Children of Depressed Mothers: a STAR*D Ancillary Study

抑郁母亲的孩子：STAR*D 辅助研究

• 批准号: 6364257
• 负责人: MYRNA M WEISSMAN
• 金额: $ 120.09万
• 依托单位: COLUMBIA UNIVERSITY HEALTH SCIENCES
• 依托单位国家: 美国
• 财政年份: 2001
• 资助国家: 美国
• 起止时间: 2001-07-19 至 2006-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6364257
• 关键词: antidepressants; behavioral /social science research tag; child behavior; child psychology; clinical research; family structure /dynamics; human subject; longitudinal human study; major depression; mental disorder chemotherapy; mother child interaction; remission /regression

The overall aim is to study the impact of a reduction of maternal depressive symptoms on children's psychiatric symptoms and social functioning, as an ancillary study to the multisite Sequenced Treatment Alternatives to Relieve Depression study (STAR D). Focusing on the common clinical question of what to do next when patients fail to respond to a standard trial of treatment, STAR D aims at defining which subsequent treatment strategies are acceptable and provide the best clinical results. This proposed ancillary study (STAR D-Child) takes advantage of a unique opportunity to follow a large culturally diverse sample of depressed mothers who will be treated, assessed and followed prospectively to determine the impact on their children. The proposed Child study is timed to coincide with the initiation of STAR D and has been approved by their ancillary studies committee. Previous studies have demonstrated that children of depressed mothers have over three-to five fivefold increased risk of serious and enduring problems. Little is known about the impact of remission of maternal depression on their offspring. The outcomes in the 8 to 16 year old children of mothers who experience a remission of their depression following exposure to a variety of treatments will be compared to children of mothers who remain depressed following exposure to treatment/s. Blind baseline and follow-up evaluations of children of mothers participating in the STAR D protocol and assessments of parenting and family functioning will be conducted in 327 mothers and 327 children in six sites. Assessments will be carried out a baseline and every three months. Children will be followed for 12 months after their mothers complete treatment. The main hypotheses are that children of treatment-responders will have fewer psychiatric symptoms and better social functioning than children of treatment-resistant mothers during the follow-up. Children of depressed mothers who spend a greater proportion of time during the follow-up interval in depression-remission will experience less symptoms and a higher level of functioning than children of mothers who remain depressed. Changes in parenting and family functioning will mediate the impact of maternal depression-remission; demographic, family composition, etc. will moderate the effect. If it is shown that successfully treating maternal depression is associated with diminished risk in offspring, the finding would have wide ranging public health implications.

总体目标是研究减少母亲抑郁症状对儿童精神症状和社会功能的影响，作为多地点缓解抑郁症序贯治疗替代方案研究（星星D）的辅助研究。 星星D着眼于当患者对标准治疗试验没有反应时下一步该怎么办的常见临床问题，旨在定义哪些后续治疗策略是可接受的，并提供最佳临床结果。这项拟议的辅助研究（星星D-儿童）利用一个独特的机会，以遵循一个大的文化多样性样本的抑郁症的母亲谁将被治疗，评估和前瞻性地跟踪，以确定对他们的孩子的影响。 拟议的儿童研究的时间安排与星星D的启动一致，并已获得其辅助研究委员会的批准。 以前的研究表明，抑郁母亲的孩子患严重和持久问题的风险增加了三到五倍。 关于母亲抑郁症的缓解对其后代的影响知之甚少。将比较接受各种治疗后抑郁症缓解的母亲的8 - 16岁儿童的结局与接受治疗后抑郁症仍然存在的母亲的儿童的结局。 将在六个地点的327名母亲和327名儿童中对参加星星D方案的母亲的子女进行盲基线和随访评估，并评估养育和家庭功能。 评估将按基线进行，每三个月进行一次。 在母亲完成治疗后，将对儿童进行为期12个月的随访。 主要的假设是，在随访期间，治疗反应者的孩子比治疗抵抗母亲的孩子有更少的精神症状和更好的社会功能。抑郁母亲的孩子在抑郁缓解的随访间隔期间花费更大比例的时间，将经历更少的症状和更高水平的功能比母亲仍然抑郁的孩子。 父母教养方式和家庭功能的改变将介导母亲抑郁缓解的影响;人口统计学、家庭组成等将缓和这种影响。 如果研究表明成功治疗孕产妇抑郁症与降低后代的风险有关，那么这一发现将产生广泛的公共卫生影响。