1985 |
Weissman, Myrna M |
U01Activity Code Description: To support a discrete, specified, circumscribed project to be performed by the named investigator(s) in an area representing his or her specific interest and competencies. |
Psychotherapy of Depression - Ipt Training Component
We were awarded a three year NIMH grant (July, 1980 - June 1983) to conduct the Interpersonal Psychotherapy (IPT) training of therapists at three sites for the pilot phase of the NIMH Treatment of Depression Collaborative Research Program. We completed the didactic and supervised practicum phases of training, and the preliminary analysis of training phase data by May, 1983. In 1983, we were awarded a two year competitive renewal to conduct the quality control monitoring of IPT therapists work with patients in the main treatment phase of the study and to complete the validation study. The treatment phase of the study at the three sites was to be completed by June, 1984, allowing us one year to complete the validation study. However, due to slow patient flow at the three research sites, there has been a one year delay in the completion of the treatment phase of the study. Because of this delay, a complete data set of therapists' performance of IPT in the main treatment phase will not be available until June, 1985. We are requesting funds for one year to complete the predictor and validation study in the full data set as follows: a. investigate the relationships among trainers' and independent raters' evaluations of IPT therapists and selected patient assessments over time; b. evaluate the predictive validity of specific training and assessment procedures in terms of patient improvement and therapists' continued adherence to the IPT treatment model, subsequent to training; and c. evaluate the overall efficacy of the training and evaluation procedures utilized in the study.
|
0.97 |
1991 — 1994 |
Weissman, Myrna M |
R01Activity Code Description: To support a discrete, specified, circumscribed project to be performed by the named investigator(s) in an area representing his or her specific interest and competencies. |
Opiate Addicts Children-Psychopathology/Neurodevelopment @ Columbia University Health Sciences
Opiate addiction is a major public health problem with an early age of onset and high comorbidity with other psychiatric disorders, including depression, anxiety disorders, other drug abuse, alcoholism, and anti-social personality. Despite this, there are virtually no data on the clinical, psychiatric, and neurologic status of children of opiate addicts in their school- age years (6 to 17 years). This is a 5-year study of 600 children of opiate addicts, 6 to 17 years of age, stratified by race, which will compare these children with already collected samples of children of normals (never psychiatrically ill) and children of parents with major depression. These children will undergo intensive clinical study with psychiatric diagnostic and neurological assessment to determine their risk for childhood psychiatric disorders (including conduct disorder, substance abuse, and affective and anxiety disorders) and neurocognitive deficits (including attention deficit disorder, development disorders, learning disabilities, I.Q., neurological soft signs, and poor motor proficiency), and impairment in school and social functioning. This design will determine whether the excess risk for childhood disorders and impairments is specific to children of opiate addicts or non-specific resembling the risk conveyed to offspring of parents with another psychiatric disorder, major depression. Risk factors predictive of specific childhood disorders and impairments will be determined by comparing affected and non-affected children within the opiate sample. This will explore, among other hypotheses, whether childhood psychopathology breeds true: that is, whether childhood depression will be predicted by parental major depression, whether conduct disorder will be predicted by parental sociopathy, and whether neurological and neurocognitive impairment will be predicted by intra-uterine drug exposure or perinatal complications. The effects of mediating and moderating factors, such as family discord or intrauterine drug exposure on risk, will be assessed. Information on the children will be collected from multiple informants, including direct interview with the child, the mother, and, if possible, the father, and/or other key informants, as necessary. In addition, there will be direct diagnostic assessment of the parents and family history data about other first-degree relatives, including the parents' siblings and own parents. Findings of this study should help in planning future preventive interventions for children of opiate addicts.
|
1 |
1992 — 1994 |
Weissman, Myrna M |
R01Activity Code Description: To support a discrete, specified, circumscribed project to be performed by the named investigator(s) in an area representing his or her specific interest and competencies. |
Children At High and Low Risk For Depression @ Columbia University Health Sciences
The overall aim is to gain understanding of the long-term nature and familial patterns of psychiatric and behavioral problems of offspring of depressed parents from childhood or adolescence through adulthood using a high risk and a longitudinal design. The offspring are at high or low risk for major depression by virtue of their parents' clinical status. The parents derive from a family-genetic study of adults with major depression or from matched normal control group drawn from a community sample. This proposal is for a ten-year follow-up when all offspring are adults. More specifically, we will determine: 1. The differential long-term clinical, social, and treatment outcome of offspring at high and low risk for major depression. 2. Parent - offspring transmission of diagnosis. 3. The continuity between childhood and adult disorders, particularly depression, in the same individual over time. 4. The long-term clinical course (incidence, recurrence, recovery) and comorbidity of the major psychiatric disorders in offspring. 5. The differential risk factors, including family history, onset, course, and impairment of offspring. These aims will be accomplished by ten-year follow-up of 219 offspring who were ages 6-23 years old when we first studied them and their parents. Extensive baseline diagnostic, medical, family, and treatment data are available from direct interviews and multiple informants on the offspring and both parents. This study will provide the first prospective data on adult offspring grown up from vulnerable families. This study is unique in that the offspring and both parents were independently, and blindly assessed using modern diagnostic criteria at two assessments, ten and eight years ago. Findings highlight the serious course of illness and differential risk factors for onset in the offspring of depressed as compared to nondepressed parents. However, retrospective data and a two-year follow-up are insufficient. A ten-year follow-up provides information critical for developing rational treatment and prevention strategies for offspring from high risk families. There are no comparable data available.
