RISK FOR SUBSTANCE ABUSE IN DEPRESSED ADOLESCENTS

抑郁青少年药物滥用的风险

• 批准号: 7724294
• 负责人: UMA RAO
• 金额: $ 0.26万
• 依托单位: UNIVERSITY OF CALIFORNIA LOS ANGELES
• 依托单位国家: 美国
• 财政年份: 2008
• 资助国家: 美国
• 起止时间: 2008-08-01 至 2009-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7724294
• 关键词: Adolescence; Adolescent; Adrenal Glands; Adult; Antidepressive Agents; Clinical; Computer Retrieval of Information on Scientific Projects Database; Depressed mood; Development; Economic Burden; Funding; Glucocorticoids; Grant; Hydrocortisone; Hypothalamic structure; Individual; Institution; Intervention; Investigation; Life Stress; Mental Depression; Mental Health; Pituitary Gland; Pituitary-Adrenal System; Population; Psychosocial Stress; Public Health; Recruitment Activity; Regulation; Research; Research Personnel; Resources; Risk; Sampling; Social Adjustment; Source; Stress; Subgroup; Substance Use Disorder; Substance abuse problem; Testing; United States National Institutes of Health; Youth; cohort; design; disorder risk; hypothalamic-pituitary-adrenal axis; psychosocial; response

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. The development of substance use disorder (SUD) during adolescence is a major public health problem which not only relates to the younger population, but also for the long-term mental health of adults. SUD often co-occurs with depression in adolescents and in some youth, depression may be a precursor to SUD. Comorbid depression and SUD is associated with significant added psychosocial and economic burden, thus highlighting the need to identify factors that increase the risk for these disorders. Several lines of investigation suggest hypotheses for examining the associations among depression, SUD, psychosocial stress and hypothalamic-pituitary-adrenal (HPA) system. In support of this hypothesis, in two preliminary studies, we have shown that elevated cortisol, or high level of life stress, is associated with increased risk for SUD in depressed youth. Using a longitudinal design, this investigation aims to examine the risk for development of SUD in depressed adolescents by recruiting you th before they develop these problems. The study also aims to evaluate the association between HPA dysregulation and risk for SUD in this cohort. The contribution of psychosocial stress in predicting risk for SUD will be assessed in those with and without HPA dysregulation. In addition to estimating the magnitude of risk for SUD in those with HPA dysregulation and/or psychosocial stress, factors that confer protection against SUD in such vulnerable individuals will be identified. The project is also designed to assess the effects of SUD on clinical course of depression and on social adjustment. If our initial results, showing a relationship between high cortisol and risk for SUD, are replicated in a larger sample of depressed adolescents, the findings potentially might be helpful in identifying the subgroup of youth who might benefit most from antidepressant or anti-glucocorticoid treatment strategies. Evidence suggests that a good response to antidepressant agents may be due to the do wn-regulation of the HPA axis. If stress contributes to the risk for SUD in some depressed youth, they might benefit from adjunctive psychosocial interventions. More focused and effective treatments potentially might be helpful in reducing the risk for SUD in depressed youth. Moreover, such treatment strategies can be extended for testing in non-depressed youth.

这个子项目是许多研究子项目中的一个 由NIH/NCRR资助的中心赠款提供的资源。子项目和 研究者（PI）可能从另一个NIH来源获得了主要资金， 因此可以在其他CRISP条目中表示。所列机构为 研究中心，而研究中心不一定是研究者所在的机构。 青春期物质使用障碍（SUD）的发展是一个重大的公共卫生问题，不仅关系到年轻人口，而且关系到成年人的长期心理健康。SUD通常与青少年的抑郁症同时发生，在某些青年中，抑郁症可能是SUD的前兆。抑郁症和SUD共病与显著增加的心理社会和经济负担相关，因此强调需要确定增加这些疾病风险的因素。几条线的调查建议的假设，检查抑郁症，SUD，心理社会应激和下丘脑-垂体-肾上腺（HPA）系统之间的关联。为了支持这一假设，在两项初步研究中，我们已经表明，皮质醇升高，或高水平的生活压力，与抑郁青年SUD的风险增加有关。本调查采用纵向设计，旨在通过在抑郁青少年出现这些问题之前招募您来检查他们出现SUD的风险。该研究还旨在评估该队列中HPA失调与SUD风险之间的关联。将在有和没有HPA失调的患者中评估心理社会压力在预测SUD风险中的作用。除了评估HPA失调和/或心理社会压力患者SUD的风险程度外，还将确定保护这些弱势个体免受SUD的因素。该项目还旨在评估SUD对抑郁症临床病程和社会适应的影响。如果我们的初步结果显示高皮质醇与SUD风险之间的关系，在更大的抑郁青少年样本中复制，则该发现可能有助于确定可能从抗抑郁药或抗糖皮质激素治疗策略中获益最多的青少年亚组。有证据表明，抗抑郁药的良好反应可能是由于HPA轴的负调节。如果压力导致一些抑郁青年的SUD风险，他们可能会受益于积极的心理社会干预。更集中和有效的治疗可能有助于降低抑郁青年的SUD风险。此外，这种治疗策略可以扩展到非抑郁青年的测试。