Phenomenology and Identification of Juvenile BPD in a Community Setting

社区环境中青少年 BPD 的现象学和识别

• 批准号: 7551687
• 负责人: JOSEPH R CALABRESE
• 金额: $ 23.79万
• 依托单位: CASE WESTERN RESERVE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2007
• 资助国家: 美国
• 起止时间: 2007-06-01 至 2008-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7551687
• 关键词: Academic Medical Centers; Adolescent; Borderline Personality Disorder; Bronchopulmonary Dysplasia; Characteristics; Child; Clinic; Communities; Community Mental Health Centers; Consensus; Diagnosis; Disease; Disruptive Behavior Disorder; Early Intervention; Effectiveness; Eligibility Determination; Goals; Measures; Mood Disorders; Outcome; Outpatient Clinics, Hospital; Patients; Performance; Population; Prevalence; Prophylactic treatment; Psychopharmacology; Purpose; Rate; Research; Sampling; Screening procedure; Testing; Treatment Efficacy; Underserved Population; Unipolar Depression; Youth; base; demographics; improved; instrument; mental health center; performance tests; prevent

The diagnosis of BPD in a CMHC is frequently challenging . Incorrectly diagnosing a patient as suffering from a unipolar mood disorder or from a disruptive behavior disorder leads to sub-optimal outcome and may worsen the course of BPD. Part of the difficulty is the current lack of consensus regarding the phenomenology of juvenile BPD. At present, there also is no certainty about the base rate at which BPD might present at a CMHC, nor is there an established set of instruments that could be used to screen a juvenile community sample for bipolar spectrum disorders. The need is great for such a screening protocol, given the long-term trajectory and serious consequences of untreated or mistreated BPD, and the potential value of early intervention and prophylaxis if cases could be identified in youths. Preliminary evidence from this research group suggests that several measures perform well at distinguishing BPD from unipolar depression, disruptive behavior disorders, and other disorders in children and adolescents. However, these findings were based on a sample presenting at a hospital outpatient clinic at an academic medical center specializing in the treatment of juvenile mood disorders and psychopharmacology research. Thus, several factors prevent the immediate application of existing findings to a community setting, including the lack of soundly-established base rates of BPD at community-based mental health centers, the unknown effects of potential ascertainment bias at a mood disorders clinic versus a community setting, changes in demographics or other sample characteristics that might interact with test performance, and the fact that test performance might degrade when exported from a research framework into a community context, much as therapeutic efficacy estimates usually exceed effectiveness findings. The purpose of the proposed project is to determine the prevalence of BPD in an ethnically diverse community sample and to develop effective means of screening patients in a CMHC for bipolar spectrum disorders, as well as to improve understanding of the early presentation of bipolar spectrum disorders, especially in underserved populations.

CMHC中BPD的诊断常常具有挑战性。错误地将患者诊断为患有单相情感障碍或 破坏性行为障碍会导致不理想的结局，并可能使BPD的病程恶化。困难的一部分 目前对青少年BPD的现象学缺乏共识。目前，有 也不能确定BPD可能出现在CMHC的基本比率，也不存在一套既定的 可用于对青少年社区样本进行双相情感障碍筛查的仪器。考虑到长期的轨迹和 不治疗或不当对待BPD的严重后果，以及早期干预和预防的潜在价值 如果能在年轻人中发现病例。来自该研究小组的初步证据表明，有几项措施 在区分BPD与单相抑郁、破坏性行为障碍和其他障碍方面表现出色 儿童和青少年。然而，这些发现是基于一家医院门诊提交的样本。 在一家专门治疗青少年情绪障碍和精神药理学的学术医学中心 研究。因此，有几个因素阻碍了现有研究成果立即应用于社区环境， 包括在以社区为基础的精神卫生中心缺乏健全的BPD基本比率， 在情绪障碍诊所与社区环境中潜在的确定偏差的未知影响，变化 人口统计或其他可能与测试性能交互的样本特征，以及测试的事实 从研究框架导出到社区上下文中时，性能可能会下降，很像 治疗效果估计通常超过疗效发现。拟议项目的目的是 确定不同种族社区样本中BPD的患病率，并制定有效的方法 在CMHC中筛查双相情感障碍的患者，以及提高对早期 双相情感障碍的表现，特别是在服务不足的人群中。