Psychiatry Consultation Liaison Service Research

精神病学咨询联络服务（PCLS）在NIH临床中心发挥着重要的综合功能。NIH内部研究项目中的有洞察力的临床医生与PCLS互动，从而在医学疾病的精神病学和心理社会学研究领域进行独特的研究合作。在NIH的其他研究所/中心参加研究试验的患者-受试者提供了无与伦比的机会来探索特定基因的作用（例如，单基因疾病）和特异性疗法（例如，干扰素α在肝炎）在精神病学和神经发育。 PCLS神经心理学咨询，在2008年10月启动，继续是一个积极的服务，每年进行约250神经心理学评估。医学疾病的神经认知表型的这些评估中有三分之二是NIMH和其他研究所（如NIAMS，NHGRI，NIAID）之间的研究合作的结果。NHLBI、NINDS和其他。 招募我们的自杀筛查工具重新验证和儿科急诊室（华盛顿，华盛顿特区，马萨诸塞州的波士顿和俄亥俄州的哥伦布）即将完工。从一个单一的急诊科网站的可行性研究中，6%的106名医疗患者谁是自杀风险筛查报告临床上显着的自杀意念。此外，96%的患者（n = 156）表示护士应在儿科急诊科筛查儿童的自杀风险。一项对自杀筛查工具的医疗记录数据的评估发现，53%的12岁以下儿童因精神病原因到急诊室筛查自杀风险呈阳性。 与心理健康和儿科肿瘤临床医生的合作，导致了一个强大的研究计划的发展，对精神和心理社会方面的儿科肿瘤护理，最终在心理和精神方面的儿科肿瘤护理手册的生产。研究慢性病青年的几项协议正处于数据收集阶段，包括对儿科医学疾病人群中“痛苦温度计”的评估，“孤独”父母的特征，以及关于其子女正在接受研究的国际家庭的经验和需求的新协议，该协议即将开始。在成人肿瘤学方面，PCLS研究人员与多学科专家合作，重新定义了临床试验中肿瘤学中精神疾病事件的分类。 由临床总监办公室人类受试者保护（HSPU）的临床研究倡导者（CRA）制作的知情同意培训视频将用于NIH所有研究生医学教育临床培训项目的培训。CRA继续提供培训课程，并在国家会议上介绍其在执行程序以标准化评价和保护研究中易受伤害的受试者方面的经验。 由国家过敏和传染病研究所（NIAID）和华盛顿特区卫生部（DOH）牵头的一项令人兴奋的新NIH倡议是华盛顿特区艾滋病毒/艾滋病进展伙伴关系（DC PFAP）。DC PFAP旨在提高专科护理的可用性，并提供基于证据的临床协议和校内研究协议。NIMH PCLS团队是这一重要举措的早期合作伙伴。NIMH将与哥伦比亚特区政府、当地学术机构、当地社区服务提供者和艾滋病毒/艾滋病患者一起，协助扩大对艾滋病毒/艾滋病的精神和行为方面的了解，特别是在哥伦比亚特区，并帮助确定最有效的战略，以减少艾滋病毒/艾滋病在华盛顿特区的精神病发病率的影响。 PCLS研究在过去的一年里取得了丰硕的成果，去年有超过25张海报、演讲或课程，以及下面列出的众多出版物。

The Psychiatric Consultation Liaison Service (PCLS) serves an important integrative function in the NIH Clinical Center. Perceptive clinicians in the NIH intramural research program interact with the PCLS which leads to unique research collaborations in the areas of psychiatric and psychosocial research in the medically ill. Patient-subjects enrolled in research trials in other Institutes/Centers at the NIH offer unparalleled opportunities to explore the roles of specific genes (e.g., monogenic diseases) and specific therapies (e.g., interferon alpha in hepatitis) in psychiatry and neurodevelopment. PCLS Neuropsychology Consultations, initiated in October, 2008, continue to be an active service, performing about 250 neuropsychological evaluations per year. Two-thirds of these evaluations for neurocognitive phenotyping of medical disorders have been as a result of research collaborations between NIMH and other Institutes such as NIAMS, NHGRI, NIAID. NHLBI, NINDS and others. Recruitment for our suicide screen tool revalidation and suicide screening of medically ill children in a pediatric emergency room (Washington, D.C., Boston, Massachusetts, and Columbus, Ohio) is nearly completed. From a feasibility study of a single emergency department site, 6% of the 106 medical patients who were screened for suicide risk reported clinically significant suicidal ideation. In addition, 96% of the total patients (n = 156) stated that nurses should screen children for suicide risk in the pediatric emergency department. An evaluation of medical record data of a suicide screening tool found that 53% of children under the age of 12 presenting to the emergency department for psychiatric reasons screened positive for suicide risk. Collaboration with mental health and pediatric oncology clinicians has led to the development of a robust research program on psychiatric and psychosocial aspects of pediatric oncology care, culminating in the production of a handbook on psychological and psychiatric aspects of pediatric oncology care. Several protocols studying chronically ill youth are in data-collection phase, including evaluation of a "distress thermometer" in pediatric medically ill populations, characterization of "lone" parenting, and a new protocol on the experiences and needs of international families whose children are in research that is about to begin. In adult oncology, PCLS researchers worked with a multidisciplinary workgroup to redefine the classification of psychiatric events in oncology in clinical trials. An informed consent training video produced by the Clinical Research Advocates (CRAs) of the Human Subjects Protections (HSPU), in the Office of the Clinical Director, will be used for training in all the Graduate Medical Education clinical training programs at the NIH. The CRAs continues to provide training courses as well as present at national meetings on their experiences regarding implementing processes to standardize the evaluation and protection of vulnerable subjects in research. An exciting new NIH initiative spearheaded by the National Institute of Allergy and Infectious Diseases (NIAID) and the D.C. Department of Health (DOH) is the D.C. Partnership for HIV/AIDS Progress (DC PFAP). DC PFAP is designed to both enhance the availability of subspecialty care and to provide access to evidence-based clinical protocols and intramural research protocols. The NIMH PCLS team is an early partner in this important initiative. In conjuction with the D.C. government, local academic institutions, local community providers and HIV/AIDS patients, NIMH will assist in expanding knowledge on psychiatric and behavioral aspects of HIV/AIDS, specifically in D.C., and help to identify the most effective strategies for reducing the impact of psychiatric morbidity of HIV/AIDS in D.C. PCLS research has had a productive year with more than 25 posters, presentations or courses in the past year and the numerous publications listed below.