Prevention of Recurrence in Depression with Drugs and CT

通过药物和 CT 预防抑郁症复发

• 批准号: 6987047
• 负责人: STEVEN DENNIS HOLLON
• 金额: $ 12.04万
• 依托单位: VANDERBILT UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2005
• 资助国家: 美国
• 起止时间: 2005-09-29 至 2010-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6987047
• 关键词: adolescence (12-20); antidepressants; behavioral /social science research tag; child psychology; clinical research; clinical trials; cognitive behavior therapy; combination therapy; data collection methodology /evaluation; disease /disorder proneness /risk; functional ability; human subject; human therapy evaluation; lithium; longitudinal human study; major depression; mental disorder chemotherapy; mental disorder prevention; nortriptyline; parent offspring interaction; paroxetine; questionnaires; relapse /recurrence; sertraline

DESCRIPTION (provided by candidate): This is a request for five more years of support via a NIH Independent Scientist Award (K02). I have long sought to integrate psychosocial and biological models of depression. I want to enhance my understanding of neurobiology and developmental processes in the nature and treatment of depression and to gain a better sense of basic genetic factors. I also want to continue to enhance the clinical realism (effectiveness) of my work. I am interested in whether cognitive therapy (CT) has a more enduring effect than antidepressant medications (ADM) and whether that enduring effect can extend to the prevention of depression in at-risk adolescents. We recently completed a placebo-controlled trial that showed that CT is as efficacious as ADM in the treatment moderate to severe depression and good as continuation ADM and better than ADM withdrawal in the prevention of subsequent relapse following treatment termination. I also completed a trial with colleagues in Seattle that largely replicated these findings and further suggested that behavioral activation (BA) may be superior to CT in the treatment of more complex patients. We are conducting a multisite trial with colleagues at Penn and Rush that asks whether adding CT to ADM can eliminate the need to keep patients on maintenance medications. We continue to study the impact of treatment on the offspring of our depressed patients and we plan to examine the genetic factors that moderate and the neurobiological processes that mediate CT's enduring effect. Finally, we are conducting a study to see if CBT can be used to prevent the onset of depression in at-risk adolescents and also plan to implement a placebo-controlled comparison of BA and ADM (alone and in combination) in the treatment of adolescent depression with colleagues in Seattle. My goal throughout has been to examine the role of both psychological and biological processes in the moderation and mediation of treatment effects and to do so in a manner that has the greatest possible impact on actual clinical practice.

描述（由候选人提供）：这是通过NIH独立科学家奖（K02）再提供五年支持的要求。我长期以来一直试图整合抑郁症的心理社会和生物学模型。我想增进对抑郁症性质和治疗中神经生物学和发育过程的理解，并更好地了解基本遗传因素。我还想继续增强我工作的临床现实主义（有效性）。我对认知疗法（CT）是否比抗抑郁药（ADM）具有更持久的作用以及这种持久作用是否可以扩展到高危青少年的抑郁症。我们最近完成了一项安慰剂对照试验，该试验表明，CT与中度至重度抑郁症的治疗中的ADM一样有效，并且在预防治疗终止后随后复发时，CT与持续ADM一样好，并且比ADM戒断更好。我还完成了西雅图的同事的试验，该试验在很大程度上复制了这些发现，并进一步表明，行为激活（BA）在治疗更复杂的患者方面可能优于CT。我们正在与宾夕法尼亚州的同事和拉什（Rush）进行多场地试验，询问将CT添加到ADM是否可以消除使患者服用维护药物的需求。我们继续研究治疗对抑郁症患者后代的影响，并计划检查中度和神经生物学过程的遗传因素，这些过程介导了CT的持久作用。最后，我们正在进行一项研究，以了解是否可以使用CBT来防止高危青少年的抑郁症发作，并计划实施安慰剂对照的BA和ADM（单独和组合）以治疗青少年的比较。西雅图与同事的抑郁症。我的整个目标是研究心理和生物学过程在适度和调解效应中的作用，并以对实际临床实践产生最大影响的方式做到这一点。