IDENTIFICATION OF PSYCHOSIS-RISK TRAITS IN AFRICA

非洲精神病风险特征的识别

• 批准号: 8410171
• 负责人: DANIEL MAMAH
• 金额: $ 14.08万
• 依托单位: WASHINGTON UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2013
• 资助国家: 美国
• 起止时间: 2013-01-10 至 2014-12-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8410171
• 关键词: Address; Adolescent; Affect; Affective; Africa; Africa South of the Sahara; Area; Attenuated; Biological Markers; Bipolar Disorder; Brain; Cephalic; Clinical; Code; Cognitive; Collaborations; Communities; Community Surveys; DSM-IV; Data; Deterioration; Developing Countries; Development; Diagnostic; Digit structure; Dimensions; Distress; Drug Formulations; Dyskinetic syndrome; Early Diagnosis; Early Intervention; Face; Family; Focus Groups; Fossa; Fostering; Foundations; Genetic Risk; Head; Health Policy; Healthcare; Height; Impaired cognition; Individual; International; Intervention; Interview; Kenya; Lead; Link; Longitudinal Studies; Major Depressive Disorder; Measures; Medial; Mental Health; Mentors; Methods; Motor; Movement; Neurobehavioral Manifestations; Neurocognitive; Neurologic; Onset of illness; Outcome; Patients; Population; Prevalence; Prevention; Probability; Psychotic Disorders; Publishing; Recruitment Activity; Reporting; Research; Research Activity; Research Personnel; Research Project Grants; Research Training; Resources; Risk; Risk Factors; Schedule; Schizoaffective Disorders; Schizophrenia; Schizophreniform Disorder; Societies; Structure; Symptoms; Syndrome; System; Temporal Lobe; Time; Training; Universities; Validation; Washington; Work; Youth; affective psychoses; aged; career development; clinical care; computerized; economic cost; help-seeking behavior; high risk; improved; indicated prevention; instrument; mental health education; mental health personnel; public health relevance; skull base; tool; trait; usability; young adult

DESCRIPTION (provided by applicant): This proposal is part of an effort and long-range international collaboration to develop longitudinal research projects to study the development and progression of psychosis-risk traits in sub-Saharan Africa. The current project focuses on evaluating adolescents and young adults in regions around Nairobi, Kenya. These areas are culturally largely homogenous, and residents are bilingual in Swahili and English. We began this effort in Kenya, by conducting youth focus groups, assessing the usability of a structured interview for evaluating "ultra-high-risk" (UHR) symptoms for developing psychosis. We have recruited and trained local research workers in administering structured instruments for identification of UHR symptoms, and have begun conducting community youth assessments using these instruments in Kibera, Kenya. This R21 proposal focuses on capacity building and training of local mental health personnel on the use of standardized diagnostic, neurocognitive, neurological and anthropological assessment in Kenya. As part of this effort, our specific aims are to 1) Characterize the neurocognitive, neurologic, and anthropometric profiles of UHR youth (14-25 yrs) and compared these to matched controls, and 2) Evaluate the progression of symptoms in UHR youth at intervals up to 18 months, identify the rate of transition to psychotic disorders and identify traits indicating progression towards psychosis. We hypothesize that there will be increased rates of abnormality in UHR compared to controls, and these abnormalities will increase the probability of transition to psychosis in UHR youth. Schizophrenia and related psychotic disorders are among the most disabling illnesses worldwide, and cause enormous economic costs to society and distress to patients and families affected. Cognitive and movement abnormalities are often noted in patients with schizophrenia and those at risk for developing psychosis in developing countries. Specific head and face dimensions have also been found in schizophrenia, and may indicate a measureable risk of developing the illness. Our proposal will begin longitudinal studies on progression of clinical traits, which would characteriz the development of UHR youth for the first time in Africa. The proposal will aim to identify and address potential challenges to longitudinal studies in the continent, assess research capacity and strengthen local research through training, career development and mentoring. These efforts are expected to have a long-term impact in advancing independent and collaborative mental health research, as well as clinical care in Kenya.

描述（由申请人提供）：该提案是一项努力和长期国际合作的一部分，旨在开发纵向研究项目，以研究撒哈拉以南非洲地区精神病风险特征的发展和进展。目前的项目侧重于评价肯尼亚内罗毕周围地区的青少年和年轻人。这些地区在文化上基本上是同质的，居民会讲斯瓦希里语和英语。我们在肯尼亚开始了这项工作，通过进行青年焦点小组，评估结构化访谈的可用性，以评估发展为精神病的“超高风险”（UHR）症状。我们招募并培训了当地研究工作者使用结构化工具来识别UHR症状，并已开始在肯尼亚基贝拉使用这些工具进行社区青年评估。这项R21建议的重点是在肯尼亚对当地精神卫生人员进行关于使用标准化诊断、神经认知、神经学和人类学评估的能力建设和培训。作为这项工作的一部分，我们的具体目标是：1）描述UHR青年（14-25岁）的神经认知、神经学和人体测量特征，并将其与匹配的对照组进行比较; 2）以长达18个月的间隔评价UHR青年的症状进展，确定向精神病性障碍转变的比率，并确定指示向精神病性进展的特征。我们假设，与对照组相比，UHR的异常率会增加，这些异常将增加UHR青年向精神病转变的概率。精神分裂症和相关的精神障碍是世界上最致残的疾病之一，给社会造成巨大的经济损失，并给受影响的患者和家庭带来痛苦。在发展中国家，精神分裂症患者和有患精神病风险的患者中经常发现认知和运动异常。在精神分裂症中也发现了特定的头部和面部尺寸，这可能表明了发展这种疾病的可测量风险。我们的建议将开始对临床特征的发展进行纵向研究，这将是非洲第一次对UHR青年的发展进行描述。该提案旨在查明和应对非洲大陆纵向研究的潜在挑战，评估研究能力，并通过培训、职业发展和辅导加强当地研究。这些努力预计将对推动肯尼亚的独立和协作精神卫生研究以及临床护理产生长期影响。