Treatment of Adolescent Suicide Attempters in Dallas

描述（由申请人提供）：本提案旨在在德克萨斯州达拉斯建立NIMH儿科精神药理学和心理社会干预研究单位（RUPP-PI）。我们的网站，德州西南医学中心在达拉斯，是一个主要的中心，研究情感障碍，在儿童和青少年的疗效研究领域的专业知识与精神疾病。我们的研究人员团队成功地在药物治疗（Graham Emslie，Russell Scheffer，Namrata Rao）和认知行为治疗（Graham Emslie，Betsy肯纳德，Sunita Stewart）中与青少年情绪障碍患者一起进行试验，并一直在多中心试验的招募中名列前茅。 该示范性研究方案针对一个主要的公共卫生问题：尽管该国青少年每年遭受200万次自杀企图，但尚未对这种情况进行对照干预研究。这项为期5年的研究将确定多模式治疗干预的有效性，以防止480名12至18岁的抑郁症青少年自杀未遂。将招募合格的受试者，仔细评估，然后随机平均分配至两种治疗条件。实验组将接受为期12周的抗抑郁药物管理（MM）;每周一次的青少年认知行为治疗（CBTASA）和加强临床管理（ECM）。对照组将转诊至社区提供者接受标准临床护理和额外ECM。两组均将在基线、第4、8、12、16、20和24、36和48周由对治疗分配不知情的独立评价者进行评估。本研究的目的是确定两组之间的自杀企图次数、抑郁严重程度、自杀意念严重程度和临床总体印象改善评分在结局方面是否存在差异。这个示范性的协议刺激了8个RUPP-PI申请人的协作组的形成。通过创建协议，该小组锻造了合作的能力。

DESCRIPTION (provided by applicant): This proposal is to establish an NIMH Research Unit for Pediatric Psychopharmacology and Psychosocial Interventions (RUPP-PI) in Dallas, Texas. Our site, UT Southwestern Medical Center at Dallas, is a major center for research in Affective Disorders, with expertise in the field of efficacy research in children and adolescents with psychiatric disorders. Our team of investigators have successfully worked together on pharmacotherapy (Graham Emslie, Russell Scheffer, Namrata Rao) and cognitive behavior therapy (Graham Emslie, Betsy Kennard, Sunita Stewart) trials with adolescents with mood disorders, and have consistently ranked at the top of recruitment on multi-site trials. The exemplary research protocol targets a major public health issue: although adolescents in this country suffer 2 million suicide attempts annually, no 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 additional suicide attempts in 480 depressed adolescents attempters, ages 12 to 18. Eligible subjects will be recruited, carefully assessed, and then randomized equally to two treatment conditions. The Experimental Group will receive a 12-week course of antidepressant medication management (MM); weekly cognitive behavioral therapy adapted for adolescent attempters (CBTASA), and enhanced clinical management (ECM). The Control Group will be referred to a community provider for standard clinical care with additional ECM. Both groups will be assessed at baseline, 4, 8, 12, 16, 20 and 24, 36 and 48 weeks by an independent evaluator blind to treatment assignment. The goal of this study is to determine if the number of suicide attempts, severity of depression, severity of suicidal ideation, and Clinical Global Impressions-Improved scores differ between the 2 groups at outcome. This exemplary protocol stimulated the formation of a collaborative group of 8 RUPP-PI applicants. By creating the protocol, the group forged an ability to work together.