DEPRESSION DIAGNOSIS AND TREATMENT IN PARKINSON DISEASE

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DESCRIPTION (provided by candidate): This grant application on behalf of Daniel Weintraub, MD, Assistant Professor of Psychiatry at the University of Pennsylvania, is for the Mentored Patient-Oriented Research Career Development Award,(K23). The focus of this award is to enable Dr. Weintraub (PI) to acquire the academic and research expertise to achieve his career goal of becoming an independent researcher in the assessment and treatment of the psychiatric complications of Parkinson's disease (PD), an area in which there is an urgent need for clinical research due to a lack of consensus over phenomenology and the lack of empirical evidence to support current treatment practice. The research plan for this award will in part involve conducting a depression screening and assessment process in two PD specialty care settings in order to determine demographic, psychiatric, neurologic, and cognitive correlates of depression and to propose modified criteria for affective disorders in PD. In conjunction with this, the PI will conduct an open-label antidepressant study using escitalopram to determine response rates under treatment as a function of different diagnostic criteria and to identify moderators of response under treatment. The impact of antidepressant treatment on comorbid psychiatric and cognitive symptoms, motor symptoms, quality of life, and caregiver burden will also be probed. Identification of modifiers of treatment response will help inform future studies and clinical decision-making. The career development plan will revolve around the acquisition of skills related to Dr. Weintraub becoming a research geriatric- and neuro-psychiatrist with expertise in Parkinson's disease and proficient in conducting intervention research in this area. The specific skill areas to be developed during the course of the proposed award relate to: (1) intervention research and biostatistics; (2) clinical neuroscience; and (3) the neurology of Parkinson's disease (PD). Methods of career development include: (1) the proposed research study; (2) the mentorship of Drs. Ira Katz and Matthew Stern; (3) consultation with experts in assessment and treatment of geriatric depression and neuropsychiatric disease; (4) formal coursework in clinical trials research, biostatistics, clinical neuroscience, and neurology; (5) training in the assessment and treatment of Parkinson's disease (6) attendance at scientific meetings; and (7) mentored data analysis and manuscript preparation.