Research Assessment and Training

Jean Endicott, Ph.D., Director
Jennifer Downey, M.D, Psychiatrist II
Margaret Spinelli, M.D., Psychiatrist (Research) II
Deborah Hasin, Ph.D., Research Scientist VI
John Nee, Ph.D., Research Scientist V
Dianne Schechter, Ph.D., Research Scientist IV
Jo Ellen Loth, M.S.W., Research Project Director

OVERVIEW
The Department of Research Assessment and Training has six senior research investigators and thirty support staff members. Members of the department are involved in a variety of research studies focused upon obtaining a better understanding of the diagnosis, evaluation of severity of symptoms and impairment in functioning, genetics, course of illness, and treatment of patients with mood disorders and/or substance use disorders. These projects include (1) the Collaborative Depression Study, a large multi-facility study of the course of illness in patients with major mood disorders, (2) genetics studies of bipolar disorder, (3) treatment of antipartum depression, (4) treatment of premenstrual dysphoric disorder, (5) genetics studies of alcohol use disorders, (6) epidemiology and course of alcohol use disorders, (7) comorbidity and the course of substance use disorders. Members of the department also continue to develop procedures to aid clinicians and investigators in their assessment of both patients and non-patients. The department also ran a Comparison Group Project to help identify individuals who were potentially suitable to serve as control subjects for studies conducted by investigators at Psychiatric Institute.

CURRENT RESEARCH
Dr. Jean Endicott and Co-PI’s of the Collaborative Depression Study received a .4 percentile rating and new funding from NIMH for years 31-35 of the project. This project has resulted in over 250 peer-reviewed publications to date. One of the seven published in 2003 explored the long-term symptomatic status of patients with Bipolar I vs. Bipolar II disorders. Patients were symptomatic approximately half of all follow-up weeks, with depressive symptoms predominating. Another noted that Bipolar I or II patients who develop a rapid cycling pattern suffer substantial depressive morbidity and are at high risk for serious suicide attempts. A third reported no significant differences in severity of impairment between patients with BPI or BPII disorder at any level of depressive symptom severity, but noted a significant stepwise increase in psychosocial impairment with each increment in depressive symptom severity.

Dr. Deborah Hasin received a large grant from NIAAA for a population-based study of alcohol metabolizing genes and variations in their effects in Israeli ethnic groups of differing backgrounds. Dr. Hasin has shown that smoking and drinking and nicotine and alcohol dependence are highly related in Israel but that ADH2*2 remains protective against various alcohol phenotypes when smoking was considered. The new project will also include study of SNPs in GABA receptor genes and exposure to politically motivated violence.

Dr. Hasin’s NIAAA-funded longitudinal community study found that frequency of binge drinking contributed to new onsets of DSM-IV alcohol abuse after 10 years of follow-up. This was distinct from predictors of new onsets of DSM IV alcohol dependence, which included frequency of binge drinking, family history of alcoholism, lack of sensitivity to alcohol effects and drinking to cope with negative affect.

Working with Dr. Bridget Grant at NIAAA and data from the 2002 National Epidemiology Survey on Alcohol and Related Conditions (NESARC), Dr. Hasin show that many individuals meeting criteria for DSM-IV alcohol dependence do not additionally manifest symptoms of DSM-IV alcohol abuse, especially women and minorities. As a consequence, surveys that use alcohol abuse as a screening procedure for dependence have produced underestimates that vary by popular subgroups.

In a NIDA-funded longitudinal study of Dr. Hasin and Dr. Nunes found that alcohol and heroin use during the follow-up but not cocaine or marijuana predicted the presence of a depressive syndrome during the week after use. Drs. Hasin and Aharonovich also found that cognitive deficits among marijuana dependent patients reduced retention in treatment.

The Comparison Group Project, directed by Dr. Dianne Schechter, assisted 27 investigators in obtaining control subjects for 30 studies. The project continued to demonstrate the importance of systematic clinical assessment of volunteers for control groups noting that only 21% of the 709 active potential subjects had never met criteria for a mental disorder.

The Pediatric Quality of Life Enjoyment and Satisfaction Questionnaire was used in a large multi-facility clinical trial and was found to have high test-retest reliability and good validity a an independent measure of clinical status. The questionnaire is now being used by many investigators and has been translated into 10 languages.

The use of the regular version of the Quality of Life Enjoyment and Satisfaction Questionnaire has grown and it is now available from Dr. Endicott in 45 languages. Similarly, the Endicott Work Productivity Scale has gained in use and is now available from Dr. Endicott in 20 languages. Both procedures have been found to be sensitive to treatment differences.

