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）获得五年以上支持的请求。长期以来，我一直在寻求整合抑郁症的心理社会和生物模型。我想提高我的神经生物学和抑郁症的性质和治疗的发展过程的理解，并获得基本遗传因素的更好的感觉。我也想继续提高我的工作的临床现实主义（有效性）。我感兴趣的是认知疗法（CT）是否比抗抑郁药物（ADM）具有更持久的效果，以及这种持久的效果是否可以扩展到预防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，表明CT在治疗中度至重度抑郁症方面与ADM一样有效，在预防治疗终止后的复发方面与继续ADM一样好，并且优于ADM停药。我还与西雅图的同事一起完成了一项试验，该试验在很大程度上复制了这些发现，并进一步表明，在治疗更复杂的患者时，行为激活（BA）可能上级CT。我们正在与Penn和Rush的同事进行一项多中心试验，询问是否将CT添加到ADM中可以消除患者对维持药物的需求。我们继续研究治疗对抑郁症患者后代的影响，并计划研究调节CT持久效应的遗传因素和神经生物学过程。最后，我们正在进行一项研究，看看CBT是否可以用于预防高危青少年抑郁症的发作，并计划与西雅图的同事一起实施BA和ADM（单独和联合）治疗青少年抑郁症的安慰剂对照比较。我的目标始终是研究心理和生物过程在治疗效果的调节和调解中的作用，并以一种对实际临床实践产生最大可能影响的方式进行研究。