DCIPS: Intervention with High Suicide Risk Individuals

本申请是对RFA#RFA-MH-04-003《开发干预中心》的响应 防止自杀(DCIPS)。虽然自杀和企图自杀的发生率在 在美国，针对这一人群的有效治疗方法的研究远远落后。不到40个 自杀干预的随机对照试验，无论是药理学的还是心理的 指挥。因此，精神病学中最致命的疾病得到了临床上最少的关注 从试验的角度来看，许多常用的干预措施从未经过实证检验。 自杀的最重要危险因素是既往自杀行为、严重和持续自杀。 构思与酒精共病(AUD)和物质使用障碍(SUD)。为了努力发展 对减少自杀企图和自杀有直接影响的干预措施，这是 自杀人口是我们中心关注的焦点。易于输出和容易的干预措施 将有针对性地进行培训，如药物战略和简短的心理社会干预。 每个主要目标都有一个培训部分，与自杀风险高的人有关，两者都是 青少年和成人：1.促进、发展和进行测试和适应的功效研究 针对自杀行为的药理学、心理社会和综合干预；2.刺激 在伦理和临床上合理地将自杀个体纳入干预研究，他们来自于 通常排除针对他们的原发疾病，例如抑郁症、双相情感障碍、AUD和SUD； 与当地精神科急诊室建立伙伴关系和网络模式，以开发更多 为有自杀倾向的人士提供有效的转介和跟进程序；及4.制订策略，加强 急诊室就诊后和就诊后自杀患者的治疗参与度、依从性和保留率 招募到干预试验中；5.加强可靠和准确的自杀评估和 为自杀干预试验制定测量方法；以及6.制定策略以了解和 处理自杀干预研究中复杂的临床和伦理问题。

This application is in response to RFA# RFA-MH-04-003, "Developing Centers on Intervention for the Prevention of Suicide (DCIPS)." While there is a high incidence of suicide and suicide attempts in the United States, research on effective treatments for this population has lagged far behind. Fewer than forty randomized controlled trials of suicide interventions, either pharmacological or psychosocial have been conducted. Thus, the most deadly condition in psychiatry has received the least attention from a clinical trials perspective and many commonly-used interventions have never been tested empirically. The most significant risk factors for suicide are prior suicidal behavior, serious and persistent suicide ideation and co-morbid alcohol (AUD) and substance use disorders (SUD). In an effort to develop interventions that have a direct impact on reducing suicide attempts and suicide, this high-risk segment of the suicidal population is the focus of our Center. Interventions that are readily exportable and easily trained, such as medication strategies and brief psychosocial interventions will be targeted. The primary goals, each with a training component, are related to high suicide risk individuals, both adolescent and adult: 1. to promote, develop and conduct efficacy studies that test and adapt pharmacological, psychosocial and combined interventions targeting suicidal behaviors; 2. to stimulate ethically and clinically-sound inclusion of suicidal individuals in intervention studies, from which they are typically excluded targeting their primary disorder, e.g.depression, bipolar disorder, AUD and SUD; 3. to develop a model of partnership and network with local Psychiatric Emergency Rooms to develop a more effective referral and follow-up process for suicidal individuals; and 4. to develop strategies to enhance treatment engagement, adherence and retention of suicidal individuals both following ER visits and after recruitment into intervention trials; 5. to enhance reliable and accurate suicide assessment and measurement development for suicide intervention trials; and 6. to develop strategies for understanding and managing the complex clinical and ethical issues in conducting suicide intervention research.