This is a competing renewal application for the continuation of Research Scientist Award K05-MH00295 (Years 16-20). The candidate proposes to continue a program of research with four broad objectives: 1) to utilize longitudinal measures of EEG sleep in characterizing the psychobiological substrate of recurrent major depression in late life (Study 1); 2) to utilize EEG sleep measures in identifying which types of maintenance therapy are best suited to ensure sustained recovery (Study 1); 3) to establish the EEG sleep correlates of nortriptyline efficacy in the treatment of bereavement-related depression, of unresolved grief, and of the post-treatment course of bereavement-related depression (Study 2); and 4) to establish the EEG sleep correlates of continued successful aging (Study 3). The candidate will complete three ongoing longitudinal studies of EEG sleep supported by MH37869: 1) in 120 patients with recurrent major depression participating in a double-blind, placebo-controlled maintenance therapies protocol (MH43832) evaluating the prophylactic efficacy of nortriptyline and interpersonal psychotherapy (Study 1); 2) in 80 elders with bereavement-related depression participating in a double-blind, placebo-controlled study of the efficacy of nortriptyline in acute and continuation therapy (Study 2); and 3) in a control group of 100 elders who exemplify successful aging (Study 3). Studies 1 and 2 both utilize double-blind, placebo-controlled designs to study EEG sleep during illness and recovery in late-life depression. Study 3, also longitudinal, permits a delineation of the medical, psychiatric, and psychosocial factors that impinge upon sleep in successfully aging control subjects and also investigates the role of sleep in the maintenanCe of successful adaptation in later life along physical and psychological dimensions. In addition to carrying out this research plan, the candidate also serves as Training Program Director of T32-MH16804-14 (""""""""Clinical Research Training in Psychiatry'). His commitment to broad, interdisciplinary research and research training in geriatric mood disorders is embodied in his service as PI of P30-MH52247-01A1 (""""""""Clinical Research Center for the Study of Mood Disorders in Late Life"""""""").
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