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: 6642231
• 负责人: MYRNA M WEISSMAN
• 金额: $ 110.6万
• 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/6642231
• 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.

总体目标是研究母亲抑郁症状减轻对儿童精神症状和社会功能的影响，作为缓解抑郁症的多中心序贯治疗替代方案研究 (STAR D) 的辅助研究。 STAR D 专注于常见的临床问题，即当患者对标准治疗试验没有反应时下一步该怎么做，旨在确定哪些后续治疗策略是可接受的并提供最佳的临床结果。这项拟议的辅助研究（STAR D-Child）利用了一个独特的机会来跟踪大量具有不同文化背景的抑郁母亲样本，这些母亲将接受前瞻性治疗、评估和随访，以确定对孩子的影响。 拟议的儿童研究的时间与 STAR D 的启动时间一致，并已得到其辅助研究委员会的批准。 先前的研究表明，抑郁母亲的孩子出现严重和持久问题的风险增加三到五倍以上。 关于母亲抑郁症缓解对其后代的影响知之甚少。接受各种治疗后抑郁症得到缓解的母亲的 8 至 16 岁孩子的结果将与接受治疗后抑郁症仍然存在的母亲的孩子进行比较。 将对 6 个地点的 327 名母亲和 327 名儿童进行盲基线和后续评估，对参与 STAR D 方案的母亲的孩子进行评估，并对养育和家庭功能进行评估。 评估将以基线为基础，每三个月进行一次。 母亲完成治疗后，将对儿童进行 12 个月的随访。 主要假设是，在随访期间，治疗有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。与抑郁母亲的孩子相比，抑郁母亲的孩子在抑郁症缓解的随访期间花费更多的时间会经历更少的症状和更高的功能水平。 养育方式和家庭功能的变化将调节母亲抑郁症缓解的影响；人口统计、家庭组成等会缓和这种影响。 如果结果表明，成功治疗母亲抑郁症与降低后代患病风险有关，那么这一发现将对公共卫生产生广泛的影响。