Treatment of Depressed Adolescents with Physical Illness

描述(申请人提供)：患有慢性躯体疾病的青少年抑郁障碍的识别和治疗是一个研究不足的领域。这个以患者为导向的导师研究发展奖(K23)的目的是使候选人成为一名独立的临床研究人员，在评估和治疗面临身体疾病的青少年抑郁症的创新方法领域。该提案将重点关注炎症性肠病(IBD)患者。该项目将在波士顿儿童医院(CHB)进行，那里有大量患有IBD的青少年。威廉·R·比尔兹利，医学博士，在抑郁症和预防方面具有专业知识，将担任主要导师。临床精神病学结果研究和心理治疗干预方面的专家、公共卫生硕士约翰·马奇和博士约翰·韦斯将担任共同发起人。研究计划：1)对患有IBD的抑郁青少年进行认知行为治疗(CBT)的随机对照试验(n=24)和社区护理治疗标准(n=24)。2)调查抑郁症和IBD青少年潜在的神经行为变化。职业发展计划：培训将强调在治疗患有慢性躯体疾病的青少年抑郁症方面进行对比临床试验所需的技能，并开始探索疾病过程的潜在神经机制。在干预研究设计和统计、发展精神病理学以及治疗反应的生物学和神经行为相关性的方法学评估方面的教学工作将补充项目顾问的监督。对病理生物学和改变机制有良好的了解，候选人的长期目标是开发和评估患有抑郁症的身体疾病儿童和青少年的认知行为和药物治疗，并调查治疗效果的神经生物学相关性。

DESCRIPTION (provided by applicant): The identification and treatment of depressive disorders in adolescents with chronic physical illness is an understudied area. The purpose of this Mentored Patient-Oriented Research Development Award (K23) is to enable the candidate to become an independent clinical researcher in the area of innovative approaches to evaluation and treatment of depression in adolescents facing physical illnesses. The proposal will focus on patients with inflammatory bowel disease (IBD). The project will be conducted at Children's Hospital Boston (CHB), where a large population of adolescents with IBD is available. William R. Beardslee, MD, with expertise in depressive disorders and prevention, will serve as the primary mentor. John March, MD, MPH and John Weisz, PhD, experts in clinical psychiatric outcome research and psychotherapy interventions, will serve as co-sponsors. Research plan: The aims are: 1) Conduct randomized comparison trial of cognitive behavioral therapy (CBT) enhanced with physical illness narrative, family education, and social skills components (n=24) to standard of community care treatment (n=24) in depressed adolescents with IBD, and 2) Investigate underlying neurobehavioral changes in adolescents with depression and IBD. Career development plan: The training will emphasize skills necessary for conducting comparative clinical trials in the treatment of depression in adolescents with chronic physical illness and begin to explore underlying neurological mechanisms of the disease process. Didactic work in intervention research design and statistics, developmental psychopathology, and assessment of methodologies for biological and neurobehavioral correlates of treatment response will complement supervision by the program consultants. With a sound understanding of pathobiology and change mechanisms, the long-term goals of the candidate are to develop and evaluate cognitive-behavioral and pharmacological treatments for physically ill children and adolescents with depression and to investigate neurobiological correlates of treatment effect.