Population-Based Epidemiologic Research

基于人群的流行病学研究

• 批准号: 10011376
• 负责人: kathleen r merikangas
• 金额: $ 77.36万
• 依托单位: NATIONAL INSTITUTE OF MENTAL HEALTH
• 依托单位国家: 美国
• 资助国家: 美国
• 起止时间: 至
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10011376
• 关键词: 16 year old; Academic Medical Centers; Address; Adolescent; Adult; Affect; Age; Alcohols; Anxiety Disorders; Area; Attention; Australia; Behavior Disorders; Behavioral; Biochemical Genetics; Bipolar Disorder; Brain; Cardiovascular Diseases; Characteristics; Child; Child Mental Health; Child Rearing; Classification; Clinic; Clinical; Cohort Studies; Collaborations; Communities; Community Health; Comorbidity; Complement; Complex; Conflict (Psychology); Country; Data; Data Sources; Databases; Development; Disease; Eating Disorders; Emotional; Environment; Epidemiology; Etiology; Family; Family Study; Family history of; Feeling suicidal; First Degree Relative; Follow-Up Studies; Frequencies; Friendships; Funding; Future; Genetic; Genetic Research; Genetic Translation; Genetic study; Genomics; Goals; Headache; Health; Health behavior; Hypersomnolence; Individual; Institutes; Interview; Investigation; Ketamine; Link; Literature; Longitudinal Studies; Manic; Mental Depression; Mental Health; Mental disorders; Methodology; Migraine; Mind; Mission; Mood Disorders; Moods; Mothers; National Institute of Mental Health; Neurologic; New York; Outcome; Paper; Participant; Pathway interactions; Pattern; Pennsylvania; Perception; Personal Satisfaction; Philadelphia; Physical activity; Population; Population Genetics; Population Heterogeneity; Population Research; Population Study; Prevalence; Prevention; Primary Health Care; Prospective Studies; Psyche structure; Public Health; Published Comment; Publishing; Reporting; Research; Research Design; Research Personnel; Resources; Risk Factors; Sampling; Schools; Scopolamine; Siblings; Sleep; Sleeplessness; Social Functioning; Sports; Statistical Data Interpretation; Statistical Methods; Substance Use Disorder; Suicide attempt; Suicide prevention; Surveys; Switzerland; Symptoms; Translating; Universities; Work; Youth; adolescent substance use; aged; alcohol use disorder; base; cardiovascular risk factor; clinical care; cohesion; developmental genetics; disease classification; epidemiology study; farmer; genetic analysis; genetic epidemiology; improved; interest; knowledge base; meter; neighborhood disadvantage; offspring; pediatric department; peer; physical conditioning; population based; proband; programs; psychogenetics; psychological distress; psychosocial; respiratory; response; social; study population; young adult

We have continued to leverage the Adolescent Supplement of the National Comorbidity Survey's (NCS-A) rich information on risk factors to expand the scientific knowledge base that can be used to inform prevention efforts. We published a study of the association between engagement in regular physical activity and adolescent psychiatric disorders (He et al, 2018), and found that physical activity was associated with lower odds of mood disorder and psychological distress, but higher odds of alcohol use disorder and eating disorder. Importantly, some associations were observed only among adolescents who did or did not participate in organized sports. In collaboration with colleagues at Columbia and Johns Hopkins Universities, we published a methodological article that focused on school- and peer-level mechanisms linking neighborhood disadvantage to adolescent substance use and substance use disorder in the NCS-A (Rudolph et al, 2018). The purpose of this paper was to assist public health researchers in choosing between, and implementing, different statistical methods that can be used to study the pathways by which risk factors affect mental health. Additionally, in accordance with NIMH's recent focus on suicide prevention, we also conducted a study of social functioning, including characteristics of friendships, sibling relationships, family cohesion, and parenting style, and its association with suicidal thoughts and suicide attempts among adolescents in the NCS-A (Van Meter et al, 2019). This study took a unique approach by addressing these questions among adolescents with and without mental illness separately. We also investigated patterns of offspring-perceived family environment and their associations with parental bipolar disorder (BD) in a prospective study of adolescents age 12-21 from urban academic medical centers in the U.S. and Australia. We found that maternal BD was associated with offspring perceiving High Maternal Conflict. It may be helpful to support mothers with BD by addressing family functioning, with attention to offspring perceptions of their wellbeing, in clinical care and psychosocial settings (Stapp et al, 2019). We have also continued to study comorbidity between psychiatric disorders and other types of health conditions. In collaboration with researchers at the Mayo Clinic, we published the only nationally-representative study of the links between hypersomnolence and mental health among adolescents (Kolla et al, 2019). We found that adolescents with hypersomnolence were more likely to have behavioral disorders and