Parental Remission from Depression and Child Psychopathology

父母抑郁症和儿童精神病理学的缓解

• 批准号: 7884584
• 负责人: MYRNA M WEISSMAN
• 金额: $ 58.66万
• 依托单位: COLUMBIA UNIVERSITY HEALTH SCIENCES
• 依托单位国家: 美国
• 财政年份: 2007
• 资助国家: 美国
• 起止时间: 2007-09-27 至 2014-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7884584
• 关键词: Acute; Adult; Age; Age of Onset; Ancillary Study; Antidepressive Agents; Anxiety; Biological; Bupropion; Caregivers; Caring; Characteristics; Child; Clinical; Clinical Treatment; Clinical Trials; Combined Modality Therapy; Comorbidity; Companions; Conduct Disorder; Control Groups; Data Collection; Demographic Factors; Depressed mood; Diagnosis; Disease; Disease remission; Drug Combinations; Effectiveness; Escitalopram; Ethnic Origin; Family; Fathers; Gender; Home environment; Lead; Letters; Life; Major Depressive Disorder; Measures; Mediating; Mediator of activation protein; Mental Depression; Mental disorders; Mono-S; Mothers; Nature; Only Child; Outcome; Parental Ages; Parenting behavior; Parents; Patients; Pattern; Pharmaceutical Preparations; Phase; Placebos; Prevention; Process; Protocols documentation; Psychopathology; Public Health; Randomized; Recording of previous events; Recruitment Activity; Research; Sampling; Sequential Treatment; Severities; Site; Social Functioning; Socioeconomic Status; Speed; Symptoms; Temperament; Testing; Time; Woman; Youth; base; blind; child depression; depressive symptoms; experience; follow-up; improved; indexing; insight; male; maternal depression; offspring; psychologic; treatment duration

DESCRIPTION (provided by applicant): Numerous studies have shown that children of depressed parents have high rates of depression, anxiety and conduct disorders. Much remains to be understood about their prevention and treatment. We hypothesized that successful treatment of a depressed parent may lead to a remission of the offspring's disorders. A treatment study of adults with MDD, STAR*D, provided us with a unique opportunity to test this hypothesis via an ancillary study of the patient's children. We found that successful treatment of the mother's depression to remission was associated with a significant reduction in the child's depression and conduct disorder at three months. If the mother did not remit, the child's symptoms worsened. At one year follow-up, the children of remitting mothers, maintained their improvement and their overall functioning also improved. These findings require replication. Many questions remain which we will follow-up in the new proposed study. 1. STAR*D only included one child per family. We will study all children age 7-17 years in each family. 2. STAR*D only included mothers. We will include depressed fathers. 3. The STAR*D was an effectiveness study and limited the amount and timing of information collected. We will study the co-parent, and care takers and will have more frequent assessment so we can see the timing and pattern of change in parent and child. 4. STAR*D was an open trial in the first 3 months and patients were randomized only if they did not improve on the first medication. The new study has adults randomized into 3 treatment groups at entrance, one of which is hypothesized to speed up remission. Our aim is to capture the opportunity to follow up and extend our findings from the STAR*D Child study in a recently submitted adult study ("Combining Antidepressants to Hasten Remission from Depression" PIs Stewart and Blier). The adult trial will determine if treating adults with MDD using a drug combination results in faster remission than using either drug alone. Our study of children will coincide with the initiation of the adult study. We will independently study 100 depressed parents undergoing treatment and 200 of their children to replicate and refine our previous findings that successful treatment of a depressed parent leads to improvement in their children. Our findings, if replicated in this proposed study, will provide new strategies for helping symptomatic children of depressed parents. The public health significance of this project is enormous as it will indicate new strategies for helping symptomatic children of depressed parents. Defining the relationship between parental remission of depression and child psychological status provides new insight into factors which may ameliorate child psychopathology. At a time when the treatment of depressed and anxious children is uncertain, new strategies are needed.

描述（由申请人提供）：大量研究表明，沮丧的父母的抑郁症，焦虑和行为障碍率很高。关于他们的预防和治疗，还有很多待了解的事情。我们假设成功治疗沮丧的父母可能会导致后代疾病的减轻。对MDD，Star*d的成年人的治疗研究为我们提供了一个独特的机会，可以通过对患者儿童的辅助研究来检验这一假设。我们发现，成功治疗母亲的抑郁症缓解与三个月时儿童抑郁和行为障碍的大幅减少有关。如果母亲没有汇入，孩子的症状会恶化。在一年的随访中，汇报母亲的孩子保持了改善，整体运作也有所改善。这些发现需要复制。我们将在新提出的研究中进行许多问题。 1。恒星*d每个家庭只包括一个孩子。我们将在每个家庭中学习所有7-17岁的儿童。 2。恒星*D仅包括母亲。我们将包括沮丧的父亲。 3。星*d是一项有效性研究，限制了收集的信息的数量和时机。我们将研究共同父母和护理人员，并将进行更频繁的评估，以便我们可以看到父母和子女的时机和变化模式。 4。STAR*D是最初三个月的公开试验，只有患者没有在第一种药物上进行改进，才会随机分组。这项新的研究使成年人在入口处随机分为3个治疗组，其中一个被假设以加快缓解。我们的目的是在最近提交的成人研究中捕获有机会跟进和扩展我们的发现，并将我们的发现从Star*d儿童研究中扩展（“结合抗抑郁药以加快抑郁症的缓解” Pis Stewart和Blier。成人试验将确定使用药物组合使用MDD治疗成年人是否会导致比单独使用任何一种药物更快。我们对儿童的研究将与成人研究的启动相吻合。我们将独立研究接受治疗的100个沮丧的父母，其中200个孩子复制和完善了我们以前的发现，即成功治疗父母会导致孩子的改善。我们的发现，如果在这项拟议的研究中得到了复制，将为有症状的父母的症状儿童提供新的策略。该项目的公共卫生意义是巨大的，因为它将表明帮助有症状父母的儿童的新策略。定义父母缓解抑郁症与儿童心理状况之间的关系，为可以改善儿童心理病理学的因素提供了新的见解。在不确定的沮丧和焦虑的孩子的治疗时，需要采取新的策略。