Abstract:
For several decades the National Institute of Mental Health (NIMH) has supported basic and translational research into cognitive impairment in schizophrenia. This article describes the Institute\'s ongoing commitment to cognitive assessment and intervention research, as reflected by three signature initiatives-Measurement and Treatment Research to Improve Cognition in Schizophrenia; Cognitive Neuroscience Treatment Research to Improve Cognition in Schizophrenia; and Research Domain Criteria-and related funding announcements that span basic experimental studies, efficacy and comparative effectiveness trials, and implementation research designed to promote cognitive healthcare in real-world treatment settings. We discuss how trends in science and public health policy since the early 2000s have influenced NIMH treatment development activities, resulting in greater attention to (1) inclusive teams that reflect end-user perspectives on the utility of proposed studies; (2) measurement of discrete neurocognitive processes to inform targeted interventions; (3) clinical trials that produce useful information about putative illness mechanisms, promising treatment targets, and downstream clinical effects; and (4) \"productive urgency\" in pursuing feasible and effective cognitive interventions for psychosis. Programs employing these principles have catalyzed cognitive measurement, drug development, and behavioral intervention approaches that aim to improve neurocognition and community functioning among persons with schizophrenia. NIMH will maintain support for innovative and impactful investigator-initiated research that advances patient-centered, clinically effective, and continuously improving cognitive health care for persons with psychotic disorders.
摘要:
几十年来,美国国家心理健康研究所(NIMH)一直支持精神分裂症认知障碍的基础和转化研究。本文介绍了该研究所对认知评估和干预研究的持续承诺,正如三项标志性举措所反映的那样:改善精神分裂症认知的测量和治疗研究;改善精神分裂症认知的认知神经科学治疗研究;研究领域标准以及涵盖基础实验研究的相关资助公告,疗效和有效性比较试验,以及旨在促进现实世界治疗环境中的认知保健的实施研究。我们讨论了自2000年代初以来科学和公共卫生政策的趋势如何影响NIMH治疗发展活动,导致更多的关注(1)反映最终用户对拟议研究的效用的观点的包容性团队;(2)测量离散的神经认知过程,以告知有针对性的干预措施;(3)产生有关推定疾病机制的有用信息的临床试验,有希望的治疗目标,和下游临床效果;(4)寻求可行和有效的精神病认知干预措施的“生产紧迫性”。采用这些原则的程序催化了认知测量,药物开发,以及旨在改善精神分裂症患者神经认知和社区功能的行为干预方法。NIMH将继续支持创新和有影响力的研究者发起的研究,促进以患者为中心的研究,临床有效,不断改善精神病患者的认知保健。