Division of Neurosciences Medicine, Duke Clinical Research Institute, Duke University Medical Center, 2400 Pratt Street, Durham, NC 27705, USA.
Depress Anxiety. 2011 Jan;28(1):88-98. doi: 10.1002/da.20754.
The rapid emergence of translational developmental neuroscience as the key driver in understanding the onset of mental illness, the restructuring of academic health science centers on the NIH Roadmap, and dramatic shifts in drug, biological, device, and psychosocial intervention development all have important consequences for pediatric anxiety disorders as a field.
This article, which tracks the final presentation at a day-long symposium on pediatric anxiety disorders at the 2010 annual meeting of the Anxiety Disorders Association of America (ADAA), will try to outline where the field will head over the next decade as these forces combine to shape research and practice.
After 20 years of large comparative treatment trials that have defined the place of current generation treatments, the field is shifting toward interventions that will emerge from the revolution in translational developmental neuroscience and that herald the dawn of stratified and ultimately personalized medicine. With a much more efficient discovery to translational continuum, intervention development and dissemination will benefit from the concurrent transformation of the clinical and clinical research enterprise.
Dramatic advances in science and changes in the structure of medicine will condition the future of clinical research across every therapeutic area in medicine. For the field of pediatric anxiety disorders to thrive it will be important to embrace and actively participate in this revolution so that anxious youth are viewed as a key target population and, consequently, preemptive, preventive, and curative interventions will be developed for children by first intent.
转化发展神经科学的迅速崛起成为理解精神疾病发病机制的关键驱动力，NIH 路线图对学术型卫生保健中心的重新构建，以及药物、生物、器械和心理社会干预措施研发方面的重大转变，所有这些都对儿科焦虑障碍领域产生了重要影响。
本文旨在追踪 2010 年美国焦虑症协会（ADAA）年会上为期一天的关于儿科焦虑障碍的专题研讨会的最终报告，试图概述在这些力量共同塑造研究和实践的过程中，该领域在未来十年的发展方向。
经过 20 年大规模的比较治疗试验，这些试验确定了当前一代治疗方法的地位，该领域正朝着从转化发展神经科学中产生的干预措施转变，预示着分层、最终个性化医学的曙光。随着向转化的连续体的发现更加高效，干预措施的开发和传播将受益于临床和临床研究企业的同步转型。
科学的巨大进步和医学结构的变化将影响医学各个治疗领域的临床研究的未来。为了使儿科焦虑障碍领域蓬勃发展，重要的是要接受并积极参与这场革命，以便将焦虑的年轻人视为一个关键目标人群，因此，将为儿童优先开发预防性、治疗性的干预措施。
