常重要。 (such作为PTSD），这可能会为这种行为提供治疗方案。症状 创伤后应激障碍可以在实体器官（例如，肝脏） 移植这样的孩子可能会变得不遵守 他们的移植药物。药物可能被视为一种 创伤性事件（医疗疾病或移植）的提醒，以及 因此避免。这项提案的目的是审查 不依从、心理社会风险因素、PTSD和 儿科移植受者的医疗结果，以确定是否 PTSD与不依从和不良结局相关。为了实现这一目标， 主要研究者将与导师和顾问合作， 将提供与本提案的研究目标相关的专业知识。的 主要研究者将进行一项前瞻性、纵向研究， 儿童移植受者将在每半年进行一次评估， 奖励期。评估将包括精神病学措施以及 医疗结果数据和依从性评估。在MSCDA的第四年， 将分析数据，并研究创伤后应激障碍、危险因素、医疗因素 将检查结果和不依从情况。研究结果 组件和通过MCSDA的教学组件获得的知识 将为未来针对创伤后症状的干预研究提供信息， 儿科移植受者，以提高对 药物以及医疗和精神病学结果。这项建议会 因此，允许主要研究者发展成为一个独立的 对现象学和治疗进行临床研究的研究者 儿童精神病和内科疾病的共病

DESCRIPTION (provided by applicant): This application for an NIMH Mentored Clinical Scientist Development Award (MCSDA) using the K-08 mechanism is entitled: "PTSD and non-adherence in pediatric transplant patients." The purpose of this proposal is to examine symptoms of Posttraumatic Stress Disorder (PTSD) in pediatric transplant recipients, and to investigate their relationship with non-adherence to medications and poor medical outcome. Non-adherence in pediatric transplant recipients is common and potentially fatal. Hence, it is important to study risk factors (such as PTSD) that may inform treatment options for this behavior. Symptoms of PTSD can develop in children who survive solid organ (e.g., liver) transplantation. Such children may become non-adherent with their transplant medications. The medication may be perceived as a reminder of the traumatic event (the medical illness or the transplant) and hence avoided. The goal of this proposal is to examine the relationship between non-adherence, psychosocial risk factors, PTSD, and medical outcome in pediatric transplant recipients so as to determine whether PTSD is associated with non-adherence and poor outcome. To achieve this goal, the principal investigator will work with the mentor and the consultants who will provide expertise related to the research aims of this proposal. The principal investigator will perform a prospective, longitudinal study of pediatric transplant recipients who will be evaluated semiannually during the award period. The evaluation will include psychiatric measures as well as medical outcome data and adherence assessments. At year 4 of the MSCDA, the data will be analyzed and associations between PTSD, risk factors, medical outcome and non-adherence will be examined. The results of the research component and the knowledge gained through the teaching component of the MCSDA will inform future intervention research targeting posttraumatic symptoms in pediatric transplant recipients for the purpose of improving adherence to medications as well as medical and psychiatric outcome. This proposal will therefore allow the principal investigator to develop into an independent investigator performing clinical research into the phenomenology and treatment of co-morbid psychiatric and medical illness in children.