PTSD and nonadherence in pediatric transplant patients

描述(由申请人提供)：本申请为NIMH导师 使用K-08机制的临床科学家发展奖(MCSDA)是 题为：《儿科移植患者的创伤后应激障碍和不依从性》。这个 这项建议的目的是检查创伤后应激症状。 儿童移植受者的精神障碍(PTSD)，并调查他们 与不坚持用药和不良的医疗结果有关。 儿科移植受者的不依从性很常见，而且有可能 致命的。因此，研究风险因素具有重要意义。 (如创伤后应激障碍)，这可能会为这种行为的治疗选择提供参考。症状： 在实体器官(如肝脏)存活的儿童中可能会出现创伤后应激障碍 移植。这样的孩子可能会变得不听话 用他们的移植药物。这种药物可能被认为是一种 提醒创伤事件(内科疾病或移植)和 因此避免了这种情况。这项提案的目标是审查 不坚持、心理社会危险因素、创伤后应激障碍与 儿科移植受者的医疗结果以确定是否 创伤后应激障碍与不坚持和不良结局有关。为了实现这一目标， 首席调查员将与导师和顾问一起工作， 将提供与这项提案的研究目标相关的专业知识。这个 首席调查员将进行前瞻性的纵向研究 儿科移植受者将每半年接受一次评估 获奖期。评估将包括精神治疗措施以及 医疗结果数据和依从性评估。在MSCDA的第四年， 将分析数据以及创伤后应激障碍、风险因素、医疗 将审查结果和不遵守情况。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依从性为目的 药物以及医疗和精神结果。这项提议将 因此允许首席调查员发展成为独立的 研究人员对现象学和治疗进行临床研究 儿童精神疾病和内科疾病并存的风险。

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.