DEPRESSION DIAGNOSIS AND TREATMENT IN PARKINSON DISEASE

描述(由候选人提供)：代表宾夕法尼亚大学精神病学助理教授丹尼尔·温特劳布医学博士提出的这份拨款申请是为了获得以患者为导向的导师研究职业发展奖(K23)。这一奖项的重点是使温特劳布博士(PI)能够获得学术和研究专业知识，以实现他的职业目标，即成为帕金森氏病(PD)精神并发症评估和治疗的独立研究员，由于对现象学缺乏共识，以及缺乏支持当前治疗实践的经验证据，该领域迫切需要临床研究。 该奖项的研究计划将部分涉及在两个PD专科护理环境中进行抑郁症筛查和评估过程，以确定抑郁症的人口统计学、精神病学、神经学和认知相关性，并提出PD患者情感障碍的修订标准。与此同时，PI将使用艾司西妥普兰进行一项开放标签的抗抑郁药物研究，以确定作为不同诊断标准的功能而接受治疗的应答率，并确定正在接受治疗的反应的调节因素。还将探讨抗抑郁药物治疗对共病的精神和认知症状、运动症状、生活质量和照顾者负担的影响。确定治疗反应的修饰物将有助于为未来的研究和临床决策提供信息。 职业发展计划将围绕着获得与温特劳布博士相关的技能，使他成为一名研究老年和神经精神病学家，拥有帕金森氏病方面的专业知识，并精通这一领域的干预研究。在拟议的颁奖过程中将发展的具体技能领域涉及：(1)干预研究和生物统计学；(2)临床神经科学；(3)帕金森病(PD)神经学。职业发展的方法包括：(1)拟议的研究研究；(2)指导艾拉·卡茨和马修·斯特恩博士；(3)咨询老年抑郁症和神经精神疾病的评估和治疗专家；(4)临床试验研究、生物统计学、临床神经科学和神经学的正式课程；(5)帕金森病评估和治疗的培训；(6)出席科学会议；以及(7)指导数据分析和手稿准备。

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.