The principal purpose of this program is to explore the usefulness of basic psychoendocrine concepts and guiding principles in the development of clinical research strategies for the study of psychiatric and psychosomatic disorders. While a primary emphasis is on the study of mechanisms of pathogenesis of stress-related illnesses, it is hoped that new leverage in the diagnosis and treatment of such disorders may also eventually emerge from this approach. A key and rather unique feature of the research strategy is emphasis on the need to study the neuroendocrine apparatus as nearly as a whole as possible, by measurement of multihormonal patterns, since the many interdependent neuroendocrine systems are apparently coordinated in a broadly organized way by the central integrative machinery. The first project is a psychoendocrine study of bereavement in older men after the death of their wife. An extensive psychological and endocrine assessment of their adjustment 2 months following the loss will provide new information on the grief process itself, as well as a prospective view of high risk factors for the subsequent development of illness. A companion epidemiologic study will provide much subsequent development of illness. A companion epidemiologic study will provide much additional social, psychological, and outcome data for correlation with hormonal findings. A second project is a combined psychological, neuroendocrine, and neurochemical study of the stages of clinical change during the course of schizophrenic psychosis. This study will also provide an opportunity to evalute some concepts concerning the possible role of hormones in the pathophysiology of schizophrenia, which were suggested by early clinical psychoendocrine workers, but which remain untested by modern research methods. Another feature of the program is an emphasis on the training of young investigators in psychoneuroendocrine research by involving them in the major projects or guiding them in innovative pilot research aimed at exploring the extent to which our present basic science foundation in psychoneuroendocrinology can be applied to develop useful new strategies for clinical research on both psychiatric and medical disorders.
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