eating disorders as well as insomnia. This study contributes to our understanding of the complex interrelationships between sleep/wake function and mental health. We have also continued to work on the Philadelphia Neurodevelopmental Cohort Study and conducted a study of comorbidity of headache and migraine with other physical and mental health conditions in youth aged 8-21 (Lateef et al, 2019). We found that youth with migraine were more likely to have specific mental and physical conditions, including respiratory and neurologic conditions as well as anxiety, behavior, and mood disorders. An important aspect of our work is the ability to use population-based studies to inform psychiatric disorder definitions and classification. During the past year we worked with a team of researchers to combine data from 9 community studies in 5 countries, including the Zurich Cohort Study, to assess the validity of the definition of BD (Angst et al, 2019). Our results showed differences between groups in psychiatric disorder comorbidity, although no differences in family history of psychiatric disorder. This study contributes to the ongoing debate in the literature regarding the classification of unipolar mania among psychiatric disorders. In line with our branch's focus on genetic epidemiology, we published two articles pertaining to the future of genetic research in mental health. The first (Arguello et al, 2019) is a report by the Genomics Workgroup of the National Advisory Mental Health Council (NAMHC). This workgroup, convened by the NIMH, is comprised of geneticists and neuroscientists to advise the NAMHC and works to enhance the NIMH's psychiatric genetics research program, prioritize follow-up studies, and provide guidance in many areas relevant to genomics research. The purpose of this article is to assist researchers in creating the most scientifically rigorous and informative research designs possible to maximize progress gained from research funding. The second (Merikangas and Merikangas, 2019) is a commentary describing current challenges, and potential solutions, to the translation of genetic discovery to improve population mental health. This article, written for a wider audience and aims to bring the public health community up to date regarding large-scale population genetic research. Our branch's expertise in the conduct of family studies and statistical genetics has facilitated our collaboration with other researchers in these areas. First, using a community-based longitudinal study of 16-year-old probands who were followed through age 30, we identified clinical characteristics of alcohol use disorders among probands that were associated with the frequency of disorder among first-degree relatives (Farmer et al, 2018). Second, in collaboration with researchers from NIMH, Mount Sinai, Baylor, and Columbia University, we conducted a statistical analysis of the genetic contribution to response to two fast-acting depression treatments, ketamine and scopolamine (Guo et al, 2018). These activities fulfill our ongoing mission to serve the wider research community in using genetic study designs to improve population mental health. Public Health Impact: The investigation of risk factors during development, which the NCS-A makes possible, is extremely important in mental health because many cases of psychiatric disorder first arise during or prior to young adulthood and because brain development is implicated in the etiology of many psychiatric disorders. Our studies of physical activity and sleep in adolescents complement our family study work on the importance of behavioral rhythms in mental health and contribute to scientific understanding of psychiatric disorder etiology and opportunities for prevention. Our continuing mission to help identify the appropriate thresholds and boundaries for defining psychiatric disorders addresses an important current challenge in translating research to improvements in public health, as discussed in our recent commentary. Our branch also continues to serve the broader scientific community by promoting advancement in research questions, study design, and statistical analysis. Future Plans: A current issue in mental health research is the need for transdiagnostic approaches to studying mental illness and brain development. Toward this end, we have continued to be active in the ongoing Child Mind Institute's Healthy Brain Network (HBN) and plan to begin intensive analysis of collected data during the next reporting period. The HBN will serve as a resource for researchers in the field who wish to tackle transdiagnostic research questions related to mental health in children and youth. To further this goal, we have also recently begun work on establishing a Child Mental Health Research Database, which will serve a resource for researchers across the world who are interested in working with data related to youth mental health. We also expect to continue publishing population-based studies related the themes of 1) the intersection between physical and mental health, 2) the relation between health behaviors and psychiatric disorder, and 3) the influence of environmental and social exposures among children and youth.

