Broadening the Investigation of Psychosis Prodrome to Different Cultural Groups

确定哪些人有发展成精神病的风险是制定精神分裂症早期干预和预防策略的核心。由美国、澳大利亚、英国、加拿大、德国和瑞士的研究人员领导的对前驱阶段人群的研究在世界范围内展开。了解发生在临床高危(CHR)阶段的生物心理社会过程是很重要的。北美前驱症状纵向研究(NAPLS)利用一套涵盖心理社会、生物、神经心理和遗传因素的综合评估方案，确定了青少年慢性阻塞性肺疾病的关键临床特征和预测因素。这是至关重要的，因为它为制定预防脑损伤的早期干预措施提供了信息。然而，NAPLS的研究仅限于北美受试者。该项目的目的是将精神病研究的现有先兆扩大到不同文化和遗传库中的人群，以检查症状表现和疾病预测因素方面的重要文化差异。这项申请的总体目标是设计和启动一个可持续的中低收入国家的慢性精神病纵向研究计划。具体地说，我们试图：1.评估上海精神卫生中心(SMHC)的潜在研究需求，该中心是世界卫生组织指定的精神健康研究中心；2.帮助开发一个关于精神分裂症从先兆到精神病进展的研究计划。初步研究包括四个主要部分：a)前驱症状受试者的临床评估。为此，前驱症状和前驱症状量表的结构化访谈(SIPS/SOPS)将被翻译成受试者的语言并随后进行验证：b)使用Matrics电池进行神经认知评估，c)耻辱，d)使用事件相关电位进行电生理评估。此外，还将收集和储存血液样本，以供将来分析。将对上述目标的性别影响进行审查。研究目标与《发展中世界的脑部疾病：跨寿命研究》(R21，PAR-11-031)的指导方针是一致的。

The identification of people who are at risk of developing psychosis is central to the development of early intervention and prevention strategies for schizophrenia. There is a world-wide movement in the study of populations at the prodromal stage led by researchers in the United States, Australia, England, Canada, Germany, and Switzerland. It is important to understand the biopsychosocial processes that occur during the clinical high risk (CHR) phase. The North American Prodrome Longitudinal Study (NAPLS) has identified key clinical characteristics and predictors of CHR youth using a comprehensive assessment package encompassing psychosocial, biological, neuropsychological, and genetic components. This is critical because it informs development of early interventions for prevention of brain damage. However, the NAPLS study is limited to the North American subjects. The purpose of this project is to broaden the existing prodrome to psychosis study to populations in a different cultural and genetic pool to examine the important cultural differences in the manifestations of the symptoms and the predictors of the illness. The overall goal of this application is to design and initiate a sustainable CHR to psychosis longitudinal program of research in a low-middle income country. Specifically, we attempt to: 1. Assess potential research needs of the Shanghai Mental Health Center [SMHC], a World Health Organization designated researcher center for mental health, and 2. Help develop a program of research on the progression of schizophrenia from prodrome to psychosis. The preliminary study contains four major components: a) clinical assessment of prodromal subjects. For this aim, the Structured Interview for Prodromal Syndromes and Scale of Prodromal Symptoms (SIPS/SOPS) will be translated into the language of the subjects and subsequently validated; b) neurocognitive assessment with the MATRICS battery, c) stigma, and d) electrophysiological assessment using event related potentials. In addition, blood samples will be collected and stored for future analyses. Gender effects will be examined across the above aims. The study goals are consistent with the guidelines of the FOA Brain Disorders in the Developing World: Research Across the Lifespan (R21, PAR-11-031).