IMPROVING THE OUTCOME OF PATIENTS WITH OCD

强迫症（OCD）是一种终生患病率高达2- 3%的致残疾病。这个K23申请提出了一个职业发展和研究计划，将帮助私家医生实现她的长期目标：改善强迫症患者的预后。该项目将在Michael Liebowitz博士的指导下进行，并与dr。Edna Foa， Marc Laruelle和其他导师(dr。唐纳德·克莱因、吉恩·恩迪科特、大卫·保罗、斯科特·劳奇、保罗·格林和伊娃·佩特科娃)。培训计划的目的是：1)发展强迫症现象学和治疗方面的专业知识（通过在强迫症患者的评估和治疗方面接受专家监督，在精神药理学治疗和使用暴露和仪式预防（EX/RP）的认知行为治疗方面接受高级培训，以及在抽动障碍方面接受专门培训）；2)获得独立临床研究人员所需的技能和经验（通过在研究设计、多元统计、结果测量和伦理方面的课程/指导以及开展多个研究项目，包括大型临床试验）；3)能够有效地与脑成像专家合作（通过学习最先进的成像方法，并帮助使用MRI和PET技术进行强迫症脑成像项目）。研究部分将包括三个互补的项目：1)评估大量治疗过的强迫症患者的残留临床症状、功能和神经认知障碍；2)一项随机对照试验，检验辅助EX/RP在强迫症患者中增加血清素再摄取抑制剂的疗效；3)测量强迫症患者和正常对照血清素转运体（使用放射性标记配体和PET），以检查强迫症患者大脑中是否存在特异性血清素能异常。这项工作的长期目标是改善强迫症患者的预后。

Obsessive-compulsive disorder (OCD) is a disabling illness with a lifetime prevalence as high as 2-3 percent. This K23 application proposes a program of career development and research that will help the P.I. achieve her long-term goal: to improve the outcome of patients with OCD. The program will be carried out under the mentorship of Dr. Michael Liebowitz and in collaboration with Drs. Edna Foa, Marc Laruelle, and other preceptors (Drs. Donald Klein, Jean Endicott, David Pauls, Scott Rauch, Paul Greene, and Eva Petkova). The training program is designed so that the P.I. will: 1) develop expertise in the phenomenology and treatment of OCD (by receiving expert supervision in the evaluation and treatment of OCD patients, advanced training in psychopharmacological treatment and cognitive-behavioral therapy using exposure and ritual prevention (EX/RP), and specialized training in tic disorders); 2) acquire the skills and experiences needed by an independent clinical researcher (by coursework/supervision in research design, multivariate statistics, outcome measures, and ethics and by conducting several research projects, including a large clinical trial); and 3) be able to collaborate effectively with brain imaging experts (by learning about state-of-the-art imaging methods and helping to conduct an OCD brain imaging project using MRI and PET technology). The research component will consist of three complementary projects: 1) the assessment of residual clinical symptoms and of functional and neurocognitive impairments in a large sample of treated OCD patients; 2) a randomized controlled trial to examine the efficacy of adjunctive EX/RP for augmenting serotonin reuptake inhibitors in OCD; and 3) the measurement of the serotonin transporter in OCD patients and normal controls (using a radiolabeled ligand and PET) to examine whether there are specific serotonergic abnormalities in the brains of OCD patients. The long-term goal of this work is to improve the outcome of patients with OCD.