我们继续利用全国合并症调查（NCS-A）丰富的风险因素的丰富信息的青少年补充，以扩大可用于预防工作的科学知识基础。我们发表了一项研究，研究了常规体育锻炼与青少年精神疾病之间的关联（He等，2018），发现体育活动与情绪障碍和心理困扰的几率相关，但饮酒障碍和饮食失调的几率更高。重要的是，只有参加或未参加有组织体育运动的青少年中才观察到一些协会。与哥伦比亚和约翰·霍普金斯大学的同事合作，我们发表了一篇方法学文章，该文章的重点是将邻里劣势与NCS-A中的青少年药物使用和药物使用障碍联系起来的学校和同行级别的机制（Rudolph等人，2018年）。本文的目的是协助公共卫生研究人员在实施和实施不同的统计方法之间进行选择，这些方法可用于研究风险因素影响心理健康的途径。此外，根据NIMH最近对预防自杀的关注，我们还对社会功能进行了研究，包括友谊的特征，兄弟姐妹关系，家庭凝聚力和育儿风格，以及它与NCS-A中青少年中自杀思想和自杀尝试的关联（Van Meter等人，2019年）。这项研究采用了一种独特的方法，通过分别解决有或没有精神疾病的青少年中的这些问题。 我们还研究了以后代感知的家庭环境的模式及其与父母双相情感障碍（BD）的关联，这是对美国和澳大利亚城市学术医学中心12-21岁的青少年的前瞻性研究。我们发现，母亲的BD与后代感知高产妇冲突有关。通过解决家庭功能来支持BD的母亲，在临床护理和社会心理环境中对后代对自己的福祉的看法，可能会有所帮助（Stapp等，2019）。 我们还继续研究精神病和其他类型的健康状况之间的合并症。与Mayo诊所的研究人员合作，我们发表了有关青少年中高性恋与心理健康之间联系的唯一全国代表性研究（Kolla等，2019）。我们发现，患有高血压的青少年更有可能患有行为障碍，饮食失调和失眠。这项研究有助于我们理解睡眠/唤醒功能与心理健康之间的复杂相互关系。我们还继续从事费城神经发育队列研究，并在8-21岁的青年中对头痛和偏头痛的合并症与其他身心健康状况进行了研究（Lateef等，2019）。我们发现，患有偏头痛的青年更有可能患有特定的心理和身体状况，包括呼吸和神经系统状况以及焦虑，行为和情绪障碍。 我们工作的一个重要方面是能够使用基于人群的研究为精神障碍定义和分类提供信息。在过去的一年中，我们与一个研究人员团队合作，结合了包括苏黎世队列研究在内的5个国家 /地区的9个社区研究的数据，以评估BD定义的有效性（Angst等，2019）。我们的结果表明，精神疾病合并症的群体之间的差异，尽管在精神疾病的家族史上没有差异。这项研究有助于文献中关于精神疾病中单极躁狂的分类的持续辩论。 根据我们分支机构对遗传流行病学的关注，我们发表了两篇有关心理健康遗传研究未来的文章。第一个（Arguello等人，2019年）是国家咨询心理健康委员会（NAMHC）基因组工作组的报告。由NIMH召集的该工作组由遗传学家和神经科学家组成，以建议NAMHC，并致力于增强NIMH的精神遗传学研究计划，优先考虑后续研究，并在许多领域与基因组学研究相关的领域提供指导。本文的目的是协助研究人员创建最科学严格和信息丰富的研究设计，以最大程度地利用从研究资金中获得的进步。第二个（Merikangas and Merikangas，2019年）是一篇评论，描述了当前的挑战和潜在解决方案，以转化基因发现以改善人口心理健康。本文为更广泛的受众撰写，旨在使公共卫生社区有关大规模的人群遗传研究。 我们分支机构在家庭研究和统计遗传学的进行方面的专业知识促进了我们与这些领域其他研究人员的合作。首先，使用对16年历史的纵向研究的纵向研究，他们一直遵循30岁的临床，我们确定了与一级亲戚之间与疾病频率相关的饮酒障碍的临床特征（Farmer等人，2018年）。其次，与NIMH，西奈山，贝勒和哥伦比亚大学的研究人员合作，我们对对两种快速作用抑郁症治疗的反应的遗传贡献，氯胺酮和scopolamine进行了统计分析（Guo等，2018）。这些活动履行了我们正在进行的为更广泛的研究社区提供遗传研究设计以改善人口心理健康的使命。 公共卫生影响： NCS-A在发展过程中对危险因素的调查在心理健康中极为重要，因为许多精神疾病病例首先在成年后或成年之前出现，并且大脑发育与许多精神疾病的病因有关。我们对青少年体育锻炼和睡眠的研究补充了我们的家庭研究工作，即行为节奏在心理健康中的重要性，并有助于对精神障碍病因和预防机会的科学理解。如我们最近的评论中所讨论的那样，我们持续的使命是确定定义精神疾病的适当阈值和界限，以解决将研究转化为改善公共卫生的重要挑战，如我们最近的评论中所述。我们的分支机构还通过促进研究问题，研究设计和统计分析的进步来继续为更广泛的科学界服务。 未来计划： 心理健康研究的当前问题是需要经诊断方法来研究精神疾病和大脑发育。为此，我们继续活跃于正在进行的儿童心理研究所的健康大脑网络（HBN）中，并计划在下一个报告期内开始对收集的数据进行深入分析。 HBN将为该领域的研究人员提供资源，他们希望解决与儿童和青少年心理健康有关的转诊研究问题。为了实现这一目标，我们最近还开始着手建立儿童心理健康研究数据库，该数据库将为全世界的研究人员提供有兴趣处理与青年心理健康有关的数据的研究人员。我们还期望继续发布基于人群的研究与1）身体健康和心理健康之间的交集，2）健康行为与精神障碍之间的关系，以及3）儿童和青少年环境和社会暴露的影响。