Bipolar Disorder Across the Life Span

贯穿一生的双相情感障碍

• 批准号: 6671613
• 负责人: JOSEPH R CALABRESE
• 金额: $ 54.33万
• 依托单位: CASE WESTERN RESERVE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2003
• 资助国家: 美国
• 起止时间: 2003-09-03 至 2008-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6671613
• 关键词: behavioral /social science research tag; biomedical facility; bipolar depression; clinical research; community mental health services; comorbidity; developmental psychology; educational resource design /development; functional ability; health education; health science research; human subject; human therapy evaluation; life cycle; longitudinal human study; medically underserved population; mental disorder chemotherapy; outcomes research; patient care management; patient oriented research; psychometrics; substance abuse related disorder; therapy compliance

DESCRIPTION (provided by applicant): Bipolar disorder (BPD) affects a minimum of 2.3 million American adults aged 18 and older (1.2% of US population) and in the 5-9% of children with serious emotional disturbances, the prevalence of BPD is unknown, in 1990, BPD in established market economies resulted in 1.7 million years of lost healthy life due to premature death or disability, third only to major depression and schizophrenia. About 15% of patients with BPD commit suicide. The proportion of the NIMH dollar that goes to support research in BPD is less than expected by NIMH leadership, and there are no NIMH-funded BPD research centers. These data suggest there exists an urgent need for an NIMH research center dedicated to BPD research across the life cycle. The proposed Center addresses many of the recommendations in the 1999 "Bridging Science and Services" report by focusing on the utilization of novel longitudinal study designs in complex comorbid groups of patients with BPD from ages 5 through the end of life, as well as by focusing on function and disability, not just symptom improvement. The scientific theme of this Center will be conduct of studies designed to "improve clinical outcomes in underserved population of BPD, including those receiving care within community mental health centers (CMHC), children and adolescents, and adults currently abusing alcohol and/or drugs. The pilot projects include: 1) a single-center psychosocial intervention study designed to develop an efficient and practical way of improving treatment adherence in 166 adults with BPD in a CMHC, 2) a single-center child services project intended to improve the early and accurate recognition of BPD in 615 children and adolescents evaluated at a CMHC, and 3) a six-month, two-center, double-blind, parallel-group comparison of two regimens of combination therapy (lithium/divalproex/lamotrigine versus lithium/divalproex/placebo) for the acute and continuation outpatient management of 90 adult patients with rapid cycling BPD comorbid with alcohol, cannabis, and/or cocaine abuse/dependence at Case Western Reserve University/University Hospitals of Cleveland and a CMHC. This application will be used to build and maintain a network of sites to conduct clinical trials research that concurrently addresses issues of efficacy and effectiveness in BPD across the life cycle. This Developing Center application will be used to develop research partnerships with community settings and grow ongoing relationships, and is intended to lead to an Advanced Center submission in five years.

描述（申请人提供）：双相情感障碍（BPD）至少影响 230 万 18 岁及以上的美国成年人（占美国人口的 1.2%），在 5-9% 患有严重情绪障碍的儿童中，BPD 的患病率未知。1990 年，成熟市场经济体中的 BPD 导致 170 万年因过早死亡或残疾而失去健康生命，仅次于重度抑郁症和精神分裂症。大约 15% 的 BPD 患者会自杀。 NIMH 用于支持 BPD 研究的资金比例低于 NIMH 领导层的预期，并且没有 NIMH 资助的 BPD 研究中心。这些数据表明，迫切需要 NIMH 研究中心致力于整个生命周期的 BPD 研究。拟议的中心解决了 1999 年“科学与服务之间的桥梁”报告中的许多建议，重点关注在 5 岁至生命终结的复杂共病 BPD 患者群体中使用新颖的纵向研究设计，并关注功能和残疾，而不仅仅是症状改善。该中心的科学主题将是开展旨在“改善服务不足的 BPD 人群的临床结果，包括在社区精神卫生中心 (CMHC) 接受护理的人群、儿童和青少年以及目前滥用酒精和/或药物的成年人。试点项目包括：1) 一项单中心心理社会干预研究，旨在开发一种有效且实用的方法，以提高 166 名 BPD 成人的治疗依从性。 CMHC，2) 一个单中心儿童服务项目，旨在提高在 CMHC 评估的 615 名儿童和青少年对 BPD 的早期和准确识别，以及 3) 对两种联合治疗方案（锂/双丙戊酸/拉莫三嗪与锂/双丙戊酸/安慰剂）进行为期六个月、两中心、双盲、平行组比较 在凯斯西储大学/克利夫兰大学医院和 CMHC 对 90 名患有快速循环 BPD 并伴有酒精、大麻和/或可卡因滥用/依赖的成人患者进行急性和持续门诊管理。该应用程序将用于建立和维护一个站点网络，以进行临床试验研究，同时解决 BPD 在整个生命周期中的功效和有效性问题。该开发中心应用程序将用于 与社区环境建立研究合作伙伴关系并发展持续的关系，旨在在五年内向高级中心提交申请。