This is a request for an NIMH Independent Scientist Award (ISA). This grant builds on Dr. Katon's extensive research in developing cost- effective interventions to improve the quality of care of common psychiatric illnesses such as major depression within the primary care and the specialty medical systems and to improve understanding about the connection between affective and anxiety disorders, unexplained medical symptoms, health care utilization and costs, functional disability and quality of life. The research program builds on an R01 held by the applicant as well as other ongoing studies aimed at improving mental health care in medical systems. The four specific career goals that will be met by the ISA are: 1) to test the generalizability of the population-based disease management interventions that my research group hs developed and tested in urban HMO patients in other geographic, socioeconomic, and clinical populations; 2) To continue to extend my research teams' knowledge and expertise to provide cost-effective intervention for major depression to the 23 primary care clinics of Group Health Cooperative; 3) To develop cooperative ties with a multi-site research network or large managed care system in order to demonstrate that improving the treatment of major depression in patients with chronic medical illness will improve: habituation to aversive medical symptoms, functioning, quality of life, and adherence to medical regimens; and 4) To continue my extensive local and national mentorship of junior investigators. These goals will be met through continued and expanded research activities, collaborations with senior scientists both locally and nationally, and graduate level course work in epidemiology, health economics at the University of Washington School of Public Health. I propose specifically to increase my knowledge about population-based disease management methods that have been tested to improve the care of common medical illness such as hypertension and diabetes in the primary care system, increase my sophistication and knowledge in cost- effectiveness and cost-utility analysis, and improve the knowledge base of the field in measurement of indirect costs of depression such as decreases in work productivity and family burden. An ISA at this stage of the applicant's career will provide release from administrative responsibilities and will provide the time and resources needed to capitalize on an excellent network of senior investigators who will provide outstanding training activities and collaborative opportunities.

Agency
National Institute of Health (NIH)
Institute
National Institute of Mental Health (NIMH)
Type
Research Scientist Development Award - Research (K02)
Project #
5K02MH001643-04
Application #
6477013
Study Section
Special Emphasis Panel (ZMH1-CRB-W (15))
Program Officer
Gonzales, Junius J
Project Start
1998-12-01
Project End
2003-11-30
Budget Start
2001-12-01
Budget End
2002-11-30
Support Year
4
Fiscal Year
2002
Total Cost
$118,476
Indirect Cost
Name
University of Washington
Department
Psychiatry
Type
Schools of Medicine
DUNS #
135646524
City
Seattle
State
WA
Country
United States
Zip Code
98195
Yu, Margaret K; Katon, Wayne; Young, Bessie A (2015) Associations between sex and incident chronic kidney disease in a prospective diabetic cohort. Nephrology (Carlton) 20:451-8
Yu, Margaret K; Weiss, Noel S; Ding, Xiaobo et al. (2014) Associations between depressive symptoms and incident ESRD in a diabetic cohort. Clin J Am Soc Nephrol 9:920-8
Yu, Margaret K; Katon, Wayne; Young, Bessie A (2013) Diabetes self-care, major depression, and chronic kidney disease in an outpatient diabetic population. Nephron Clin Pract 124:106-12
Yu, Margaret K; Lyles, Courtney Rees; Bent-Shaw, Luis A et al. (2012) Risk factor, age and sex differences in chronic kidney disease prevalence in a diabetic cohort: the pathways study. Am J Nephrol 36:245-51
Young, Bessie Ann; Lin, Elizabeth; Von Korff, Michael et al. (2008) Diabetes complications severity index and risk of mortality, hospitalization, and healthcare utilization. Am J Manag Care 14:15-23
McCauley, Elizabeth; Katon, Wayne; Russo, Joan et al. (2007) Impact of anxiety and depression on functional impairment in adolescents with asthma. Gen Hosp Psychiatry 29:214-22
Katon, Wayne J; Richardson, Laura; Russo, Joan et al. (2006) Quality of mental health care for youth with asthma and comorbid anxiety and depression. Med Care 44:1064-72
Lin, Elizabeth H B; Katon, Wayne; Rutter, Carolyn et al. (2006) Effects of enhanced depression treatment on diabetes self-care. Ann Fam Med 4:46-53
Ciechanowski, Paul S; Russo, Joan E; Katon, Wayne J et al. (2006) The association of patient relationship style and outcomes in collaborative care treatment for depression in patients with diabetes. Med Care 44:283-91
Fenton, Joshua J; Von Korff, Michael; Lin, Elizabeth H B et al. (2006) Quality of preventive care for diabetes: effects of visit frequency and competing demands. Ann Fam Med 4:32-9

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