(provided by candidate): This is the resubmission of an application for a K24 Midcareer Investigator Award in patient-oriented research. The candidate -- a tenured Associate Professor of Psychiatry at the University of Pittsburgh with an established record as a clinical researcher and mentor-- is dedicated to improving the treatment of severe mood disorders in late-life. The Career Development Plan will allow the candidate to: (1) enhance his ability to design, implement, and lead large multicenter trials focused on older patients with severe mood disorders (e.g., with psychotic depression or with bipolar disorder); (2) develop his expertise on how to improve participation of older depressed African Americans in these controlled trials; (3) improve his mentoring skills and his ability to recruit and mentor underrepresented minority trainees. These objectives will be reached through a combination of courses, workshops, seminars, and directed readings or tutorials with senior consultants. The Mentorinq Plan is targeted towards beginning investigators who want to learn to design and conduct intervention trials for late-life mood disorders. Under supervision by the candidate, trainees will obtain hands-on experience by conducting research assessments of patients participating in ongoing clinical trials, participating in multidisciplinary recruitment, protocol management, and data meetings, and by preparing scientific reports for presentation and publication. Advanced trainees will also be mentored in the development of their own independent pilot studies and preparation of entry-level K awards. All trainees will receive instruction in the responsible conduct of research. The Research Plan is focused on the pharmacologic treatment of psychotic major depression (PMD), a severe disorder that is associated with suicide, severe functional impairment, and resistance to antidepressant treatment. Building on findings from the candidate and collaborating investigators, the primary aims of this funded study are to improve the pharmacologic treatment of psychotic depression and to test whether older patients with psychotic depression have a diminished tolerance or response to pharmacologic treatment than younger patients. With the support of this award, additional work proposed in this application will focus on improving recruitment and retention of older minority subjects with severe mood disorders in this and other trials.

National Institute of Health (NIH)
National Institute of Mental Health (NIMH)
Midcareer Investigator Award in Patient-Oriented Research (K24)
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Study Section
Interventions Research Review Committee (ITV)
Program Officer
Evans, Jovier D
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University of Pittsburgh
Schools of Medicine
United States
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Young, Robert C; Mulsant, Benoit H; Sajatovic, Martha et al. (2017) GERI-BD: A Randomized Double-Blind Controlled Trial of Lithium and Divalproex in the Treatment of Mania in Older Patients With Bipolar Disorder. Am J Psychiatry 174:1086-1093
Østergaard, Søren D; Rothschild, Anthony J; Flint, Alastair J et al. (2016) Establishing the cut-off score for remission and severity-ranges on the Psychotic Depression Assessment Scale (PDAS). J Affect Disord 190:111-114
Davies, Simon J C; Mulsant, Benoit H; Flint, Alastair J et al. (2016) SSRI-antipsychotic combination in psychotic depression: sertraline pharmacokinetics in the presence of olanzapine, a brief report from the STOP-PD study. Hum Psychopharmacol 31:252-5
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Gerretsen, Philip; Flint, Alastair J; Whyte, Ellen M et al. (2015) Impaired insight into delusions predicts treatment outcome during a randomized controlled trial for Psychotic Depression (STOP-PD study). J Clin Psychiatry 76:427-33
Rej, Soham; Butters, Meryl A; Aizenstein, Howard J et al. (2014) Neuroimaging and neurocognitive abnormalities associated with bipolar disorder in old age. Int J Geriatr Psychiatry 29:421-7
Østergaard, S D; Meyers, B S; Flint, A J et al. (2014) Measuring psychotic depression. Acta Psychiatr Scand 129:211-20
Davies, Simon J C; Mulsant, Benoit H; Flint, Alastair J et al. (2014) Differential impact of anxiety symptoms and anxiety disorders on treatment outcome for psychotic depression in the STOP-PD study. Compr Psychiatry 55:1069-76
Østergaard, Søren D; Meyers, Barnett S; Flint, Alastair J et al. (2014) Measuring treatment response in psychotic depression: the Psychotic Depression Assessment Scale (PDAS) takes both depressive and psychotic symptoms into account. J Affect Disord 160:68-73
Ismail, Zahinoor; Emeremni, Chetachi A; Houck, Patricia R et al. (2013) A comparison of the E-BEHAVE-AD, NBRS, and NPI in quantifying clinical improvement in the treatment of agitation and psychosis associated with dementia. Am J Geriatr Psychiatry 21:78-87

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