Training in Early Detection and Prevention in Psychiatric Disorders

描述（由申请人提供）：我们提出一个新的博士后培养项目，研究精神障碍、情绪障碍和焦虑症的早期发现和预防。由于这些疾病发作相对较早，而且往往是慢性和使人衰弱的，患有这些疾病的个人将不成比例的公共资金用于医疗服务和残疾。现有的治疗方法在减轻症状严重程度方面仅部分有效，通常需要持续的维持治疗才能做到这一点（副作用负担不断累积），并且不能改善与这些综合征相关的职业和社会功能缺陷或对未来发作的脆弱性。此外，对于其中一些疾病，发病后越早开始治疗，长期结果越好，这表明潜在疾病过程的进展方面使这些疾病对干预的反应越来越弱。该项目将在早期发现和预防精神疾病方面整合教学课程、研讨会和监督研究培训。我们根据四个目标整合了评估受训者和项目的机制。首先，如果下一代研究人员掌握了确定风险标志和机制以及开发和测试预防性干预措施所需的工具，那么针对这些疾病的有效预防计划的进展将会更快。其次，鉴于这些形式的精神病理学是复杂的决定现象，涉及生物和社会心理过程，下一代研究人员必须能够有效地整合这些不同层次的分析，以他们的方法进行风险检测和预防干预。第三，我们对过渡年龄人群的关注将有助于克服青少年和成人精神病理学研究之间的传统界限，促进发展视角的整合。最后，让受训者接触到精神病理学多个领域的早期检测和预防方法，将提供有用的比较和对比点，并将刺激各领域之间的交叉受精。

DESCRIPTION (provided by applicant): We propose a novel program for post-doctoral training in early detection and prevention of psychotic disorders, mood disorders, and anxiety disorders. Because these disorders strike relatively early in life and tend to be chronic and debilitating, individuals with these conditions utilize a disproportionate share of public funds for medical services and disability. Existing treatments are only partially effective in reducing symptom severity, generally requiring on-going maintenance therapy to do so (with accumulating side effect burden), and do not ameliorate the deficits in occupational and social functioning associated with these syndromes or the vulnerability to future episodes. In addition, for some of these conditions, the earlier treatment is initiated after the onset of illness, the better the long-term outcome, suggesting that progressive aspects of the underlying disease processes make these illnesses increasingly less responsive to interventions. This program will integrate didactic coursework, seminars, and supervised research training in early detection and prevention of psychiatric disorders. We integrate mechanisms to evaluate trainees and the program in relation to four objectives. First, progress toward effective prevention programs for these disorders will be more rapid if the next generation of researchers is armed with the tools needed both to ascertain risk markers and mechanisms and to develop and test preventive interventions. Second, given that these forms of psychopathology are complexly determined phenomena, involving biological and psychosocial processes, the next generation of researchers must be able to integrate effectively across these different levels of analysis in their approach to risk detection and preventive intervention. Third, our focus on transitional age populations will help to overcome the traditional boundaries between research in adolescent and adult forms of psychopathology, facilitating the integration of a developmental perspective. Finally, exposure of trainees to early detection and prevention approaches to multiple domains of psychopathology will provide useful points of comparison and contrast and will stimulate cross-fertilization between areas.