Psychiatry Consultation Liaison Service Research

精神科咨询联络服务研究

• 批准号: 8745750
• 负责人: Maryland Pao
• 金额: $ 46.52万
• 依托单位: NATIONAL INSTITUTE OF MENTAL HEALTH
• 依托单位国家: 美国
• 资助国家: 美国
• 起止时间: 至
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/8745750
• 关键词: AIDS/HIV problem; Acquired Immunodeficiency Syndrome; Address; Adolescent; Adolescent Medicine; Adult; Advance Care Planning; Advocate; Affect; Anxiety; Anxiety Disorders; Archives; Area; Behavioral; Bioethics; Bone Marrow Transplantation; Boston; Caregivers; Caring; Child; Childhood; Chronic; Chronic Disease; Clinical; Clinical Research; Clinical Services; Cognitive; Collaborations; Communities; Complex; Consent; Consultations; Development; Developmental Delay Disorders; Disease; Distress; District of Columbia; Enrollment; Evaluation; Extramural Activities; Faculty; Family; Feeling suicidal; Genes; Government; HIV; Health Professional; Health Services Research; Hepatitis; Hereditary Disease; Hospitals; Human Development; Informed Consent; Inpatients; Institutes; Institutional Review Boards; Intellectual functioning disability; Interest Group; Interferons; International; Intramural Research; Journals; Knowledge; Life; Literature; Malignant Neoplasms; Manuscripts; Medical; Medical center; Mental Depression; Mental Health; Mission; Mood Disorders; Names; National Heart, Lung, and Blood Institute; National Human Genome Research Institute; National Institute of Allergy and Infectious Disease; National Institute of Arthritis and Musculoskeletal and Skin Diseases; National Institute of Mental Health; National Institute of Neurological Disorders and Stroke; Neurocognitive; Neuropsychological Tests; Neuropsychology; Neurosciences; Nurses; Ohio; Outcome Measure; Palliative Care; Pamphlets; Paper; Parenting behavior; Parents; Patients; Pediatric Hospitals; Pediatric Oncology; Pediatrics; Peer Review; Phenotype; Physicians; Police; Population; Preparation; Prevention strategy; Process; Protocols documentation; Provider; Psychiatrist; Psychiatry; Psychologist; Psychophysiologic Disorders; Psychosomatic Medicine; Publications; Publishing; Rare Diseases; Research; Research Personnel; Research Project Grants; Research Subjects; Research Support; Resources; Role; Rotation; Services; Siblings; Social Workers; Staging; Suicide; Suicide prevention; Symptoms; Thermometers; Training; Training and Education; Translating; United States National Institutes of Health; Universities; Voice; Vulnerable Populations; Work; Youth; base; biopsychosocial; experience; graduate medical education; healthy volunteer; human subject protection; improved; instrument; meetings; member; methylmalonic aciduria; multidisciplinary; neurodevelopment; neuropsychiatry; neuropsychological; phase 2 study; posters; programs; psychologic; psychopharmacologic; psychosocial; public health ethics; review of reported cases; screening; suicidal behavior; symposium; tool; young adult

The NIMH Psychiatric Consultation Liaison Service (PCLS) provides important psychiatric services to the many constituencies of the NIH. While providing such services to the NIH Community, PCLS clinicians conduct research and collaborate with NIH investigators by providing expertise in the areas of psychiatric, neurocognitive, and psychosocial functioning in NIH research subjects who often have complex medical and neuropsychiatric symptoms. Patient-subjects enrolled in research trials in other Institutes/Centers at the NIH offer unparalleled opportunities to explore the roles of specific genes (e.g., monogenic diseases such as methylmalonic acidemia (MMA)) and specific therapies (e.g., interferon in hepatitis) in psychiatry and neurodevelopment. Psychosomatic medicine trainees on the PCLS are encouraged during their rotations to pursue research projects that result in publications in peer reviewed journals, including literature reviews, case reports and poster presentations at national conferences. Active NIH research collaborators include the CC Bioethics Department, NCI Pediatric Oncology Branch (POB), the NIAID HIV/AIDS Service, and the Smith-Magenis Research Team to name just a few. The PCLS Neuropsychology Consultation Service performs neuropsychological evaluations for neurocognitive phenotyping of medical disorders resulting in research collaborations with other Institutes such as NIAMS, NHGRI, NIAID, NHLBI, NINDS and others. The PCLS conducts collaborative research with the NCI POB and provides research support to the Pediatric Oncology Psychosocial Research Program which studies palliative care, psychopharmacologic management in pediatric oncology patients, sibling, parent and caregivers concerns, and screening for distress in bone marrow transplantation recipients as compared to other chronic diseases, among other topics. This active research program on psychiatric and psychosocial aspects of pediatric oncology care has led to several shared protocols including evaluation of a distress thermometer in pediatric medically ill