CDRC Discoveries

Mood Disorders Research

Advancing Mood Disorders Research

The Center for Depression Research and Clinical Care has one vision: a future free from the burden of depression. More than a center, we are a community of committed faculty and staff, collaborators, clinicians, research participants, and community partners, as well as, the donors and advocates who are critical to our mission.

Housed within the Department of Psychiatry at UT Southwestern Medical Center, we have one of the strongest programs in the nation for mood disorders research and treatment. 

51 Publications in 2022
6 # years Dr. Trivedi awarded Highly Cited Researcher by Reuters
9 # Grants Awarded since 2020
65 Publications in 2021
Mood Disorders Research

Improving Diagnosis

Through scientific research and rigorous peer review, we have expanded our understanding of depression. Key findings are improving the way physicians diagnose and treat this disease.

    Predicting future suicidal events in adolescents using the Concise Health Risk Tracking Self-Report (CHRT-SR)

    • Several self-report rating scales have been developed to assess suicidal ideation, yet most have limited utility in predicting future suicide attempts. This is particularly critical in adolescence, where suicide is the second leading cause of death. This study evaluated the Concise Health Risk Tracking Self-Report (CHRT-SR) as a prospective predictor of suicide attempts and events in high-risk adolescents enrolled in a suicide-prevention intensive outpatient program (IOP).
    • The CHRT-SR14 self-report predicts suicide attempts and events with at least 80% sensitivity and acceptable specificity in adolescents at high-risk for suicide.

    Read one of our publications.

    Depression Screening and Education: Options to Reduce Barriers to Treatment (DESEO): protocol for an educational intervention study

    • Barriers to depression treatment among Hispanic populations include persistent stigma, inadequate doctor patient communication (DPC) and resultant sub-optimal use of anti-depressant medications.
    • Primary care settings often are the gateway to identifying undiagnosed mental health disorders, particularly for people with comorbid physical health conditions. This study is unique in that it aims to examine the specific role of patient education as an intervention to increase engagement in depression treatment. By participating in the DEI, it is expected that patients will have time to understand treatment options, participate in shared decision-making with their provider, and increase engagement in treatment of depression which might lead to improved overall health.

    Read one of our publications.

    Dallas 2K

    • A total of 1,477 participants have enrolled in the study, and we have obtained over 4500 blood samples; 3700 behavioral and cognitive tests; 3400 EEGs; and 1300 MRIs.
    • We launched a satellite clinic in Fort Worth at the Moncrief Cancer Institute, and enrolled over 50 people in the first several months of opening.

    Read one of our publications.

    Establishing Moderators and Biosignatures for Antidepressant Response in Clinical Care

    • EMBARC, which is the largest study to date to examine a full spectrum of clinical and biological markers for depression treatment response. N=309 with MDD and 40 healthy controls
    • 9 publications to date, and over 25 planned for next year.

    Read one of our publications.

    View Dr. Trivedi discussing the EMBARC study.

     

    Identification of psychiatric disorder subtypes from functional connectivity patterns in resting-state electroencephalography

    • The understanding and treatment of psychiatric disorders, which are known to be neurobiologically and clinically heterogeneous, could benefit from the data-driven identification of disease subtypes. Here, we report the identification of two clinically relevant subtypes of post-traumatic stress disorder (PTSD) and major depressive disorder (MDD) on the basis of robust and distinct functional connectivity patterns, prominently within the frontoparietal control network and the default mode network.
    • The subtype whose functional connectivity differed most from those of healthy controls was less responsive to psychotherapy treatment for PTSD and failed to respond to an antidepressant medication for MDD. By contrast, both subtypes responded equally well to two different forms of repetitive transcranial magnetic stimulation therapy for MDD. Our data-driven approach may constitute a generalizable solution for connectome-based diagnosis.

    Read one of our publications.

    Treatment of SSRI-Resistant Depression In Adolescents (TORDIA) 

    • Aims to develop useful clinical guidelines for the care and management of adolescent depression. Adolescents ages 12 to 18, currently taking a prescribed selective serotonin reuptake inhibitor (SSRI) and still experiencing depression, participate in a 12-week randomized treatment study that includes one of four conditions: (1) switching to an alternative SSRI, (2) switching to a different non-SSRI antidepressant, (3) switching to an alternative SSRI and receiving cognitive behavioral therapy (CBT), or (4) switching to a different non-SSRI antidepressant and receiving CBT.  

    Read one of our publications.

    Mood Disorders Research

    Improving Treatment

    From identifying novel drugs to advancing our understanding of mental health, the CDRC's research demonstrates its commitment to improve patient outcomes.

      Accelerated Development of Additive Pharmacotherapy Treatment (ADAPT-2) for Methamphetamine Use Disorder

      • The use of naltrexone plus bupropion to treat methamphetamine use disorder has not been well studied. We conducted this multisite, double-blind, two-stage, placebo-controlled trial with the use of a sequential parallel comparison design to evaluate the efficacy and safety of extended-release injectable naltrexone (380 mg every 3 weeks) plus oral extended-release bupropion (450 mg per day) in adults with moderate or severe methamphetamine use disorder.
      • Among adults with methamphetamine use disorder, the response over a period of 12 weeks among participants who received extended-release injectable naltrexone plus oral extended-release bupropion was low but was higher than that among participants who received placebo.

      Read one of our publications.

       

      The Augmentation versus Switch: Comparitive Effectiveness Research Trial for Antidepressant Incomplete and Non-responders with Treatment Resistant Depression

      • Multi-year, multi-site, randomized, open-label, effectiveness study examining three treatment strategies for treatment resistant depression (aripiprazole augmentation, TMS augmentation and switching to venlafaxine XR).
      • More than 229 participants were randomized, and several new sites were opened across the US and Canada.

