Treatment of Depressed Adolescents with Physical Illness

描述（由申请人提供）：慢性身体疾病青少年抑郁症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研究发展奖（K23）的目的是使候选人成为一个独立的临床研究人员，在创新的方法来评估和治疗面临身体疾病的青少年抑郁症。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。William R. Beardslee，医学博士，具有抑郁症和预防方面的专业知识，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John March医学博士、公共卫生硕士和John Weisz博士将作为共同发起人。研究计划：目的是：1)将认知行为疗法（CBT）结合身体疾病叙述、家庭教育和社交技能成分（n=24）与标准社区护理治疗（n=24）对抑郁IBD青少年进行随机对照试验。2)调查抑郁IBD青少年潜在的神经行为改变。职业发展计划：培训将强调在治疗患有慢性身体疾病的青少年抑郁症的比较临床试验中进行必要的技能，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相关的生物和神经行为方法评估方面的教学工作将补充项目顾问的监督。具有良好的病理生物学和变化机制的理解，候选人的长期目标是开发和评估认知行为和药物治疗的身体疾病的儿童和青少年抑郁症，并调查治疗效果的神经生物学相关。

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.