Using neurocognitive and time series data to improve treatment outcomes in depression

使用神经认知和时间序列数据改善抑郁症的治疗结果

• 批准号: 2874874
• 金额: --
• 依托单位: University of Bath
• 依托单位国家: 英国
• 项目类别: Studentship
• 财政年份: 2023
• 资助国家: 英国
• 起止时间: 2023 至 无数据
• 项目状态: 未结题
• 来源: https://gtr.ukri.org/projects?ref=studentship-2874874
• 关键词: Using; neurocognitive; time; series; data

This research aims to investigate what happens during the delay that is often experienced between starting antidepressant medication and feeling improvements in subjective mood. Patients with depression may have to wait for up to six weeks before experiencing the positive effects of antidepressant medication. This extended waiting time can be dangerous for patients with severe symptoms of depression, and demotivating in cases where the medication does not work. This is despite the fact that some research shows that antidepressant medication may lead to very early neurocognitive changes, such as increased sensitivity to positive facial expressions. Previous studies have focused on neurocognitive changes that occur within hours of taking the first dose of antidepressant medication, in healthy volunteers who have never taken the medication before. Thus, less is known about both how antidepressants modify cognition when taken over longer periods, and if the neurocognitive effects are the same in people with depression as in healthy people. To address this, we will conduct a longitudinal study where we follow primary care patients with depression who are taking antidepressant medication for the first time. Data collection is proposed to take place over a 12 week period, subject to participant burden, which will be explored in a preliminary feasibility study. We will track neurocognitive changes using regular online tests, and monitor patients' mood, and the quality and frequency of their social interactions over time, as positive social interactions have been posited as an important contributor to successful antidepressant treatment response. Diagnostic interviews will be conducted to establish how patients' symptoms responded to the medication. Taken together, these measures will be used to establish the relationship, if any, between neurocognitive changes, social interactions, and the outcome and latency of treatment response. This study will be one of the first to examine neurocognitive responses to antidepressant treatment in patients with depression and to do so over an extended duration of time. The longitudinal, within-subjects, timeseries methodology will allow us to collect rich and ecologically valid data which has been scarce thus far in this research context. This research is timely, as although depression is a leading cause of disability worldwide and antidepressant medication is a first-line treatment, little is known about the medication's mechanism of action. Benefits of this research include improved theoretical understanding of early markers of antidepressant treatment response, and antidepressant mechanisms of action. This research holds implications for the feasibility of using early neurocognitive markers as predictors of antidepressant treatment response, which in practice could dramatically reduce the waiting time needed for patients to know if a particular antidepressant medication is suitable for them. By exploring the role of social interaction in antidepressant response, this research also holds implications for the significance of social mental health interventions.

这项研究的目的是调查在开始服用抗抑郁药物和感觉主观情绪改善之间经常经历的延迟期间发生了什么。抑郁症患者可能需要等待长达六周的时间才能体验到抗抑郁药物的积极效果。对于有严重抑郁症状的患者来说，这种延长的等待时间可能是危险的，在药物不起作用的情况下，这种等待时间会使患者失去动力。尽管一些研究表明，抗抑郁药物可能会导致非常早期的神经认知变化，比如对积极的面部表情的敏感性增加。以前的研究集中在从未服用过抗抑郁药物的健康志愿者服用第一剂抗抑郁药物后数小时内发生的神经认知变化。因此，对于长期服用抗抑郁药是如何改变认知的，以及抑郁症患者和健康人的神经认知效果是否相同，我们所知甚少。为了解决这个问题，我们将进行一项纵向研究，跟踪第一次服用抗抑郁药物的初级保健抑郁症患者。数据收集工作建议在12周内进行，但参加者须承担责任，这将在初步可行性研究中加以探讨。我们将使用定期的在线测试来跟踪神经认知变化，并监测患者的情绪，以及他们社交互动的质量和频率，因为积极的社交互动被认为是成功的抗抑郁治疗反应的重要因素。将进行诊断性访谈，以确定患者的症状对药物的反应。综上所述，这些措施将用于建立神经认知变化、社会互动和治疗反应的结果和延迟之间的关系。这项研究将是第一个研究抑郁症患者抗抑郁药物治疗后神经认知反应的研究之一，并将在较长时间内进行研究。纵向，主题内，时间序列方法将使我们能够收集丰富和生态有效的数据，这些数据迄今为止在本研究背景下是稀缺的。这项研究是及时的，因为尽管抑郁症是世界范围内致残的主要原因，抗抑郁药物是一线治疗方法，但对药物的作用机制知之甚少。这项研究的好处包括提高了对抗抑郁药物治疗反应的早期标志物的理论认识，以及抗抑郁药物的作用机制。这项研究为使用早期神经认知标记作为抗抑郁治疗反应的预测指标提供了可行性，这在实践中可以显着减少患者了解特定抗抑郁药物是否适合他们所需的等待时间。通过探索社会互动在抗抑郁反应中的作用，本研究也为社会心理健康干预的意义提供了启示。