EDUCATION AND TRAINING
The department does not have any special funding for our educational efforts. However, during the year under review fellows and post-docs were mentored by senior members of the department on data analysis, manuscript and grant proposal preparation. Examples follow:

David Mysels, M.D. had a summer placement and completed analyses and preparation of a paper. Mentored by Drs. Endicott and Nee.

Clair Henderson, M.D., a Public Psychiatry fellow prepared and submitted a grant proposal and several manuscripts. Mentored by Dr. Hasin.

Renee Goodwin, Ph.D. submitted a grant proposal and prepared papers for submission. Mentored by Dr. Hasin.

Efrat Aharonovich, Ph.D. worked on several papers and a grant proposal. Mentored by Dr. Hasin.

AWARDS AND HONORS

Dr. Margaret Spinelli was selected to receive the American Psychiatric Association’s Guttmacher Book Award for “Prevention and the Promise of Saved Lives in Infanticide: Psychological and Legal Perspectives on Mothers Who Kill”, American Psychiatric Press, Washington D.C., 2002

Dr. Deborah Hasin received a Senior Scientist award from NIAAA.

Dr. Hasin was appointed to the Substance Use Disorders committee at the DSM-V kick-off meeting in February, 2004.

Dr. Hasin Served as Chairperson of the Measurement Workgroup for the NIDA Clinical Trials Network, a l7-university project on clinical trials for substance abuse.

Dr. Hasin gave an invited Plenary Presentation at the Israel Biological Psychiatry Conference in March, 2004

Drs. Jennifer Downey and Richard Friedman were invited Plenary Speakers at the 311th Scientific Meeting of the Psychoanalytic Association of New York, November, 2003

GRANTS

Jean Endicott, Ph.D. PI NIMH Grant #23864 “Collaborative Depression Study”, l998-09

Jean Endicott, Ph.D., PI Pfizer, Inc. “Psychometric Assessment of the Reliability and Validity of Two Outcome Measures for Use in Chronic Spinal Cord Injury Population, 2001-04

Jean Endicott, Ph.D. and Dianne Schechter, Ph.D., Co-Prin I ( Laslo Papp, M.D., PI) NIMH Grant # 61274 “CoGENT for Mood and Anxiety Disorder Research”, 2000-04.

Jean Endicott, Ph.D. Co-Prin I. ( Miron Baron, M.D., PI) NIMH Grant #59602 “Molecular Genetics of Bipolar Disorder”, l998-04

Deborah Hasin, Ph.D. PI NIAAA Grant #9159 “Alcohol Dependence: General Population Validity, l990-05

Deborah Hasin, Ph.D. PI NIAAA Grant # 13654 “Alcohol in Israel: Genetic and Environmental Effects. 2003-08

Deborah Hasin, Ph.D. Co-Prin I (Ned Nunes, M.D. PI) NIDA Grant 1303502 “CU Partners: NY/Long Island Regional Node” 2001-05

Deborah Hasin, Ph.D. Co-Prin I (Patrick McGrath, M.D. PI) NIAAA Grant # 13303 “Alcohol Use Disorder in Patients Treated for Depression.” 2001-05.

Deborah Hasin, Ph.D. Co-Invest. (Efrat Aharonovich, Ph.D., PI) NIDA Grant # 14091 2002-05.

BIBLIOGRAPHY
Aharonovich E, Nunes E, Hasin D. Cognitive impairment, retention and abstinence among cocaine
abusers in cognitive-behavioral treatment. Drug & Alcohol Depend 71(2): 207-211, 2003.

Borenstein JE, Dean BB, Endicott J, Wong J, Yonkers KA. The health and economic impact of premenstrual syndrome. J Reproduct Med 48(7):515-524, 2003.

Coryell W, Solomon D, Turvey C, Keller M, Leon AC, Endicott J, Schettler P, Judd L, and Mueller T. The
long-term course of rapid cycling bipolar disorder. Arch Gen Psych 60(9):914-920, 2003.

Downey JI. Why do certain patients not finish cancer treatment? In Vivo 2(2): 7, 2003.

Egeland JA, Shaw JA, Endicott J, Pauls DL, Allen CR, Hostetter AM, Sussex JN. Prospective study of prodromal features for Bipolarity in well Amish children. J Am Acad Child Adoles Psych 42(7):786-796, 2003.

Endicott J, McLaughlin TP, Grudzinski AN. Comparison of managed care charges among patients treated with selective serotonin reuptake inhibitors for premenstrual dysphoric disorder. 12(64):1511-1516, 2003.

