Charles F. Reynolds III

The Department of Psychiatry in Pitt’s School of Medicine has been awarded a five-year, $6.8 million grant by the National Institute of Mental Health (NIMH) to develop and test new treatment methods for late-life depression, anxiety, grief, and insomnia and to bring these treatments to the people who need them most. The grant will establish the Advanced Center for Interventions and Services Research for Late Life Mood Disorders at Western Psychiatric Institute and Clinic.

The center will provide an infrastructure to support research and programs with the goal of improving the care of elderly people living with depression and other severe mood disorders. The center’s research will focus on the prevention of depression and suicide in the elderly, especially those at high risk owing to other coexisting medical conditions; providing support and assistance to families of those with late-life mood disorders; and removing barriers to effective treatment in the community setting, specifically the African American community.

“Depression and mood disorders affect the elderly in a much more complex way than they affect younger people, and many elderly have coexisting conditions that make the disorder harder on the patient and harder to treat,” said Charles F. Reynolds III,Pitt professor of psychiatry, neurology, and neuroscience and the grant’s principal investigator. “With this center, we hope to bring the best treatments to those who need them the most.”

The Advanced Center for Interventions and Services Research builds on years of research conducted at the University of Pittsburgh to develop new approaches to treating this problem. Related centers have been funded at similar amounts over the past 10 years, first as the Clinical Research Center in Late Life Mood Disorders (1995-2000) and later as the Intervention and Research Center for Late Life Mood Disorders (2000-2005). Each successive center grant builds on the work of the previous center.

These centers have supported research resulting in 17 grant awards from NIMH focused on treating mood disorders in the elderly, including depression, bipolar disorder, and anxiety, and on preventing suicide in the elderly. Additionally, research supported by the centers has yielded impressive findings that have had significant clinical applications for late-life mood disorders. Results include:

• Demonstrating effectiveness of combined antidepressant medication and interpersonal psychotherapy in people up to age 75 with recurrent major depression and the effectiveness of antidepressant pharmacotherapy for people older than 75 with single episodes of major depression;

• Demonstrating the effectiveness of depression management strategies performed by nonphysician clinicians for reducing suicidal thoughts and symptoms of depression in elderly people attending primary care clinics. In one study, researchers showed that these strategies were useful in real-world settings;

• Discovering that the speed of response to antidepressant medication is dependent on a person’s genetics, which led to the idea that a pharmacogenetic analysis can help physicians and their patients understand how a patient will respond to a medication; and

• Establishing that most elderly people with depression also demonstrate some level of cognitive impairment.

Under the new grant, investigators will continue to build on their past 10 years of research, with a more concerted focus on delivering effective treatments to the patients in the community setting. They plan to do this by forming alliances among the caregivers, families, and community organizations to offer support to those who live with late-life mood disorders.

Community partners that make up the Research Network Development Core will be key to creating these alliances. This group will help the center build a presence in the community and improve communication with older primary care patients. Partners include: Coordinated Care Network, UPMC’s Community Medicine, Inc., and the Mental Health Association of Allegheny County.

In addition to Reynolds, primary researchers in the Advanced Center for Interventions and Services Research include Pitt faculty members Robert Bies, assistant professor of pharmaceutical sciences and psychiatry; Charlotte Brown, associate professor of psychiatry; Meryl Butter, associate professor of psychiatry; Mario Cruz, assistant professor of psychiatry; Mary Amanda Dew, professor of psychiatry, psychology, and epidemiology; Linda Garand, assistant professor of nursing; Ariel Gildengers, assistant professor of psychiatry; Amy Kilbourne, assistant professor of medicine and psychiatry; Eric Lenze, assistant professor of psychiatry; Francis Lotrich, assistant professor of psychiatry; Lynn Martire, assistant professor of psychiatry; Sati Mazumdar, professor of biostatistics; Benoit Mulsant, professor of psychiatry; Harold Pincus, professor of psychiatry; Bruce Pollock, professor of psychiatry, pharmacology, and pharmaceutical sciences; Edward Post, assistant professor of medicine and psychiatry; Richard Schulz, professor of psychiatry; Katalin Szanto, assistant professor of psychiatry; and Ellen Whyte, assistant professor of psychiatry.

For more information, visit the center’s Web site, www.latelifedepression.org, or call 412-246-6006.