      Learn more about this project.

      Study to Evaluate the Efficacy and Safety of Adjunctive Pimavanserin in Major Depressive Disorder

      • This was an analysis of the effect of pimavanserin, a 5-hydroxytryptamine-2A antagonist and inverse receptor agonist, on dysregulated sleep in patients with major depressive disorder (MDD) by DSM-5 criteria and an inadequate antidepressant response.
      • Adjunctive pimavanserin significantly improved sleep/wakefulness disturbance during treatment of MDD, an improvement that was associated with greater improvement in function.

      Read one of our publications.

      Combining Medications to Enhance Depression Outcomes

      • Two antidepressant medication combinations were compared with selective serotonin reuptake inhibitor monotherapy to determine whether either combination produced a higher remission rate in first-step acute-phase (12 weeks) and long-term (7 months) treatment.
      • Neither medication combination outperformed monotherapy. The combination of extended-release venlafaxine plus mirtazapine may have a greater risk of adverse events.

      Read one of our publications.

      Sequenced Treatment Alternatives to Relieve Depression trial

      • The overall goal of the STAR*D trial was to assess the effectiveness of depression treatments in patients diagnosed with major depressive disorder, in both primary and specialty care settings.
      • It is the largest and longest study ever conducted to evaluate depression treatment. 

      Read one of our publications.

      • Beginning in 1995, The Texas Medication Algorithm Project (TMAP) was developed by the Texas Department of Mental Health and Mental Retardation (TDMHMR*) in collaboration with Texas universities to assess the value of an algorithm-driven disease management program in the pharmacological management of mentally ill patients.
      • The result has been a set of algorithms for the treatment of the three major disorders most commonly encountered in the Texas public mental health system: schizophrenia (SCZ), bipolar I disorder (BDI), and major depressive disorder (MDD).A best practice treatment has been defined as a series of treatment steps that guides physicians in determining medication treatment plans, thereby generating the best outcome for each individual consumer.

      Read one of our publications.

      Mood Disorders Research

      Improving Quality of Life

      Furthering research and understanding is an important pillar of our vision to identify and build lifelong coping and resilience skills that help avoid the negative physical, emotional, and social outcomes caused by depression.

        Promoting Activity in Cancer Survivors

        • The purpose of the PACES study is to evaluate multiple strategies for increasing physical activity in breast cancer survivors. Results of this study will provide in an optimized intervention for increasing physical activity in breast cancer survivors.
        • Physical activity improved across all treatment groups:By 3 months, 67.5% of participants were meeting the recommended physical activity guidelines. This continued, with 63.1% meeting the guidelines by 6 months.
        • All groups showed improvements in other important areas, such as sleep quality, fatigue, depression, and functioning.

        Read one of our publications.

        PlanoUp!

        • In partnership with Plano Independent School District (PISD), the CDRC conducted depression screening to support the PISD’s efforts to provide wraparound services for youth between the ages of 11 and 19 who demonstrated symptoms of depression, resided in a high need area, and attended one of three designated schools. Our work sought to uncover social determinants of health that contribute to student depression, such as food insufficiencies, housing insecurity, lack of clothing, and lack of transportation.  

        • We implemented the Youth Aware of Mental Health (YAM) intervention program in selected Plano ISD schools, and conducted depression screening using VitalSign6 software. This partnership resulted in 378 students participating in the YAM program, and 103 staff receiving Mental Health First Aid training. Of those 99 students screened, 68% met the criteria for a depression diagnosis, and 88% were enrolled in the intervention. To date, 15% of the students identified as depressed have achieved PHQ-9 scores indicating remission.

        Resilience in Adolescent Depression

        • 10-year study of 1,500 participants (ages 10-24) that will help uncover the factors that contribute to resilience among children, adolescents, and young adults at risk for mood and anxiety disorders. 
        • Resilience and risk factors related to youth depression are not well understood, and addressing mental illness in youth will not only require screening and treatment, but also early intervention and prevention for those at risk. Particularly, little is known about how to build resilience, which is an interactive process that occurs as a result of life events, individual characteristics, and environmental influences. As we begin to understand how this process works, we may begin to identify strategies to improve resilience, and thereby reduce the risk of serious mental illness. 

        Read one of our publications.

        Stimulant Reduction Intervention using Dosed Exercise

        • The STRIDE study was a multi-site investigation (9 study sites) designed to investigate the efficacy of supplementing TAU with either a dosed exercise intervention (DEI) or a health education intervention (HEI) in individuals diagnosed with stimulant abuse and/or dependence.
        • The primary aim is to compare days of abstinence, as measured by the Timeline Follow Back, between the DEI and HEI groups during a 12-week period.

        Read one of our publications.

        Work Productivity

        • Education, baseline depression severity, and melancholic, atypical, and recurrent depression subtypes were all independently associated with lower benefit to work productivity domains.
        • Patients with clinically significant reductions in symptom severity during initial treatment were more likely than nonresponders to experience significant improvements in work productivity. In contrast, patients who achieved symptom remission in second-step treatment continued to have impairment at work. Patients who have demonstrated some degree of treatment resistance are more prone to persistent impairment in occupational productivity, implying a need for additional, possibly novel, treatments.

        Read one of our publications.

        Focus on Youth

        Be part of the great impact we're having on science and medical care across the globe.

        The CDRC has received two grants which fund adolescent research prevention and treatment. Because depression often begins early in life, our goal is to proactively study the disease in young people to ultimately prevent or minimize its impact population-wide. To better understand the areas of greatest impact, we have identified, and partnered with schools, youth organizations, and healthcare systems on initiatives to improve diagnosis and treatment of mood disorders and suicide prevention in youth.