Clinical Assessment Strategies Unit (Research Methods Core)

临床评估策略单元（研究方法核心）

• 批准号: 8110771
• 负责人: BARBARA A. CORNBLATT
• 金额: $ 14.89万
• 依托单位: FEINSTEIN INSTITUTE FOR MEDICAL RESEARCH
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-07-27 至 2015-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8110771
• 关键词: Address; Adherence; Adolescent; Adult; Adverse effects; Adverse event; Age; Attention; Biological Markers; Brain; Chronic; Clinical; Clinical assessments; Cognition; Cognitive; Complex; Data; Data Analyses; Detection; Development; Diagnosis; Doctor of Medicine; Doctor of Philosophy; Endocrine; Exposure to; Goals; Hospitals; Intervention; Measures; Mental disorders; Metabolic; Mind; National Institute of Mental Health; Neurosecretory Systems; Occupational; Outcome; Patients; Pharmaceutical Preparations; Pharmacotherapy; Phase; Play; Population; Prevention; Procedures; Process; Psychopathology; Psychotic Disorders; Recommendation; Research Methodology; Role; Schools; Social Development; Staging; Strategic Planning; Testing; Weight Gain; functional disability; improved; infrastructure development; neuroimaging; novel; outcome forecast; response; tool; treatment response; young adult

Clinical Assessment Strategies Unit Diagnosis in eariy phase patients is more complex and uncertain, yet treatment decisions at this stage can have important consequences (both positive and negative). Age and developmental issues complicate the assessment of clinical response and adverse effects (e.g. weight gain, sexual side effects and neuroendocrine abnormalities), as well as the interpretation of cognitive and neuroimaging data. Recognition has increased throughout the field that social and role (academic/occupational) functioning are critical components of the illness process that severely limit prognosis. It is, therefore, essential to identify functional deficits and characterize their developmental course as eariy as possible to develop optimum eariy interventions. Adherence Unit Adherence in medication-taking as well as following overall treatment recommendations is a critical variable in treatment response and outcome (particulariy long term). The challenges of accepting the reality and implications of a potentially devastating illness, as well as accepting the need to take (often stigmatizing) medication with significant adverse effects are particulariy difficult for adolescents and young adults. It is critical to develop and test strategies with these populations in mind. In addition, we must address the added challenge of illness phases in which there can remain considerable uncertainly as to the diagnosis. Adverse Effects Unit The diagnosis, management and prevention of adverse effects in eariy phase psychosis is enormously important. First, the populations in which we are focusing have enormous reluctance/ambivalence about medication from the outset. Second, their vulnerabilities to and the consequences of metabolic and endocrine adverse effects might differ in important ways from adult and more chronic populations. Third, long-term pharmacotherapy beginning at a young age likely means considerable chronic exposure to these medications. Although the Adverse Events Unit is conducting studies and analyzing data across the age range, we have a particular focus on the implications for adolescents and young adults with psychotic disorders. Biomarkers Unit The challenges in using biomarkers in these populations require special attention and provide unique opportunities. The potential to examine the role of biomarkers in illness presentation and treatment response is particulariy valuable in eariy phase illness before a variety of confounding factors may come into play. In neuroimaging and cognition, there are special considerations for the developing brain that the Biomarkers Unit has special expertise in assessing.

临床评估策略组 早期患者的诊断更加复杂和不确定，但在这个阶段的治疗决定可能会产生重要的后果（积极和消极）。年龄和发育问题使临床反应和不良反应（例如体重增加、性副作用和神经内分泌异常）的评估以及认知和神经影像学数据的解释复杂化。整个领域越来越认识到，社会和角色（学术/职业）功能是 严重限制预后疾病过程。因此，有必要尽早识别功能缺陷并描述其发展过程，以制定最佳的早期干预措施。 粘附单元 服药依从性以及遵循总体治疗建议是治疗反应和结局（尤其是长期）的关键变量。接受现实的挑战 对于青少年和年轻人来说，接受一种潜在的毁灭性疾病的影响，以及接受需要服用（通常是污名化的）具有显著不良反应的药物尤其困难。至关重要的是，要考虑到这些人群制定和测试战略。此外，我们还必须解决增加的 疾病阶段的挑战，其中可能仍然存在相当大的不确定性，以诊断。 不良反应股 早期精神病不良反应的诊断、处理和预防是非常重要的。首先，我们所关注的人群从一开始就对药物治疗有着巨大的不情愿/矛盾心理。第二，他们的脆弱性和后果的代谢和内分泌 对成年人和慢性病患者的不利影响可能在重要方面有所不同。第三，从年轻时开始的长期药物治疗可能意味着相当多的长期暴露于这些药物。 虽然不良事件部门正在进行研究和分析各年龄段的数据，但我们特别关注青少年和年轻人精神障碍的影响。 生物标志物股 在这些人群中使用生物标志物的挑战需要特别关注，并提供独特的机会。在各种混杂因素可能发挥作用之前，检查生物标志物在疾病表现和治疗反应中的作用的潜力在早期疾病中特别有价值。在神经成像和认知方面，生物标志物部门在评估大脑发育方面有特殊的考虑。