Early Phase Psychosis: Informing Treatment Decisions

早期精神病：告知治疗决策

• 批准号: 8301782
• 负责人: JOHN M KANE
• 金额: $ 154.65万
• 依托单位: FEINSTEIN INSTITUTE FOR MEDICAL RESEARCH
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-07-27 至 2015-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8301782
• 关键词: Address; Adherence; Adolescent; Adverse effects; Affect; Antipsychotic Agents; Bipolar Disorder; Categories; Clinical Trials; Collaborations; Community Hospitals; Development; Diagnosis; Diagnostic; Differential Diagnosis; Disease remission; Dose; Drops; Early treatment; Ensure; Environment; Evidence based treatment; Family; Fertilization; Fostering; Goals; Government; Health Status; Impaired cognition; Individual; Individuation; Intervention; Intervention Studies; Investigation; Knowledge; Medical; Metabolic syndrome; Methods; Mission; Morbidity - disease rate; National Institute of Mental Health; Nature; Odds Ratio; Onset of illness; Outcome; Patients; Pharmaceutical Preparations; Pharmacologic Substance; Phase; Play; Population; Psychopathology; Psychotic Disorders; Public Health; Quality of life; Recovery; Recovery of Function; Recruitment Activity; Relapse; Research; Research Infrastructure; Research Personnel; Research Subjects; Research Training; Resources; Risk; Role; Schizoaffective Disorders; Schizophrenia; Schizophreniform Disorder; Series; Severities; Smoking; Staging; Symptoms; Therapeutic; Time; Training; Treatment Effectiveness; Treatment Refusal; Weight Gain; clinically significant; design; evidence base; experience; global health; high risk; improved; interest; mortality; prevent; programs; psychosocial; success; technological innovation; young adult

DESCRIPTION (provided by applicant): Psychotic disorders occurring for the first time in adolescents and young adults pose enormous challenges. Often diagnosis is unclear and potential treatments are not sufficiently evidence-based. Early, appropriate and consistent intervention is necessary in order to optimize outcomes in an early manifestation of a psychotic disorder and we will systematically address a range of issues in this context. Antipsychotic medications are frequently used in these diverse groups. At the same time that their use might be appropriate/efficacious in the short term, there are major unanswered questions regarding their intermediate and long-term use. What are the optimal treatments, dosing and duration of intervention to achieve remission, recovery and to prevent relapse in such individuals? Therapeutic engagement and adherence with treatment are key drivers of outcomes in these populations. As we consider the appropriateness, acceptability and benefit-to-risk ratio of antipsychotic treatments in adolescents and young adults, we also have to consider and address the potential effects of our interventions on global health and, in particular, on those illness and treatment-related factors which contribute so dramatically to increased medical morbidity and mortality in these populations (i.e. weight gain, metabolic syndrome and smoking).The mission of our Center will be to help to establish and support core enabling infrastructure and a series of investigations which can inform critical diagnostic and individual treatment decisions regarding early phase psychotic disorders. We define early phase as being within the first five years following a diagnosis or being in a major high risk category. Under the rubric of high risk and early phase psychotic disorders we include the schizophrenia and bipolar prodrome, schizophreniform disorder, psychosis NOS, substance-induced psychotic disorder, bipolar disorder with psychotic features and schizophrenia or schizoaffective disorder within five years of diagnosis. Ultimately, we hope to improve the outcome (i.e. remission, recovery, functioning, quality of life and global health) of individuals affected by any psychotic illness during a critical stage of development and individuation. Our ability to intervene appropriately, effectively and consistently in this population can have profound long-term public health consequences.

描述（由申请人提供）：青少年和年轻人首次提出了巨大的挑战。诊断通常不清楚，潜在治疗不足以证据。为了在精神病障碍的早期体现中优化结果，需要早期，适当和一致的干预措施，并且在这种情况下，我们将系统地解决一系列问题。这些不同的组经常使用抗精神病药。同时，它们在短期内可能是适当的/有效的，关于它们的中间和长期使用存在重大问题。哪些最佳治疗方法，剂量和干预持续时间是为了获得缓解，康复和防止此类人的复发？治疗参与和遵守治疗是这些人群中结果的关键驱动力。当我们考虑青少年和年轻人中抗精神病药物治疗的适当性，可接受性和利益风险比率时，我们还必须考虑并解决干预措施对全球健康的潜在影响，特别是对这些疾病和治疗相关的因素，这些因素对这些群体的促进性和死亡人口的贡献是如此之所以促进这些群体的范围，以使这些人群变得更加重要。并支持启用基础设施的核心和一系列调查，这些调查可以为早期精神病患者提供关键的诊断和个人治疗决策。我们将早期阶段定义为诊断后的头五年或主要高风险类别。在高风险和早期精神病的标题下，我们包括精神分裂症和躁郁症，精神分裂症，精神分裂症，NOS，药物诱发的精神病，具有精神病性特征和精神分裂症或精神分裂症或精神分裂症的双相情感障碍。最终，我们希望在关键的发展和个性化阶段，改善受任何精神病疾病影响的个人的结果（即缓解，恢复，功能，生活质量和全球健康）。我们在这个人群中适当，有效，一致地进行干预的能力可能会带来深远的长期公共卫生后果。