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

7.项目摘要/摘要： 对青少年和年轻人的早期干预在世界范围内掀起了一场运动 出现精神病的早期症状或被描述为精神病的临床高危(CHR)，主要由 澳大利亚、欧洲和北美的研究人员。在亚洲早期精神病网络内，台湾 和新加坡已经开始解决CHR人口的问题。据我们所知，我们是第一个研究小组 在亚洲一个中低收入国家开展社区卫生资源研究。自2012年以来，由NIMH/Fogarty支持 1R21MH093294-01A1和NIMH R01 MH101052-01，我们与上海市精神卫生局密切合作 中国在上海成立了中国植物生长发育研究中心(SMHC)。已完成的R21和正在进行的 R01项目旨在确定在大约一年的时间内转换氯氟化碳的风险因素。在我们的 目前的提案，回应NIH FOA PAR-14-332，全球大脑和神经系统疾病研究 在整个生命周期(R01)中，我们将继续加强SMHC的研究能力建设，以及 合作开展对临床结果的广泛跟踪研究，如转化为精神病和 残疾水平，我们将评估生物标记物的演变，如事件相关电位、静息 状态功能磁共振成像(MRI)，由扩散张量成像MRI评估的脑白质， 和神经认知。我们将跟踪300名特征良好的慢性再生障碍性贫血和健康对照(HC)参与者 在15岁至45岁之间再进行两次后续评估。该项目的纵向性质是新颖的 在中国和全世界，这将是第一次全面检查生物心理社会参数的研究 预测精神病转化和疾病进展长达6年，包括两项新的 生物标志物(包括基线在内的4项评估)。此外，与西方的许多研究不同，几乎100% 的参与者在进入研究时表现出精神上的天真，而评估是在一次 站点(SMHC)，减少与药物和多个站点相关的混淆。我们的目标是工作 与SMHC的研究人员合作，建立可持续的CHR纵向研究计划 为中国的早期干预奠定坚实的基础。为以下项目开发预测器 转化为精神病，2)。研究慢性阻塞性肺疾病的临床和生物标记物进展。演示 慢性阻塞性肺疾病的临床特征、生物学指标与残疾的关系；探索可行性 对慢性阻塞性肺疾病受试者进行早期干预。能力建设和研究培训将在和 除了拟议的项目外，还将促进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.