Depression treatment and risk for cardiovascular disease
Principal Investigator: MATTHEW CHARLES WHITED
Abstract: DESCRIPTION (provided by applicant): Matthew Whited, PhD is a clinical psychologist at the University of Massachusetts Medical School. His long- term goal is to elucidate the mechanisms of the association between depression and cardiovascular disease (CVD) and to identify depression treatments that influence both physical and mental long-term health. Depression is strongly and consistently associated with risk for CVD onset, but the influence of depression treatment on CVD onset is poorly understood. This indicates a need to investigate the effects of the various available depression treatments, and to more thoroughly understand the mechanisms of action by which depression treatments could influence CVD risk. The majority of studies that seek to influence CVD through depression treatment are studies of secondary prevention. This proposal will provide Dr. Whited with the training and mentorship needed to develop expertise in both epidemiological and clinical trials approaches that investigate the effects of depression treatments on primary CVD risk (first CVD event). Two studies are proposed to investigate the effects of each of two types of depression treatment (Selective Serotonin Reuptake Inhibitors: SSRIs and Cognitive Behavioral Therapy: CBT) on CVD risk. Autonomic balance (measured by heart rate variability;HRV) is associated with depression, and is also an established risk factor for CVD;autonomic balance will be the main CVD mechanism of interest in these studies. Study 1 of this proposal will help inform clinical recommendations of SSRI treatment by determining if SSRIs differentially influence primary CVD incidence in patients who are at higher or lower risk for CVD according to a predictive risk score (Framingham Risk Score: FRS). Following this, Heart Rate Variability (HRV) will be examined as a mediator of the SSRI and CVD association. Study 2 is a pilot clinical trial that will reduce depressive symptoms via an evidence-based psychotherapy to observe the effect of depression symptom reduction on HRV in the absence of pharmacotherapy. These studies are linked in that they both investigate the effects of depression treatment on autonomic balance by independently focusing on either antidepressant medications or psychotherapy. Dr. Whited's prior research in psychophysiology complements the training plan, which will provide Dr. Whited with additional knowledge in depression, its treatment, cardiovascular physiology, autonomic imbalance, along with the experience and expertise necessary to study primary CVD risk using epidemiological and clinical trials methodology. His long-term program of research will focus on understanding the influence of depression treatment on primary CVD risk and risk factors in order to inform clinical guidelines for depression treatment based on both physiological and psychological assessment and psychological and physiological treatment targets.
Funding Period: 2012-08-15 - 2017-05-31
more information: NIH RePORT
- Depression severity, diet quality, and physical activity in women with obesity and depressionBradley M Appelhans
Departments of Preventive Medicine and Behavioral Sciences, Rush University Medical Center, 1700 W Van Buren St, Chicago, IL 60612, USA
J Acad Nutr Diet 112:693-8. 2012..Future studies should identify mechanisms linking depression to diet quality and determine whether diet quality improves with depression treatment...
- Delay discounting and intake of ready-to-eat and away-from-home foods in overweight and obese womenBradley M Appelhans
Department of Preventive Medicine, Rush University Medical Center, 1700 W Van Buren St, Chicago, IL 60612, USA
Appetite 59:576-84. 2012..Impulsivity was associated with the quantity of away-from-home and ready-to-eat foods consumed, but not the frequency of their consumption. Home food preparation may be critical to weight control for impulsive individuals...
- Can attention control conditions have detrimental effects on behavioral medicine randomized trials?Sherry L Pagoto
Division of Preventive and Behavioral Medicine, Department of Medicine, University of Massachusetts Medical School, 55 Lake Avenue North, Worcester, MA 01760, USA
Psychosom Med 75:137-43. 2013..The primary aim of the present study is to demonstrate a scenario in which use of AC in a behavioral randomized trial was unnecessary and possibly detrimental...
- Randomized controlled trial of behavioral treatment for comorbid obesity and depression in women: the Be Active TrialS Pagoto
Division of Preventive and Behavioral Medicine, Department of Medicine, University of Massachusetts Medical School, Worcester, MA, USA
Int J Obes (Lond) 37:1427-34. 2013..The purpose of the present study was to test the hypothesis that delivering evidence-based behavior therapy for depression before a lifestyle weight loss intervention improves both weight loss and depression...
- Assessing depression in obese women: an examination of two commonly-used measuresKristin L Schneider
University of Massachusetts Medical School, United States Electronic address
J Psychosom Res 75:425-30. 2013....
- Severity of depressive symptoms and accuracy of dietary reporting among obese women with major depressive disorder seeking weight loss treatmentMatthew C Whited
Department of Psychology, East Carolina University, Greenville, North Carolina, United States of America
PLoS ONE 9:e90361. 2014..These results suggest that any study investigating associations between diet quality and depression should also include an index of reporting accuracy of dietary intake as accuracy varies with the severity of depressive symptoms...
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- Depression, Estrogen Replacement, and Cardiovascular Health in the PerimenopauseDavid R Rubinow; Fiscal Year: 2013..abstract_text> ..
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- 1/3-Improving Depression Outcome by Adding CBT for Insomnia to AntidepressantsRachel Manber; Fiscal Year: 2013..The results of this study may offer a method for improving the treatment of major depression without the use of additional medication. ..
- 1/2-Personalized Antidepressant Adherence Strategies for Depressed EldersJo Anne Sirey; Fiscal Year: 2013..As a brief manualized intervention, TIP-PC is designed to fit easily within primary care practices and to be delivered by non-MD staff. ..
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- Family and Neighborhood Interventions to Reduce Heart Disease Risk in East L.A.Alexander N Ortega; Fiscal Year: 2013....
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- 2/2-Personalized Antidepressant Adherence Strategies for Depressed EldersHelen C Kales; Fiscal Year: 2013..As a brief manualized intervention, TIP-PC is designed to fit easily within primary care practices and to be delivered by non-MD staff. ..
- INTEGRATED MECHANISMS OF CARDIAC MALADAPTATIONR John Solaro; Fiscal Year: 2013..Studies proposed here offer the potential for novel diagnostic procedures early in the progression of the disorders, and targets for novel therapies. (End of Abstract) ..
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- Boston Puerto Rican Health Study - CVD Risk FactorsKatherine L Tucker; Fiscal Year: 2013..abstract_text> ..