Developing Strategies to Reduce DUP in the Age of Social Medial and the Internet

制定策略以减少社交媒体和互联网时代的 DUP

• 批准号: 8900345
• 负责人: JOHN M KANE
• 金额: $ 40.02万
• 依托单位: FEINSTEIN INSTITUTE FOR MEDICAL RESEARCH
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-08-01 至 2018-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8900345
• 关键词: Adolescent and Young Adult; Age; American; Antipsychotic Agents; Anxiety Disorders; Applications Grants; Attenuated; Belief; Caring; Clinic; Clinical Research; Clinical Trials; Control Groups; Data; Delusions; Development; Diagnosis; Distress; Evolution; Family; Funding; General Population; Glean; Goals; Growth; Hallucinations; Health; Hospitals; Individual; Internet; Intervention; Interview; Link; Longitudinal Studies; Medial; Mental Health Services; Mood Disorders; National Institute of Mental Health; New York City; Outcome; Pathway interactions; Patients; Pattern; Persons; Population; Prize; Psychotic Disorders; Quality of life; Recovery; Schizophrenia; Self Assessment; Services; Severities; Signs and Symptoms; Specific qualifier value; Students; Surveys; Symptoms; Teenagers; Telephone; Testing; Thinking; Time; Work; Youth; attenuated psychosis syndrome; base; college; design; experience; first episode psychosis; functional decline; help-seeking behavior; high risk; high school; hospital readmission; improved; innovation; novel; outreach; prodromal psychosis; programs; psychoeducational; psychotic symptoms; response; social; university student; web site

DESCRIPTION (provided by applicant): A critical development in recent years has been the enormous growth of internet and social media utilization, particularly among young people. We are proposing to conduct three integrated, exploratory/developmental projects utilizing internet and social media directed towards reducing the duration of untreated psychosis (DUP). Approximately 100,000 adolescents and young adults in the U.S. experience a first episode of psychosis (FEP) every year. Despite symptom severity and declines in functioning, the time between symptom onset and receiving appropriate care in the U.S. is on average 2 years. Data from our ongoing NIMH-funded Recovery After an Initial Schizophrenia Episode (RAISE) project, being conducted at 34 clinics across the U.S. involving 404 FEP patients, indicate a median duration of untreated psychosis (DUP) of 74 weeks. The North American Prodrome Longitudinal Study (NAPLS) shows a similar period (i.e., 2 years) during which emerging attenuated symptoms develop into full-blown psychosis (the prodromal period). Thus, for many young people with emerging psychotic disorders, the total period of active (attenuated plus full-blown) symptoms before initiation of treatment may be 4 years on average; furthermore, their "pathways to care" are often less than ideal. Longer DUP has been shown to independently predict more hospital readmissions, greater symptom severity and poorer quality of life. Results from the proposed projects will provide novel information that is critical for establishing internet/social media means of outreach and engagement, which can be leveraged to identify and refer patients with either prodromal (attenuated positive) symptoms or signs and symptoms of FEP for timely, specialized treatment. These projects will establish the acceptability and feasibility of specific approaches: (1) We will refine an interview that is the first to document hw the internet and social media were utilized during, and in response to, the evolution of each young person's psychotic or attenuated psychotic symptoms. This will provide critical information identifying potential points of intervention and how to utilize the internet/social meda in a clinical study to improve pathways to care and help steer patients into treatment in a more timely fashion. (2) We will test the feasibility of using an e-survey instrument with college students, which can provide anonymous self-assessment for early signs of psychosis, with linkages to educational websites and referrals to established first-episode programs for those who score above a specified threshold. (3) We will also work with teams of students at two of the top public and private high schools in New York City to engage them in competing for prizes for developing promising internet and social media strategies to identify youth at high risk of psychosis or with FEP and link them to treatment. The students will also advise us on other aspects of the project. All of this work is designed with the goal of developing and refining strategies to be used in the conduct of subsequent, large-scale studies intended to demonstrate our ability to significantly reduce DUP in the U.S. via internet and social media strategies.

描述（由申请人提供）：近年来的关键发展是互联网和社交媒体利用的巨大增长，尤其是在年轻人中。我们建议通过互联网和社交媒体进行三个综合的探索/发展项目，这些项目用于减少未经治疗的精神病（DUP）的持续时间。美国大约有100,000名青少年和年轻人每年都会出现精神病（FEP）的第一集。尽管症状严重程度和功能下降，但在美国症状发作和接受适当护理之间的时间平均为2年。在最初的精神分裂症发作（加薪）项目后，我们正在进行的NIMH资助的恢复中的数据是在美国的34家诊所进行的，涉及404名FEP患者，表明未经治疗的精神病（DUP）的中位持续时间为74周。北美前动物纵向研究（NAPL）显示出一个相似的时期（即2年），在此期间，新兴的衰减症状发展为成熟的精神病（前驱时期）。因此，对于许多有新兴精神病患者的年轻人来说，开始治疗前的积极（衰减加成熟）症状的总时期平均可能为4年。此外，他们的“护理途径”通常不那么理想。已显示较长的DUP可以独立预测更多的医院再入院，症状严重程度更大和生活质量较差。拟议项目的结果将提供新的信息，这些信息对于建立互联网/社交媒体的外展和参与方式至关重要，可以利用这些信息来识别和转介患有前驱（阳性阳性）症状（衰减的阳性）症状或FEP的体征和症状以及时，专门治疗。这些项目将确定特定方法的可接受性和可行性：（1）我们将完善采访，这是第一个记录HW互联网和社交媒体的访谈，并响应每个年轻人的精神病或衰减精神病性症状的演变。这将提供关键信息，以识别干预的潜在点以及如何在临床研究中利用互联网/社交MEDA来改善护理途径，并帮助患者及时地将患者引导到治疗中。 （2）我们将测试与大学生一起使用电子调查工具的可行性，这可以为早期的精神病迹象提供匿名的自我评估，并与教育网站联系，并将其转介给为在指定阈值高于指定阈值的人的既定第一集计划。 （3）我们还将与纽约市两所顶级公立和私立高中两所顶级公立和私立高中的学生团队合作，参与竞争奖品，以制定有前途的互联网和社交媒体策略，以确定患有精神病高的年轻人或与FEP的高风险，并将他们与治疗联系起来。学生还将就项目的其他方面提供建议。所有这项工作的设计旨在制定和完善策略，以进行随后的大规模研究，旨在证明我们通过互联网和社交媒体策略显着减少美国DUP的能力。