This application requests a Mentored Patient-Oriented Research Career Development Award (K23). The candidate is a geriatric psychiatrist and postdoctoral research fellow at the University of Pittsburgh who proposes to develop research skills for geriatric psychiatry research in medical rehabilitation settings. Funding of this award would provide time and resources necessary for him to develop into an independent investigator capable of conducting depression intervention studies in elderly patients undergoing rehabilitation after disabling medical events such as hip fracture. Studies of elders undergoing rehabilitation suggest that depression is associated with poorer outcomes and an increased likelihood of permanent disability and institutionalization. Therefore, it would be of tremendous public health benefit to determine the most efficacious interventions for late-life depression in the medical rehabilitation setting. However, little such intervention research has been done, in part because not enough is known about depression in this setting, and in part due the difficulty of carrying out psychiatric Intervention studies in this setting. To perform such research, the candidate will develop skills in the areas of psychiatric assessment of patients in medical settings, design of intervention trials, measurement of rehabilitation outcomes, and data management and biostatistical analysis. Proposed research consists of a longitudinal descriptive study characterizing late-life depression in medical rehabilitation settings, leading to a pilot intervention study assessing effects of depression treatment on rehabilitation outcomes. The proposed activities will take place in the NIMH-funded Intervention Research Center for Late Life Mood Disorders, directed by the candidate's sponsor, in the Department of Psychiatry at the University of Pittsburgh.
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