Computerized Screening in Adolescents with Substance or Psychiatric Disorders

对患有物质或精神疾病的青少年进行计算机筛查

• 批准号: 8250321
• 负责人: Kenneth A Kobak
• 金额: $ 24.37万
• 依托单位: CENTER FOR PSYCHOLOGICAL CONSULTATION
• 依托单位国家: 美国
• 财政年份: 2011
• 资助国家: 美国
• 起止时间: 2011-04-01 至 2014-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8250321
• 关键词: Adolescent; Alcohol or Other Drugs use; Area; Behavioral; Behavioral Sciences; Child; Clinical; Comorbidity; Computers; Data; Detection; Development; Devices; Diagnosis; Diagnostic; Disease; Early identification; Early treatment; Environment; Etiology; Evaluation; Failure; Fee-for-Service Plans; Feeling suicidal; Goals; Gold; Interview; Knowledge; Medical; Mental Health; Mental disorders; Monitor; NIH Program Announcements; National Institute of Mental Health; Neurosciences; Online Systems; Parents; Patients; Psyche structure; Public Health; Reporting; Research; Resistance; Resources; Risk; Role; Screening procedure; Severities; Small Business Innovation Research Grant; Societies; Standardization; Substance Use Disorder; Substance abuse problem; Symptoms; System; Time; Training; Treatment outcome; United States Substance Abuse and Mental Health Services Administration; Validity and Reliability; base; computerized; computerized tools; cost; cost effective; design; dual diagnosis; effective therapy; functional disability; health care service utilization; improved; interest; public health relevance; satisfaction; social; social stigma; suicidal risk; tool

DESCRIPTION (provided by applicant): Psychiatric comorbidity is a major concern for adolescents with substance use or psychiatric disorders. Eighty-five percent of adolescents in treatment for a substance use disorder have an additional psychiatric comorbidity. Similarly, psychiatric disorders have an important role in the etiology of and vulnerability to substance use disorders. Adolescents with both mental and substance disorders are more persistent, severe, and treatment resistant than patients with pure disorders, have more behavioral and medical problems, and higher suicide risk. While effective treatments exist for adolescents with comorbid substance and psychiatric disorders, clinicians fail to identify the comorbid psychiatric condition 65% of the time (the detection rate was as low as 5% in fee for service systems). SAMHSA's "Blueprint for Action" calls increased screening of comorbidity a national priority. The current study will develop an on-line, computerized screening tool to identify comorbid psychiatric disorders in adolescents with substance use or psychiatric disorders. The tool, based on the KSADS, will also contain embedded severity scales to monitor change over time. Computerization facilitates accessibility, enabling wider dissemination, especially when clinician-diagnosticians are unavailable. Fifty adolescents and their parents will take computer and clinician versions of the interview in counterbalanced order; ancillary scales will evaluate construct validity. The study will generate data on reliability, validity, feasibility, clinical utility, user satisfaction, and equivalence to clinician administered diagnosis. PUBLIC HEALTH RELEVANCE: Comorbid substance abuse and psychiatric disorders in adolescents has been identified as a major public health issue. Failure to identify the comorbidity is common, and results in significantly worse treatment outcomes for patients and greater burden on society. A web-based screening device will help facilitate detection and treatment of comorbidity, resulting in more effective treatment outcomes for patients and decreased societal burden.

描述（由申请人提供）：精神共病是青少年物质使用或精神疾病的主要问题。85%接受药物使用障碍治疗的青少年有额外的精神病合并症。同样，精神障碍在药物使用障碍的病因学和易患性方面也发挥着重要作用。患有精神障碍和物质障碍的青少年比单纯的精神障碍患者更持久，更严重，更难治疗，有更多的行为和医疗问题，自杀风险更高。虽然存在有效的治疗与共病的物质和精神疾病的青少年，临床医生未能确定共病的精神状况的65%的时间（检测率低至5%的服务系统的费用）。SAMHSA的“行动蓝图”呼吁增加科摩罗的筛查，这是国家的优先事项。目前的研究将开发一个在线的，计算机化的筛选工具，以确定共病的精神疾病的青少年与物质使用或精神疾病。该工具以KSADS为基础，还将包含嵌入式严重程度量表，以监测随着时间的推移而发生的变化。计算机化便利了获取，使传播范围更广，特别是在没有临床诊断医生的情况下。50名青少年和他们的父母将采取计算机和临床医生版本的采访中的平衡顺序，辅助量表将评估结构效度。本研究将生成关于可靠性、有效性、可行性、临床效用、用户满意度以及与临床医生进行的诊断等效性的数据。 公共卫生相关性：青少年药物滥用和精神障碍共病已被确定为一个主要的公共卫生问题。未能识别合并症是常见的，并导致患者的治疗结果显着恶化，给社会带来更大的负担。基于网络的筛查设备将有助于促进合并症的检测和治疗，从而为患者提供更有效的治疗结果，并减轻社会负担。