This is a request for five years of salary support via the Midcareer Investigator Award in Patient-Oriented Research (K24). Throughout my career I have sought to bridge basic neurobiological and clinical domains, with special emphasis on mood disorders. By the early 1990's, I began to redirect my energies toward the development of a series of studies using newer molecular biological methods to investigate the causes and possible treatments for depression. Using a fibroblast cell culture model, my collaborators and I have discovered that melancholic major depressives have a reduction of cyclic AMP binding to the regulatory subunit of protein kinase A (PKA) linked to beta adrenoceptors. This results in a concomitant reduction in phosphorylation activity (including that of CREB) and altered gene expression. We also have shown an altered expression of a specific nuclear phosphatase gene using the differential display reverse transcription polymerase chain reaction methodology with cPCR. Herein, I have outlined these findings along with plans for related projects over the next five years. I also have described briefly two other project areas that stand in the mid-ground between basic and clinical investigations. One is an investigation of mood regulation using new clinical ratings instruments (developed, in part by our research group) to measure components of mood under conditions of pharmacological manipulation. The second represents a novel therapeutic intervention in refractory major depression. Drawing from a set of basic laboratory observations, I have conducted a successful trial of the combination of olanzapine and fluoxetine in refractory depressives. Together, these study areas demonstrate my capacity to bridge from basic laboratory findings, on the one hand, to clinical phenomenology and treatment, on the other. Finally, consistent with the goals of the K24, I have a long track-record of mentorship of new investigators from a number of disciplines. However, an increasing burden of administrative and clinical responsibilities threatens my research productivity and mentorship. This award will relieve me of many of these demands and will allow me to: 1.Develop further expertise in basic molecular biological methods; 2. Develop new projects oriented to future funding opportunities; and 3. Continue to mentor the next generation of investigators.

Agency
National Institute of Health (NIH)
Institute
National Institute of Mental Health (NIMH)
Type
Midcareer Investigator Award in Patient-Oriented Research (K24)
Project #
5K24MH001741-05
Application #
6650708
Study Section
Special Emphasis Panel (ZRG1-BDCN-6 (01))
Program Officer
Meinecke, Douglas L
Project Start
1999-08-01
Project End
2006-07-31
Budget Start
2003-08-01
Budget End
2006-07-31
Support Year
5
Fiscal Year
2003
Total Cost
$106,340
Indirect Cost
Name
Vanderbilt University Medical Center
Department
Psychiatry
Type
Schools of Medicine
DUNS #
004413456
City
Nashville
State
TN
Country
United States
Zip Code
37212
Sasso, Katherine E; Strunk, Daniel R; Braun, Justin D et al. (2016) A re-examination of process-outcome relations in cognitive therapy for depression: Disaggregating within-patient and between-patient effects. Psychother Res 26:387-98
Garbett, K A; Vereczkei, A; Kálmán, S et al. (2015) Fibroblasts from patients with major depressive disorder show distinct transcriptional response to metabolic stressors. Transl Psychiatry 5:e523
Garbett, Krassimira A; Vereczkei, Andrea; Kálmán, Sára et al. (2015) Coordinated messenger RNA/microRNA changes in fibroblasts of patients with major depression. Biol Psychiatry 77:256-265
Forand, Nicholas R; DeRubeis, Robert J (2014) Extreme response style and symptom return after depression treatment: the role of positive extreme responding. J Consult Clin Psychol 82:500-9
Kálmán, Sára; Garbett, Krassimira A; Vereczkei, Andrea et al. (2014) Metabolic stress-induced microRNA and mRNA expression profiles of human fibroblasts. Exp Cell Res 320:343-53
Forand, Nicholas R; Derubeis, Robert J (2013) Pretreatment anxiety predicts patterns of change in cognitive behavioral therapy and medications for depression. J Consult Clin Psychol 81:774-82
Fournier, Jay C; DeRubeis, Robert J; Hollon, Steven D et al. (2010) Antidepressant drug effects and depression severity: a patient-level meta-analysis. JAMA 303:47-53
Strunk, Daniel R; Brotman, Melissa A; DeRubeis, Robert J et al. (2010) Therapist competence in cognitive therapy for depression: predicting subsequent symptom change. J Consult Clin Psychol 78:429-37
Shelton, Richard C; Miller, Andrew H (2010) Eating ourselves to death (and despair): the contribution of adiposity and inflammation to depression. Prog Neurobiol 91:275-99
Fournier, Jay C; DeRubeis, Robert J; Shelton, Richard C et al. (2009) Prediction of response to medication and cognitive therapy in the treatment of moderate to severe depression. J Consult Clin Psychol 77:775-87

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