RUPP-PI

描述（由申请人提供）：这份U10提案，匹兹堡RUPP-PI是在匹兹堡建立一个儿童精神药理学-社会心理干预NIMH研究单位。在情绪障碍和自杀行为的临床流行病学、社会心理治疗发展、SSRI的药代动力学以及参与许多成功执行的单点和多点临床试验（包括CBT、抗抑郁药及其对情绪和焦虑障碍的联合治疗）方面，拟议的单元建立在匹兹堡站点的优势之上。支持这一研究和培训项目的资源包括：T32儿童精神病学研究博士后培训基金、早发性情绪和焦虑症干预研究中心、抗抑郁药药代动力学RUPP，以及国家支持的情绪障碍和自杀行为专科诊所。“青少年自杀未遂者的治疗” （TASA）范例研究议定书针对的是一个重大的公共卫生问题：尽管我国青少年每年有200万人自杀未遂，但尚未针对这一情况进行大规模、多模式对照干预研究。这项拟议的5年研究将确定多模式治疗干预的有效性，以防止8个地点480名年龄在12至18岁的抑郁青少年再次尝试。实验治疗组将接受为期24周的抗抑郁药物治疗（MM）和认知行为治疗。对照治疗组将被转介给社区提供者进行标准临床护理，并加强临床监测和病例管理，以鼓励治疗依从性。两组将在基线2、4、8、12、24、36和48周时由独立评估者对治疗分配进行盲测。我们假设，在为期一年的观察中，实验治疗将导致更少的自杀企图，减少抑郁和自杀意念的严重程度，并且两组之间的总体改善得分差异更大。RUPP-PI现场的专门知识和经验也将用于培训新的调查人员。在创建TASA的过程中，一个由8名申请人组成的协作小组培养了一起工作的能力。

DESCRIPTION (provided by applicant) : This U10 proposal, RUPP-PI in Pittsburgh is to establish an NIMH Research Unit for Pediatric Psychopharmacology-Psychosocial Intervention in Pittsburgh. The proposed unit builds on the strengths of the Pittsburgh site in clinical epidemiology of mood disorders and suicidal behavior, psychosocial treatment development, pharmacokinetics of SSRI's, and participation in numerous success- fully performed, single and multi-site clinical trials involving CBT, antidepressants, and their combination for mood and anxiety disorders. Resources to support this program of research and training include a T32 postdoctoral training grant in child psychiatry research, an Intervention Research Center on early-onset mood and anxiety disorders, a RUPP devoted to pharmacokinetics of antidepressants, and a state-supported specialty clinic for mood disorders and suicidal behavior. The exemplar research protocol, "Treatment of Adolescent Suicide Attempters" (TASA), targets a major public health issue: although adolescents in this country suffer 2 million suicide attempts annually, no large scale, multimodal controlled intervention studies for this condition have been conducted. The proposed 5-year study will determine the effectiveness of a multi-modal treatment intervention to prevent further reattempts in 480 depressed adolescents attempters, ages 12 to 18, at 8 sites. The Experimental Treatment Group will receive a 24-week course of antidepressant medication management (MM), and cognitive behavioral therapy. The Control Treatment Group will be referred to a community provider for standard clinical care plus enhanced clinical monitoring and case management to encourage treatment adherence. Both groups will be assessed at baseline 2, 4, 8, 12, 24, 36 and 48 weeks by an independent evaluator blind to treatment assignment. We hypothesize that the experimental treatment will result in fewer suicide attempts, diminished depression and severity of suicidal ideation, and greater global improvement scores differ between the 2 groups over a one-year period of observation. The expertise and experience at this RUPP-PI site also will be directed to train new investigators. In creating TASA, a collaborative group of 8 applicants forged the ability to work together.