A Psychobiological Follow-up Study of Transition from Prodrome to Early Psychosis

7.项目概要/摘要： 有一个世界性的运动，在早期干预的青少年和年轻人出现， 出现精神病的早期体征或被描述为精神病的临床高风险（CRD），主要由以下因素导致 研究人员在澳大利亚，欧洲和北美。亚洲早期精神病网络（Asian Network for Early Psychosis） 和新加坡已经开始解决这一问题。据我们所知，我们是第一个 在亚洲的一个中低收入国家开展可持续发展研究。自2012年以来，由NIMH/Fogarty支持 1 R21 MH 093294 - 01 A1和NIMH R 01 MH 101052 -01，我们与上海市精神卫生局密切合作， 中心（SMHC），在中国上海开发一个可持续发展研究项目。已完成的R21和正在进行的 R 01项目的目的是在大约一年的时间内查明转用生物燃料的风险因素。在我们 目前的提案，响应NIH FOA PAR-14-332，全球脑和神经系统疾病研究 在整个生命周期（R 01），我们将继续加强SMHC的研究能力建设， 合作开展临床结果的广泛随访研究，如转化为精神病， 残疾水平，我们将评估生物标志物的演变，如事件相关电位，静息电位， 状态功能磁共振成像（MRI），通过扩散张量成像MRI评估的白色物质， 和神经认知我们将随访300名特征良好的CHR和健康对照（HC）参与者 年龄在15-45岁之间，进行两次后续评估。该项目的纵向性质是新颖的 因为这将是第一项全面检查生物心理社会参数的研究， 预测精神病转换和疾病进展长达6年，包括两次新的随访， 生物标志物（包括基线在内的4次评估）。此外，与西方的许多研究不同， 的参与者在进入研究时是精神病幼稚的，评估是在一个 临床试验机构（SMHC），减少与药物和多个部位相关的混淆。我们的目标是 与SMHC的研究人员合作，建立一个可持续的纵向研究计划 在中国的研究，为早期干预打下坚实的基础。本项目旨在：1）。开发预测器 转化为精神病，2）。研究胰腺癌的临床和生物标志物进展，3）。表现出 临床特征、生物学指标和残疾之间的相关性，以及4）。探讨可否 早期干预的可能性。能力建设和研究培训将在 除了拟议的项目，以促进SMHC的可持续研究。

7. Project Summary/Abstract: There is a worldwide movement in the early intervention for adolescents and young adults appearing to develop early signs of psychosis or described as at clinical high risk (CHR) for psychosis, led mainly by researchers in Australia, Europe, and North America. Within the Asian Network for Early Psychosis, Taiwan and Singapore have started to address the CHR population. To our knowledge, we are the first research group carrying out CHR studies in a low-middle income country in Asia. Since 2012, supported by NIMH/Fogarty 1R21MH093294-01A1 and an NIMH R01 MH101052-01, we have worked closely with the Shanghai Mental Health Center (SMHC), to develop a CHR research program in Shanghai, China. The completed R21 and on-going R01 projects aim at identification of the risk factors for CHR conversion over approximately one year. In our current proposal, in response to NIH FOA PAR-14-332, Global Brain and Nervous System Disorders Research across the Lifespan (R01), we will continue to enhance research capacity building at SMHC, and collaboratively carry out an extensive follow-up study of clinical outcomes such as conversion to psychosis and level of disability, and we will evaluate the evolution of biomarkers such as event related potentials, resting state functional magnetic resonance imaging (MRI), white matter as assessed by diffusion tensor imaging MRI, and neurocognition. We will follow-up 300 well characterized CHR and Healthy Control (HC) participants between the ages of 15-45 for two more follow-up assessments. The longitudinal nature of the project is novel in China and worldwide as this will be the first study to comprehensively examine biopsychosocial parameters predictive of psychosis conversion and illness progression for up to 6 years, including two new follow-ups of the biomarkers (4 assessments including baseline). Moreover, unlike many studies in the West, virtually 100% of the participants are psychotropically naïve when they enter the study, and the assessments are done at one site (SMHC), reducing confounds associated with medications and multiple sites. Our goal is to work collaboratively with researchers at the SMHC to establish a sustainable CHR longitudinal program of research in China and to lay a solid foundation for CHR early intervention.This project aims to: 1). Develop predictors for conversion to psychosis, 2). Investigate clinical and biomarker progression in CHR, 3). Demonstrate an association between clinical features, biological measures and disability in CHR, and 4). Explore the feasibility of early intervention with CHR subjects. Capacity building and research training will be conducted during and beyond the proposed project to facilitate sustainable research at SMHC.