|
1 |
2001 — 2005 |
Weissman, Myrna M |
R01Activity Code Description: To support a discrete, specified, circumscribed project to be performed by the named investigator(s) in an area representing his or her specific interest and competencies. |
Children of Depressed Mothers: a Star*D Ancillary Study @ Columbia University Health Sciences
The overall aim is to study the impact of a reduction of maternal depressive symptoms on children's psychiatric symptoms and social functioning, as an ancillary study to the multisite Sequenced Treatment Alternatives to Relieve Depression study (STAR D). Focusing on the common clinical question of what to do next when patients fail to respond to a standard trial of treatment, STAR D aims at defining which subsequent treatment strategies are acceptable and provide the best clinical results. This proposed ancillary study (STAR D-Child) takes advantage of a unique opportunity to follow a large culturally diverse sample of depressed mothers who will be treated, assessed and followed prospectively to determine the impact on their children. The proposed Child study is timed to coincide with the initiation of STAR D and has been approved by their ancillary studies committee. Previous studies have demonstrated that children of depressed mothers have over three-to five fivefold increased risk of serious and enduring problems. Little is known about the impact of remission of maternal depression on their offspring. The outcomes in the 8 to 16 year old children of mothers who experience a remission of their depression following exposure to a variety of treatments will be compared to children of mothers who remain depressed following exposure to treatment/s. Blind baseline and follow-up evaluations of children of mothers participating in the STAR D protocol and assessments of parenting and family functioning will be conducted in 327 mothers and 327 children in six sites. Assessments will be carried out a baseline and every three months. Children will be followed for 12 months after their mothers complete treatment. The main hypotheses are that children of treatment-responders will have fewer psychiatric symptoms and better social functioning than children of treatment-resistant mothers during the follow-up. Children of depressed mothers who spend a greater proportion of time during the follow-up interval in depression-remission will experience less symptoms and a higher level of functioning than children of mothers who remain depressed. Changes in parenting and family functioning will mediate the impact of maternal depression-remission; demographic, family composition, etc. will moderate the effect. If it is shown that successfully treating maternal depression is associated with diminished risk in offspring, the finding would have wide ranging public health implications.
|
1 |
2007 — 2010 |
Weissman, Myrna M |
R01Activity Code Description: To support a discrete, specified, circumscribed project to be performed by the named investigator(s) in an area representing his or her specific interest and competencies. |
Parental Remission From Depression and Child Psychopathology @ Columbia University Health Sciences
[unreadable] DESCRIPTION (provided by applicant): Numerous studies have shown that children of depressed parents have high rates of depression, anxiety and conduct disorders. Much remains to be understood about their prevention and treatment. We hypothesized that successful treatment of a depressed parent may lead to a remission of the offspring's disorders. A treatment study of adults with MDD, STAR*D, provided us with a unique opportunity to test this hypothesis via an ancillary study of the patient's children. We found that successful treatment of the mother's depression to remission was associated with a significant reduction in the child's depression and conduct disorder at three months. If the mother did not remit, the child's symptoms worsened. At one year follow-up, the children of remitting mothers, maintained their improvement and their overall functioning also improved. These findings require replication. Many questions remain which we will follow-up in the new proposed study. 1. STAR*D only included one child per family. We will study all children age 7-17 years in each family. 2. STAR*D only included mothers. We will include depressed fathers. 3. The STAR*D was an effectiveness study and limited the amount and timing of information collected. We will study the co-parent, and care takers and will have more frequent assessment so we can see the timing and pattern of change in parent and child. 4. STAR*D was an open trial in the first 3 months and patients were randomized only if they did not improve on the first medication. The new study has adults randomized into 3 treatment groups at entrance, one of which is hypothesized to speed up remission. Our aim is to capture the opportunity to follow up and extend our findings from the STAR*D Child study in a recently submitted adult study ("Combining Antidepressants to Hasten Remission from Depression" PIs Stewart and Blier). The adult trial will determine if treating adults with MDD using a drug combination results in faster remission than using either drug alone. Our study of children will coincide with the initiation of the adult study. We will independently study 100 depressed parents undergoing treatment and 200 of their children to replicate and refine our previous findings that successful treatment of a depressed parent leads to improvement in their children. Our findings, if replicated in this proposed study, will provide new strategies for helping symptomatic children of depressed parents. The public health significance of this project is enormous as it will indicate new strategies for helping symptomatic children of depressed parents. Defining the relationship between parental remission of depression and child psychological status provides new insight into factors which may ameliorate child psychopathology. At a time when the treatment of depressed and anxious children is uncertain, new strategies are needed. [unreadable] [unreadable] [unreadable]