populations, characterization of "lone" parenting and a protocol to understand the experiences and needs of international families whose children are in research all of which resulted in recent publications. The PCLS research group provides mental health consultation on a number of educational brochures and booklets and recently developed "Voicing My Choices," an advance care planning guide for adolescents and young adults. Over 9000 copies of "Voicing My Choices" has been distributed nationally and internationally. It has been translated into Spanish and Italian. The PCLS group is also studying assessment instruments of mood and anxiety disorders for adolescents and young adult (AYA) healthy volunteers and AYA with cancer. The PCLS research team has taken a central role in NIMH's collaboration with NIAID and the District of Columbia (DC) in establishing an interdisciplinary, cross-institutional research collaborative effort with local investigators (see list of extramural collaborators), the DC-NIH Partnership for AIDS Progress (DC PFAP), to enhance knowledge of the biopsychosocial mental health aspects of HIV/AIDS. PCLS staff are working with DC Government leaders, clinical providers and administration, and community groups to identify gaps in services and knowledge to develop related research opportunities. PCLS researchers have co-founded and co-chaired the DC CFAR "Mental Health and Neuroscience" Scientific Interest Group which includes more than 30 investigators from DC based universities and meets monthly to discuss research collaborations. PCLS researchers have also co-founded and co-chaired the intramural NeuroHIV Interest Group Steering Committee, which meets monthly and oversees and coordinates five intramural research protocols at various stages of development; two protocols were co-authored and are co-led by PCLS researchers while all five receive substantial logistical support from PCLS, including neuropsychological testing and mental health screening which are among the key outcome measures for all these protocols. The PCLS research group continues to describe the processes involved in developing adequate programs for the protection of healthy volunteers as well as vulnerable subjects while conducting cutting-edge research. An informed consent training video produced by the Clinical Research Advocates (CRAs) of the Human Subjects Protections Unit (HSPU), in the Office of the Clinical Director, is now being used for training in all the Graduate Medical Education programs at the NIH as well as throughout the CC. The CRAs continue to provide training courses as well as present at national meetings on their experiences regarding implementing processes to standardize the evaluation and protection of vulnerable subjects in research. They continue to serve on the Ability to Consent Assessment Team (ACAT) with the CC Bioethics department and are utilized frequently throughout the Clinical Center to provide additional safeguards to vulnerable subjects. The PCLS also provides mental health consultation to the National Institute for Child Human Development (NICHD), and assigns a mental health professional to serve on the NICHD IRB. PCLS faculty regularly serve as reviewers for peer reviewed journals in mental health, psychosomatic medicine, pediatrics, neuropsychology, ethics, and public health. The PCLS research group is involved in several timely research projects that align with NIMH's mission to improve suicide prevention strategies. Three suicide screening projects address suicide screening in the medical setting. This past year we concluded a multisite study of pediatric EDs at Children's National Medical Center, Boston Children's Hospital and Nationwide Children's Hospital in Columbus, Ohio led by the PCLS group. A four-item screening instrument was developed, the ASQ (Ask Suicide-Screening Questions), and has been published by Archives of Pediatrics and Adolescent Medicine (now JAMA Pediatrics). To address the issue of suicidality in hospital settings, the PCLS research group created a suicide screening instrument and educational program to assist nurses on inpatient medical units with suicide assessment. The Ask Suicide-Screening Questions to Everyone in Medical Settings (asQem) Quality Improvement Project was initiated in January 2012 and was published in Psychosomatics in 2013. The third project involves an international collaboration and is focused on developing a suicide screening tool for youth with developmental delay and adults with intellectual disabilities. Phase 2 of this study was completed in July 2013 with the first manuscript in preparation. Due to the PCLS's expertise in this area of research, PCLS members have presented in-services to physicians, nurses and NIH police around the NIH CC on the topic of suicide prevention. The PCLS research team had a productive year with more than a dozen posters, more than 20 papers and numerous presentations and educational courses in the past year.

