Treatment of Adolescent Suicide Attempters in Dallas

描述(由申请人提供)：这项建议是建立一个NIMH研究单位的儿科精神药理学和心理社会干预(RUPP-PI)在达拉斯，得克萨斯州。我们的网站，达拉斯的德克萨斯大学西南医学中心，是情感障碍研究的主要中心，在患有精神障碍的儿童和青少年的疗效研究领域拥有专业知识。我们的研究团队成功地合作了药物疗法(Graham Emsle、Russell Scheffer、Namrata Rao)和认知行为疗法(Graham Emsle、Betsy Kennard、Sunita Stewart)对患有情绪障碍的青少年的试验，并在多地点试验中一直位居招募榜首。 示范研究方案针对的是一个主要的公共卫生问题：尽管这个国家的青少年每年有200万次自杀未遂，但没有对这种情况进行受控干预研究。这项拟议的为期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岁至18岁的抑郁症青少年尝试自杀。合格的受试者将被招募、仔细评估，然后随机分为两种治疗条件。试验组将接受为期12周的抗抑郁药物管理(MM)、适用于青少年的每周认知行为疗法(CBTASA)和增强临床管理(ECM)的疗程。控制组将被转介到社区提供者，进行标准的临床护理和额外的ECM。两组都将在基线、4、8、12、16、20和24、36和48周由独立评估员进行评估，对治疗分配不予考虑。这项研究的目的是确定自杀未遂的次数、抑郁的严重程度、自杀意念的严重程度以及临床总体印象-改善的分数在两组结果中是否存在差异。这一示范方案促成了一个由8名RUPP-PI申请者组成的协作组。通过制定协议，该小组形成了一种合作的能力。

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.