IMPROVING THE OUTCOME OF PATIENTS WITH OCD

强迫症(OCD)是一种终生患病率高达2-3%的致残性疾病。这份K23应用程序提出了一个职业发展和研究计划，将帮助P.I.实现她的长期目标：改善强迫症患者的预后。该计划将在Michael Liebowitz博士的指导下进行，并与Edna Foa博士、Marc Laruelle博士和其他导师(Donald Klein博士、Jean Endicott博士、David Pauls博士、Scott Rauch博士、Paul Greene博士和Eva Petkova博士)合作进行。培训计划的目的是：1)培养强迫症现象学和治疗方面的专业知识(接受强迫症患者评估和治疗方面的专家监督，接受精神药理治疗和使用暴露和仪式预防的认知行为治疗(EX/RP)的高级培训，以及抽动障碍的专门培训)；2)获得独立临床研究人员所需的技能和经验(通过研究设计、多元统计、结果衡量和伦理方面的课程工作/监督，以及通过开展几个研究项目，包括大型临床试验)；以及3)能够有效地与脑成像专家合作(通过了解最先进的成像方法，并使用MRI和PET技术帮助进行强迫症脑成像项目)。研究部分将由三个补充项目组成：1)评估接受治疗的强迫症患者的残余临床症状以及功能和神经认知障碍；2)随机对照试验，检查辅助的EX/RP在强迫症患者中增加5-羟色胺再摄取抑制剂的有效性；以及3)测量强迫症患者和正常对照组的5-羟色胺转运体(使用放射性标记配体和PET)，以检查强迫症患者大脑中是否存在特定的5-羟色胺能异常。这项工作的长期目标是改善强迫症患者的预后。

Obsessive-compulsive disorder (OCD) is a disabling illness with a lifetime prevalence as high as 2-3 percent. This K23 application proposes a program of career development and research that will help the P.I. achieve her long-term goal: to improve the outcome of patients with OCD. The program will be carried out under the mentorship of Dr. Michael Liebowitz and in collaboration with Drs. Edna Foa, Marc Laruelle, and other preceptors (Drs. Donald Klein, Jean Endicott, David Pauls, Scott Rauch, Paul Greene, and Eva Petkova). The training program is designed so that the P.I. will: 1) develop expertise in the phenomenology and treatment of OCD (by receiving expert supervision in the evaluation and treatment of OCD patients, advanced training in psychopharmacological treatment and cognitive-behavioral therapy using exposure and ritual prevention (EX/RP), and specialized training in tic disorders); 2) acquire the skills and experiences needed by an independent clinical researcher (by coursework/supervision in research design, multivariate statistics, outcome measures, and ethics and by conducting several research projects, including a large clinical trial); and 3) be able to collaborate effectively with brain imaging experts (by learning about state-of-the-art imaging methods and helping to conduct an OCD brain imaging project using MRI and PET technology). The research component will consist of three complementary projects: 1) the assessment of residual clinical symptoms and of functional and neurocognitive impairments in a large sample of treated OCD patients; 2) a randomized controlled trial to examine the efficacy of adjunctive EX/RP for augmenting serotonin reuptake inhibitors in OCD; and 3) the measurement of the serotonin transporter in OCD patients and normal controls (using a radiolabeled ligand and PET) to examine whether there are specific serotonergic abnormalities in the brains of OCD patients. The long-term goal of this work is to improve the outcome of patients with OCD.