|
1 |
2010 — 2015 |
Mc Grath, Patrick J Parsey, Ramin V (co-PI) [⬀] Weissman, Myrna M |
U01Activity Code Description: To support a discrete, specified, circumscribed project to be performed by the named investigator(s) in an area representing his or her specific interest and competencies. |
Biosignatures of Treatment Remission in Major Depression @ Columbia University Health Sciences
Major Depressive Disorder (MDD) is associated with structural, functional, and neurochemical alterations in key interrelated brain circuits involved in emotion, reward, and executive functioning. Current models of its etiology, including genetic expression, gene environment interactions, the monoamine hypothesis, and neurogenesis guided our choice of biomarkers. We propose to use biomarkers from several levels of organization that address one or more of these models and examine their ability to predict treatment remission. At the genetic level, we will examine epigenetic measures and the transcriptome. At the molecular level, the utility of measures of 5HT1a neuroreceptor binding using Position Emission Tomography and proteomics will be investigated. At the anatomical level, we will examine white matter tract integrity and regional decreases in cortical thickness. Functional assessments include electroencephalography, loudness dependent auditory evoked potentials, and neurocognitive performance. Clinical features will be studied as well, e.g. presence of anxious depression, family history of depression, and others. While receiving supportive clinical management, 300 patients will be observed medication free for 3 weeks, to diminish the influence of placebo response and minimize effects on biosignature assays. Those still meeting criteria after the 3 weeks will receive all aforementioned assessments. Patients then will be randomized in a doublemasked fashion to bupropion or escitalopram, two of the most commonly prescribed treatments for depression, with putatively distinct mechanisms of action. Treatment will be for 12-14 weeks. Treatment outcome will be remission, measures of symptomatic improvement, and assessment of adverse events. Non-remitters will be crossed over. Outcomes will be measured with both traditional and contemporary clinical assessments. Patients will be followed for 6 months after randomization to assess maintenance of response and remission. We will also use a comprehensive analysis algorithm, using novel statistical techniques for high dimensional data to develop an optimal predictive model of treatment outcome that includes all data recorded from all modalities. The statistical team will develop new strategies to address the complex data set to be generated by this study. The resulting optimized algorithm for predicting remission can serve as the basis for a new study intended to validate this tool for personalized treatment of depression. Data and biological materials collected in this project would become part of a repository, open to qualified individuals for additional analysis.
|
1 |
2011 |
Weissman, Myrna M |
T32Activity Code Description: To enable institutions to make National Research Service Awards to individuals selected by them for predoctoral and postdoctoral research training in specified shortage areas. |
Genetic Analysis: Psychiatric and Other Complex Diseases @ Columbia University Health Sciences
DESCRIPTION (provided by applicant): This is a proposal to continue a successful research training program in the genetic epidemiology and statistical analysis of psychiatric and other complex diseases. The field of psychiatric genetics is changing rapidly, and successful investigators must be competent in a broad array of techniques, must be able to speak the languages of fields outside their own, and must be able to collaborate effectively with scientists in other fields. The program trains postdoctoral (M.D., Ph.D., and Dr.P.H.) and predoctoral Fellows. Training has both (a) didactic and (b) research components. (a) The didactic component is further broken down into an academic program and a series of practical laboratory rotations. The academic program includes a series of academic courses in human genetics, epidemiology, statistical genetics, computer simulations, research communication skills, and responsible conduct of research. The laboratory rotations take place in a number of laboratories at Columbia University, where a rich and broad variety of genetic studies are being carried out. (b) In the research component each Fellow works closely with a Preceptor on an independent research project of the Fellow's choosing;the Fellow prepares a clearly written research proposal, carries out the proposal, prepares an oral description of the study and its results, and prepares a publishable manuscript based on the completed study. At the end of training, Fellows understand: the biological underpinnings of genetic influences on disease risk;how to formulate testable hypotheses in human genetics and design studies to test those hypotheses;the critical importance of phenotype definition;how to design data collection strategies for genetic studies;the factors that go into selecting appropriate samples;issues of responsible conduct of research and Good Clinical Practice;the mathematical underpinnings of genetic analysis, including familial aggregation studies, twin studies, and segregation, linkage, and association analysis;laboratory techniques such as genotyping and sequencing, extracting DMA from blood, PCR, etc.;proper data management of genetic and clinical data through the use of a data base management system;how to use current genetic analysis programs, to interpret the results, and to test and evaluate new methods of genetic analysis as they become available;and microarray technology and other current molecular-biological techniques.
|
1 |