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: 6799268
• 负责人: MYRNA M WEISSMAN
• 金额: $ 101.84万
• 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/6799268
• 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.

总体目的是研究减少母体抑郁症状对儿童精神病症状和社会功能的影响，这是对减轻抑郁症研究的多站点测序治疗替代方法的辅助研究（Star D）。 为了关注患者未能对标准治疗试验做出反应的常见临床问题，旨在确定哪些随后的治疗策略是可以接受的，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跟随大量文化多样的沮丧的母亲样本，这些样本将受到治疗，评估和遵循，以确定对孩子的影响。 拟议的儿童研究是与Star D的启动时期的时间，并已获得其辅助研究委员会的批准。 先前的研究表明，沮丧的母亲的孩子患有三到五倍以上的严重和持久问题的风险增加。 关于孕产妇抑郁症对后代的减轻影响知之甚少。在暴露于各种治疗后遭受抑郁症的母亲的8至16岁子女中的结果将与接受治疗后仍然沮丧的母亲的孩子进行比较。 盲人基线和参与Star D方案的母亲的儿童的随访评估以及对育儿和家庭职能的评估将在327位母亲和327名儿童中进行六个地点进行。 评估将每三个月进行一次基准。 母亲完成治疗后，儿童将被追踪12个月。 主要的假设是，治疗反应者的孩子的精神病症状将较少，而在随访期间，耐药母亲的孩子比耐药母亲的孩子更好。与保持沮丧的母亲的孩子相比，在抑郁症犯下的随访间隔期间花费更大时间的沮丧母亲的孩子会经历更少的症状和更高的功能水平。 育儿和家庭功能的变化将介导产妇抑郁症的影响；人口统计学，家庭组成等将减轻效果。 如果表明成功治疗孕产妇抑郁症与​​后代风险降低有关，则该发现将对公共卫生的影响很大。