Clinical Assessment Strategies Unit (Research Methods Core)

临床评估策略股 早期患者的诊断更加复杂和不确定，但在这个阶段的治疗决定可能会产生重要的后果(无论是积极的还是消极的)。年龄和发育问题使临床反应和不良反应(例如体重增加、性副作用和神经内分泌异常)的评估以及认知和神经成像数据的解释复杂化。整个外地越来越多地认识到，社会和角色(学术/职业)职能是 严重限制预后的疾病过程。因此，必须及早识别功能缺陷并描述其发育过程，以制定最佳的早期干预措施。 遵守单位 坚持服药以及遵循总体治疗建议是治疗反应和结果(特别是长期)的关键变量。接受现实的挑战和 对于青少年和年轻人来说，接受潜在的破坏性疾病的影响，以及接受服用具有重大不良影响的药物的必要性(往往是耻辱的)，尤其困难。考虑到这些人群，制定和测试战略是至关重要的。此外，我们必须解决增加的 疾病阶段的挑战，在这一阶段中，对诊断仍有相当大的不确定性。 不良反应股 早期精神病的诊断、处理和不良反应的预防是非常重要的。首先，我们关注的人群从一开始就对药物治疗有极大的不情愿/矛盾心理。第二，他们对代谢和内分泌的脆弱性及其后果 不良反应可能在重要方面不同于成人和更长期的人群。第三，从年轻开始的长期药物治疗可能意味着长期接触这些药物。 虽然不良事件股正在进行研究和分析整个年龄段的数据，但我们特别关注对患有精神障碍的青少年和年轻人的影响。 生物标志物单位 在这些人群中使用生物标记物的挑战需要特别关注，并提供独特的机会。研究生物标记物在疾病表现和治疗反应中的作用对于在各种混杂因素发挥作用之前的早期疾病尤其有价值。在神经成像和认知方面，生物标记物单位在评估方面对发育中的大脑有特殊的考虑。

Clinical Assessment Strategies Unit Diagnosis in eariy phase patients is more complex and uncertain, yet treatment decisions at this stage can have important consequences (both positive and negative). Age and developmental issues complicate the assessment of clinical response and adverse effects (e.g. weight gain, sexual side effects and neuroendocrine abnormalities), as well as the interpretation of cognitive and neuroimaging data. Recognition has increased throughout the field that social and role (academic/occupational) functioning are critical components of the illness process that severely limit prognosis. It is, therefore, essential to identify functional deficits and characterize their developmental course as eariy as possible to develop optimum eariy interventions. Adherence Unit Adherence in medication-taking as well as following overall treatment recommendations is a critical variable in treatment response and outcome (particulariy long term). The challenges of accepting the reality and implications of a potentially devastating illness, as well as accepting the need to take (often stigmatizing) medication with significant adverse effects are particulariy difficult for adolescents and young adults. It is critical to develop and test strategies with these populations in mind. In addition, we must address the added challenge of illness phases in which there can remain considerable uncertainly as to the diagnosis. Adverse Effects Unit The diagnosis, management and prevention of adverse effects in eariy phase psychosis is enormously important. First, the populations in which we are focusing have enormous reluctance/ambivalence about medication from the outset. Second, their vulnerabilities to and the consequences of metabolic and endocrine adverse effects might differ in important ways from adult and more chronic populations. Third, long-term pharmacotherapy beginning at a young age likely means considerable chronic exposure to these medications. Although the Adverse Events Unit is conducting studies and analyzing data across the age range, we have a particular focus on the implications for adolescents and young adults with psychotic disorders. Biomarkers Unit The challenges in using biomarkers in these populations require special attention and provide unique opportunities. The potential to examine the role of biomarkers in illness presentation and treatment response is particulariy valuable in eariy phase illness before a variety of confounding factors may come into play. In neuroimaging and cognition, there are special considerations for the developing brain that the Biomarkers Unit has special expertise in assessing.