This is an application for a Mentored Patient-Oriented Research Career Development Award (K23). The candidate, a neuropsychiatrist, proposes to acquire specific skills and knowledge to become an independent investigator and leader in traumatic brain injury (TBI) psychiatric research. The candidate will conduct a prospective study on risk factors for post-TBI depression under the mentorship of Drs. C. G. Lykestos and J. Brandt, and with associated faculty including Drs. D. Schretlen, H. Armenian, K. Bandeen-Roche, C. Reynolds, R. Robinson, and J. Silver. The goals for this five year plan include: conduct a 1-year prospective cohort study of TBI patients; enhance research related skills; broaden knowledge; and publish regularly. These goals will be accomplished through conducting research on risk factors for post-TBI depression. Other activities that will contribute towards the goals include pursuit of a Masters of Health Sciences in Epidemiology degree at the Johns Hopkins School of Public Health, regular meetings with mentors and consultants, attendance at scientific meetings, and travel to other sites of TBI/neuropsychiatric research. The focus of the proposed research is the risk factors associated with post-TBI depression. TBI is a serious public health problem in the United States, with an annual incidence of 2 million per year. 25-50 % of people who sustain TBI develop depression. The pathogenesis of post-TBI depression is still unclear. The primary aim is to assess the rates of major depression in those with executive dysfunction at time of injury and at 1, 6, and 12 months post-injury. The hypothesis is that patients with executive dysfunction will have higher rates of depression than those without executive dysfunction. A secondary aim is to assess rates of depression in those with poor pre-injury social functioning. The hypothesis is that patients with poorer pre-injury social functioning will have higher rates of depression than those with better pre-injury functioning.
A third aim i s to compare the strength of these two risk factors. The hypothesis is that the effect of executive dysfunction will be larger than that of pre-injury social functioning. All three hypotheses will hold true at each time point, even when gender, personal past psychiatric history, family history, and alcohol/substance abuse/depedence are adjusted for in the analysis. ? ?
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