Knowledge Transfer Unit(OPERATIONS CORE)

概述：ACISR研究能力的发展、基本原理、任务和目标 在我们目前的ACISR过程中以及它在过去四年中促进的工作中，我们 在优化早期患者的临床结果方面实现了一些重要目标 精神分裂症。然而，与此同时，我们认识到，证据中存在重要差距。 对出现精神病症状的年轻人做出关键的治疗决定是必要的 症状(可能是也可能不是精神分裂症的早期表现)。我们的工作是确定， 数百例首发精神分裂症和5例前驱精神分裂症患者的招募与研究 多年来强调了诊断仍不清楚的患者的数量，和/或 治疗决定没有足够的证据。再加上我们相信，早期、适当和 持续的干预对于优化精神病患者早期表现的结果是必要的 为了解决青少年和青壮年的精神障碍问题，我们将系统地解决这方面的一系列问题。 21岁出现与药物使用有关的精神错乱，18岁出现 伴随着减轻的阳性和抑郁症状的混合，19岁表现出躁狂和 精神病症状是所有可以考虑服用抗精神病药物的人，并且 经常使用。同时，它们的使用在短期内可能是适当/有效的，同时还有 关于它们的中期和长期使用的主要悬而未决的问题。最理想的治疗方法是什么， 干预的剂量和持续时间，以达到缓解、康复和防止此类患者复发的目的？ 此外，我们还需要知道这些患者目前在更大范围内是如何接受评估和治疗的 社区，以了解患者和家属以及 在这些环境中工作的心理健康专业人员。 在这方面，我们还了解到，治疗参与和坚持治疗是关键 我们治疗过的所有人群的结果驱动因素，并将继续存在于其他 我们现在要研究的群体。这些问题需要更充分和更积极地在 社区比他们现在更多。当我们考虑适当性、可接受性和收益风险比时 对于青少年和年轻人的抗精神病药物治疗，我们还必须考虑和解决 我们的干预措施对全球健康的潜在影响，特别是与疾病和治疗相关的影响 导致这些人群的医疗发病率和死亡率显著增加的因素(即 体重增加、代谢综合征和吸烟)。这是对以下背景和基本原理的简要介绍 我们目前的提案

OVERVIEW: DEVELOPMENT OF ACISR RESEARCH CAPACITY, RATIONALE, MISSION AND GOALS During the course of our current ACISR and the work that it has facilitated over the past four years we achieved a number of important goals in optimizing clinical outcomes for individuals with eariy phase schizophrenia. At the same time, however, we have recognized that there are important gaps in the evidence necessary to make critical treatment decisions for young individuals experiencing psychotic signs and symptoms (which may or may not be an eariy manifestation of schizophrenia). Our work in ascertaining, recruiting and studying hundreds of first-episode schizophrenia and putafive prodromal schizophrenia patients over the years has highlighted the number of patients in whom the diagnosis remains unclear, and/or for whom treatment decisions are not sufficiently evidence based. Coupled with our belief that eariy, appropriate and consistent intervention is necessary to optimize outcomes in an early phase manifestation of a psychotic disorder in adolescents and young adults, we will systematically address a range of issues in this context. The 21 year old who presents with a psychosis associated with substance use, the 18 year old who presents with a mixture of attenuated positive and depressive symptoms, the 19 year old who presents with mania and psychotic symptoms are all individuals for whom antipsychotic medications might be considered, and are frequently used. At the same time that their use might be appropriate/efficacious in the short term, there are major unanswered questions regarding their intermediate and long-term use. What are the optimal treatments, dosing and duration of intervention to achieve remission, recovery, and to prevent relapse in such individuals? In addition, we also need to know how such patients are currently being evaluated and treated in the larger community in order to understand the "real worid" issues that confront patients and families as well as the mental health professionals working in those settings. In this context, we have also learned that therapeutic engagement and adherence with treatment are key drivers of outcomes in all of the populations that we have treated, and, will continue to be in the additional groups we will now study. These issues need to be addressed far more adequately and proactively in the community than they are currently. As we consider the appropriateness, acceptability and benefit-to-risk ratio of antipsychotic treatments in adolescents and young adults we also have to consider and address the potential effects of our interventions on global health and in particular those illness- and treatment-related factors which contribute so dramatically to increased medical morbidity and mortality in these populations (i.e. weight gain, metabolic syndrome, and smoking). This is a brief perspective on the background and rationale for our current proposal