This application is for an additional continuation year, so that the original objectives formulated for the psychopharmacotherapy training component of the Treatment of Depression Collaborative Research Program can be accomplished. The objectives include completing the testing of the efficacy of the psychopharmacotherapy training program, the validity of the behaviors emphasized in the Psychopharmacotherapy Manual and the Psychopharmacotherapy Rating Scale (PRS) as well as the application of this scale to the outcomes of the treatment study which will be completed in 1985. The data including that generated from patients admitted into the study during the closing phase in year 05 will be collected, collated, and used in analyses and studies that address specific questions concerned with the impact, effectiveness and results of the standardization of the Imipramine-Placebo/Clinical Management Condition by means of the Training Program, as assessed by the Psychopharmacotherapy Rating Scale (PRS).
The specific aims i nclude: use of the PRS, derived from the training manual and empirical findings during the training phase, to study psychopharmacotherapy therapy clinical management factors with respect to compliance, attrition, clinical outcome measures and patient satisfaction. This work includes studies on competency and changes in clinical management styles in relationship to these factors and will be carried out within the treatment phase and in comparison to the training phase. Collaborative efforts with the other training sites will be directed towards the elucidation of common factors which may be of significance across all of the treatment conditions. Appropriate statistical methods will be used to address these aims. These include use of two factor log linear and Cox regression models. Finally a set of conclusions and recommendations, based on the results of the analyses and studies will be developed as guidelines for further research, training and education in the area of psychopharmacologic clinical management. This work will be reported in a series of publications.
