Rapoport Judith L
Child Psychiatry Branch, NIMH/NIH, Bethesda, MD 20892-1600, USA.
J Child Psychol Psychiatry. 2009 Jan;50(1-2):36-43. doi: 10.1111/j.1469-7610.2008.01975.x. Epub 2008 Nov 1.
The past 50 years have seen dramatic changes in childhood psychopathology research. The goal of this overview is to contrast observational and experimental research approaches; both have grown more complex such that the boundary between these approaches may be blurred. Both are essential. Landmark observational studies with long-term follow-up (Robins, 1966; Yarrow, Campbell, & Burton, 1970) have had - and continue to have - unique impact on clinical research and practice. Epidemiological studies showed high rates of psychological disorder and their close tie to neurological impairment (Rutter, Tizard, & Whitemore, 1970). These studies have current impact with respect to brain imaging correlates of clinical outcome. Pharmacological studies, particularly those on stimulants and on treatment of pediatric obsessive compulsive disorder (OCD), have propelled experimental methodology and inspired translational approaches. Predicted future trends are: more informed subgrouping of our heterogeneous phenotypes, reliance on multicenter trials, and documentation of non-conventional methods of care delivery.
在过去50年里,儿童精神病理学研究发生了巨大变化。本综述的目的是对比观察性研究和实验性研究方法;这两种方法都变得更加复杂,以至于它们之间的界限可能变得模糊。这两种方法都是必不可少的。具有长期随访的里程碑式观察性研究(罗宾斯,1966年;亚罗、坎贝尔和伯顿,1970年)对临床研究和实践产生了——并且仍在产生——独特的影响。流行病学研究表明心理障碍的高发病率及其与神经损伤的密切关系(鲁特、蒂扎德和怀特莫尔,1970年)。这些研究在临床结果的脑成像相关性方面具有当前的影响。药理学研究,特别是那些关于兴奋剂和儿童强迫症(OCD)治疗的研究,推动了实验方法的发展并激发了转化方法。预测未来的趋势是:对我们异质性表型进行更明智的亚组划分,依赖多中心试验,以及记录非传统的护理提供方法。