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将科学机遇转化为公共卫生影响:精神疾病研究战略计划

Translating scientific opportunity into public health impact: a strategic plan for research on mental illness.

作者信息

Insel Thomas R

机构信息

Natrional Institute of Mental Health, 6001 Executive Blvd, Bethesda, MD 20892, USA.

出版信息

Arch Gen Psychiatry. 2009 Feb;66(2):128-33. doi: 10.1001/archgenpsychiatry.2008.540.

Abstract

CONTEXT

Research has transformed many areas of medicine, with profound effects on morbidity and mortality. Exciting advances in neuroscience and genomics have transformed research but have not yet been translated to public health impact in psychiatry. Current treatments are necessary but not sufficient for most patients.

OBJECTIVES

To improve outcomes we will need to (1) identify the neural circuitry of mental disorders, (2) detect the earliest manifestations of risk or illness even before cognition or behavior appear abnormal, (3) personalize care based on individual responses, and (4) implement broader use of effective psychosocial interventions.

RESULTS

To address these objectives, NIMH, working with its many stakeholders, developed a strategic plan for research. The plan calls for research that will (1) define the pathophysiology of disorders from genes to behavior, (2) map the trajectory of illness to determine when, where, and how to intervene to preempt disability, (3) develop new interventions based on a personalized approach to the diverse needs and circumstances of people with mental illnesses, and (4) strengthen the public health impact of NIMH-supported research by focusing on dissemination science and disparities in care.

CONCLUSIONS

The NIMH is shifting its funding priorities to close the gap between basic biological knowledge and effective mental health care, paving the way for prevention, recovery, and cure.

摘要

背景

研究改变了医学的许多领域,对发病率和死亡率产生了深远影响。神经科学和基因组学方面令人兴奋的进展改变了研究,但尚未转化为对精神病学公共卫生的影响。目前的治疗方法对大多数患者来说是必要的,但并不充分。

目标

为了改善治疗效果,我们需要:(1)确定精神障碍的神经回路;(2)在认知或行为出现异常之前检测出风险或疾病的最早表现;(3)根据个体反应进行个性化治疗;(4)更广泛地实施有效的社会心理干预措施。

结果

为了实现这些目标,美国国立精神卫生研究所(NIMH)与其众多利益相关者合作,制定了一项研究战略计划。该计划要求开展的研究将:(1)从基因到行为确定疾病的病理生理学;(2)描绘疾病轨迹,以确定何时、何地以及如何进行干预以预防残疾;(3)基于个性化方法开发针对精神疾病患者不同需求和情况的新干预措施;(4)通过关注传播科学和护理差异,加强NIMH支持的研究对公共卫生的影响。

结论

NIMH正在改变其资金优先事项,以缩小基础生物学知识与有效的精神卫生保健之间的差距,为预防、康复和治愈铺平道路。

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