Friedman RC and Downey JI. Male and female homosexuality in heterosexual life. In: Handbook of Cinical Sexuality for Mental Health Professionals, (SB Levine, CB Risen and SE Althof, Eds.). New York: Taylor & Francis, Inc., Chapter 16, pages 277-290, 2003.

Hasin D. Classification of alcohol use disorders. Alcohol Rsch & Health 27(1): 5-17, 2003.

Hasin DS, Schuckit MA, Martin CS, Brant BF, Bucholz KK, Helzer JE. The validity of DSM-IV alcohol dependence: What do we know and what do we need to know? Alcohol Clin Exp Rsch 27(2)244-252, 2003.

Judd LL, Akiskal HS, Schettler PJ, Coryell W, Endicott J, Maser JD, Solomon DA, Leon AC, and Keller MB. A prospective investigation of the natural history of the long-term weekly symptomatic status of bipolar-II disorder. Arch Gen Psychiatry 60(3): 261-269, 2003.

Judd LL, Schettler PJ, Akiskal HS, Maser J, Coryell W, Solomon D, Endicott J and Keller M. Long-term symptomatic status of bipolar I vs. bipolar II disorders. Int J Neuropsychopharmacol 6(2):127-137, 2003

Leon AC, Solomon DA, Mueller TI, Endicott J, Rice JP, Maser JD, Coryell W and Keller MB. A 20-year
longitudinal observational study of somatic antidepressant treatment effectiveness. Am J Psychatry 160(4):727-733, 2003

Lipton RB, Dodick D, Sadovsky R, Kolodner K, Endicott J, Hettiarachchi J, Harrison W. A self-administered screener for migraine in primary care: The ID MigraineTM validation study. Neurology 61:375-382, 2003.

Liu J, Juo SH, Dewan A, Grunn A, Tong X, Brito M, Park N, Loth JE, Kanyas K, Lerer B, Endicott J, Penchaszadeh G, Knowles JA, Ott J, Gilliam TC, and Baron M. Evidence for a putative bipolar disorder locus on 2p13-16 and other potential loci on 4q31, 7q34, 8q13, 9q31, 10q21-24, 13q32, 14q21 and 17q11-12. Molecular Psychiatry 8:333-342, 2003.

Rucci P, Frank E, Fagiolini A, Kupfer DJ, Shear MK, Dell’Osso L, Banti S, Mauri M, Grochocinski VJ, Maser JD, Endicott J, Cassano GB. Development and preliminary testing of the General 5-Spectrum Measure (GSM-V). Depression & Anxiety 18(3):109-117, 2003.

Sbrana A, Dell’osso L, Impagnatiello P, Doria MR, Spagnolli S, Ravani L, Cassano GB, Frank E, Shear MK, Grochocinski VJ, Rucci P, Maser JD, Endicott J. Acceptability, validity and reliability of the Structured Clinical Interview for the Spectrum of Substance Use (SCI-SUBS): A pilot study. Int J Methods Psychiatr Res 12(2):105-15, 2003.
Solomon DA, Leon AC, Endicott J, Coryell W, Mueller TI, Posternak MA, and Keller MB. Unipolar Mania: A 20-year follow-up study. Am J Psychiatry 160(11): 2049-2051, 2003.

Spinelli MG. (ed) Infanticide: Psychosocial and Legal Perspectives on Mothers Who Kill. American Psychiatric Publishing, Inc., Washington, D.C., 272 pages, 2003.

Spinelli MG. Medical and legal dilemmas of postpartum psychiatric disorders. In: Infanticide: Psychosocial
and Legal Perspectives on Mothers Who Kill. (Spinelli MG, ed) American Psychiatric Publishing, Inc.,
Washington, D.C., pp.167-183, 2003.

Spinelli M. Neonaticide: A systemic investigation of 17 cases. In: Infanticide: Psychosocial and Legal
Perspectives on Mothers Who Kill. (Spinelli MG, ed) American Psychiatric Publishing, Inc., Washington,
D.C., pp 105-118, 2003.

Spinelli M: The promise of saved lives: recognition, treatment and prevention In: Infanticide: Psychosocial and Legal Perspectives on Mothers Who Kill. (Spinelli MG, ed) American Psychiatric Publishing, Inc., Washington, D.C., pp 235-265, 2003.

Spinelli MG and Endicott J. Controlled Clinical Trial of Interpersonal Psychotherapy vs. Parenting Education Program for depressed pregnant women. Am J Psychiatry 160(3): 555-562, 2003.