NIMH精神病学咨询联络服务（PCLS）为NIH的许多选区提供了重要的精神病服务。在为NIH社区提供此类服务时，PCLS临床医生通过在NIH研究对象中提供精神病，神经认知和心理社会功能领域的专业知识，并与NIH研究人员合作，并与经常患有复杂的医学和神经精神症状的专业知识。 NIH的其他机构/中心参加研究试验的患者可能会提供无与伦比的机会，可以探索特定基因的作用（例如，单基因疾病，例如甲基丙二酸酸血症（MMA））和特定的疗法（例如，肝炎中的肝脏炎）在精神病和神经界面中的作用。在轮换过程中，鼓励PCL上的心身医学学员从事研究项目，从而在同行评审期刊上出版，包括文献综述，案例报告和国家会议的海报演示。活跃的NIH研究合作者包括CC生物伦理学系，NCI儿科肿瘤科（POB），NIAID HIV/AIDS服务和Smith-Magenis Research Team仅举几例。 PCLS神经心理学咨询服务对医学疾病的神经认知表型进行了神经心理学评估，从而与NIAMS，NHGRI，NHGRI，NIAID，NHLBI，NINDS等其他机构进行了研究合作。 PCLS与NCI POB进行了合作研究，并为儿科肿瘤学心理社会研究计划提供研究支持，该计划研究了姑息治疗，小儿肿瘤学患者的心理药物管理，同胞，父母，父母，父母和护理问题，并筛查与其他骨髓移植者相比，与其他儿童疾病相比，筛选骨莫尔的痛苦。这项有关儿科肿瘤学护理的精神病和社会心理方面的积极研究计划，导致了几项共同的方案，包括评估儿科医学疾病人群中的遇险温度计，对“孤独”育儿的表征以及一项协议，以了解其在最近出版物中所导致的国际家庭的经验和需求。 PCLS研究小组就许多教育手册和小册子提供了心理健康咨询，并最近开发了“我的选择”，这是针对青少​​年和年轻人的预先护理计划指南。超过9000份“表达我的选择”的副本已在国内和国际上分发。它已翻译成西班牙和意大利语。 PCLS组还正在研究青少年和年轻人（AYA）健康志愿者和患有癌症的年轻人的情绪和焦虑症评估工具。 PCLS研究团队在NIMH与NIAID和哥伦比亚特区（DC）的合作中发挥了核心作用，在与当地研究人员的跨学科，跨机构研究的合作工作（请参阅校外合作者列表），DC-NIH的DC-NIH艾滋病伙伴关系的艾滋病伙伴关系进步（DC PFAP），以增强对INSCOSSECTIOSS Inspersects Inspersys for Incellips of Hand acoccials for hh hh hh hh hh hh hh hh hh hh hh hh hh hh hh hh hh hh hh hh hh hy cosc s aft的伙伴。 PCLS员工正在与DC政府领导人，临床提供者和行政管理人员以及社区团体合作，以确定服务和知识的差距，以开发相关研究机会。 PCLS的研究人员已共同创立并共同主持了DC CFAR“心理健康与神经科学”科学兴趣小组，其中包括来自DC大学的30多名研究人员，并每月开会以讨论研究合作。 PCLS的研究人员还共同创建并共同主持了壁内神经兴趣小组指导委员会，该委员会每月与监督并协调五个在发展阶段的壁内研究方案； PCL研究人员共同撰写了两个方案，并由PCL共同领导，而所有五个方案都获得了PCL的大量后勤支持，包括神经心理学测试和心理健康筛查，这是所有这些方案的关键结果指标之一。 PCLS研究小组继续描述开发适当计划以保护健康志愿者以及弱势群体的过程，同时进行尖端研究。临床主任办公室的临床研究倡导者（CRA）制作的知情同意培训视频现已用于NIH以及整个CC的所有研究生医学教育计划的培训。 CRA继续提供培训课程，并出席在国家会议上有关实施程序以标准化研究中评估和保护弱势群体的经验的经验。他们继续在CC生物伦理学系的同意评估团队（ACAT）的能力上，并在整个临床中心经常使用，以提供较大的受试者的额外保障措施。 PCL还向美国国家儿童发展研究所（NICHD）提供心理健康咨询，并分配了精神卫生专业人员来担任NICHD IRB。 PCL的教职员工定期担任同伴评论心理健康，心理医学，儿科，神经心理学，伦理学和公共卫生期刊的评论者。 PCLS研究小组参与了几项及时的研究项目，这些研究项目与NIMH的使命是改善预防自杀策略。 三个自杀筛查项目涉及医疗环境中的自杀筛查。在过去的一年中，我们在儿童国家医疗中心，波士顿儿童医院和俄亥俄州哥伦布的全国儿童医院在俄亥俄州PCLS集团领导的儿童医疗中心和全国儿童医院进行了多次研究研究。开发了一种四项筛查工具，即ASQ（提出自杀筛查问题），并已由儿科和青少年医学档案（现为JAMA PEDIATRICS）发表。为了解决医院环境中自杀问题的问题，PCLS研究小组创建了一项自杀筛查工具和教育计划，以帮助护士进行自杀评估的住院医疗单位。 在2013年1月启动了医疗环境中的所有人（ASQEM）质量改进项目的要求自杀式问题（ASQEM）质量改进项目。2013年在Psychosomatics发表。第三个项目涉及国际合作，并专注于为具有发展延迟的年轻人开发自杀筛查工具，并具有智力障碍。这项研究的第二阶段于2013年7月完成，并准备了第一个手稿。由于PCLS在这一研究领域的专业知识，PCLS成员就NIH CC围绕自杀式预防主题向医生，护士和NIH警察提供了服务。 PCLS研究团队在过去一年中拥有十多个海报，20多篇论文以及众多演讲和教育课程，度过了富有成效的一年。