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障碍的主要问题。在接受药物使用障碍治疗的青少年中，85%有额外的精神合并症。同样，精神疾病在物质使用障碍的病因和易感性方面也起着重要作用。与纯粹的精神障碍患者相比，同时患有精神障碍和物质障碍的青少年更持久、更严重、更难以治疗，他们有更多的行为和医疗问题，自杀风险也更高。虽然对患有物质和精神疾病共病的青少年存在有效的治疗方法，但临床医生在65%的情况下未能识别出共病的精神疾病（在收费服务系统中，检出率低至5%）。SAMHSA的“行动蓝图”呼吁增加对合并症的筛查，这是国家的优先事项。目前的研究将开发一种在线的、计算机化的筛查工具，以识别青少年药物使用或精神障碍的共病性精神障碍。该工具以KSADS为基础，还将包含嵌入式严重性尺度，以监测随时间的变化。计算机化促进了可及性，使传播更广泛，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以平衡的顺序接受电脑版和临床版的访谈；辅助量表将评估构念效度。该研究将产生关于可靠性、有效性、可行性、临床效用、用户满意度和临床医生管理诊断的等效性的数据。