SEVERE DEPRESSION IN WOMEN AFTER CARDIAC SURGERY

在每年进行的约573,000例冠状动脉搭桥（CABG）手术中，女性占27%，围手术期死亡率和术后发病率（包括抑郁症）高于男性。抑郁症是其他心脏病患者死亡率和发病率的预测因子。它与细胞介导的免疫力下降有关。虽然CABG术后抑郁很常见，但对其严重程度及其与术后结果（如免疫功能、感染并发症、功能状态、心理社会适应和生活质量）的关系知之甚少。一种专门设计用于缓解抑郁症的结构化认知行为干预尚未在CABG患者术后早期恢复中进行测试，尽管它是轻度至中度抑郁症的治疗选择。拟议的研究计划有两个总体目标。第一个目标是获得与接受CABG的非抑郁女性相比，抑郁女性免疫功能受损的术后并发症风险的证据。第二个目的是描述认知行为疗法在CABG术后早期抑郁女性中的应用。拟议奖项的总体目标是增加申请人在免疫学和认知行为治疗方面的知识，以便她更好地从事生物行为科学的研究事业。提出了3年培训计划。该计划在每个领域的科学家和临床专家的指导下，将免疫学和认知行为疗法的正式课程与实验室培训结合起来。作为奖励的一部分，拟议的研究旨在完成申请人的正式和实验室培训。

Women account for 27% of the estimated 573,000 coronary artery bypass (CABG) graft surgeries performed annually and suffer greater perioperative mortality and post-operative morbidity, including depression, than men. Depression is a predictor of both mortality and morbidity in other cardiac patients. It has been associated with decreased cell-mediated immunity. While depression after CABG is common, little is known about its severity or its association with post-operative outcomes, such as immune function, infectious complications, functional status, psychosocial adjustment, and quality of life. A structured cognitive behavioral intervention designed specifically to relieve depression has not been tested during early postoperative recovery of CABG patients, even though it is the therapy of choice for mild to moderate depression. The proposed research plan has two overall objectives. The first objective is to obtain evidence regarding the risk of postoperative complications associated with compromised immune function in depressed women compared to non-depressed women undergoing CABG. The second objective is to describe the application of cognitive behavioral therapy in depressed women early after CABG. The overall objective of the proposed award is to increase the applicant's knowledge in immunology and in the delivery of cognitive behavioral therapy, so that she is better equipped to pursue a research career in biobehavioral science. A 3-year training plan is proposed. The plan incorporates formal classes in immunology and cognitive behavioral therapy with laboratory training, under the direction of scientists and clinical experts, in each field. The research proposed as part of the award is designed to completed the applicant's formal and laboratory training.