Depression is a very common disorder that is most often chronic or recurrent in nature. Many subjects do not respond adequately to an initial antidepressant treatment trial. Subjects who do not respond adequately to multiple therapeutic interventions are considered to have treatment-resistant depression (TRD). Among the treatment options for subjects with TRD is Vagus Nerve Stimulation (VNS) Therapy.This blinded, randomized, multicenter controlled study is intended to collect evidence that VNS Therapy as an adjunctive therapy improves health outcomes for patients with TRD.
The current study aims to adapt and test a brief computer-assisted intervention for pregnant women with elevated posttraumatic stress symptoms. Twenty pregnant women in their first trimester will be invited to participate in the study if they endorse elevated posttraumatic stress symptoms. Along with self-report measures, hormones will be measured at baseline, one month post-intervention, three months post-intervention, and post-delivery. In addition, women will receive a psychoeducation + skills intervention during their first trimester and women will be offered a "booster session" intervention following delivery to enhance utilization of skills during a critical period for maternal mental and physical health outcomes.
The purpose of this research study is to determine if there is a difference in the way that people pay attention to their surroundings when they are depressed. This can be tested by using a line bisection test, where people with and without depression are asked to divide a line in half. We have hypothesized that people with depression, who are more self-reflective, will demonstrate a downward preference when they perform the line bisection test compared to people without depression.
Depression and insomnia occur together in a substantial number of patients. Transcranial magnetic stimulation (TMS) is an effective treatment for depression, but does not help insomnia symptoms in depressed patients. A form of cognitive behavioral therapy (CBT) has been developed that specifically helps with insomnia (CBT-I). We will give CBT-I to patients who are being treated with TMS for depression, who also have insomnia, to determine if it helps insomnia symptoms.
The purpose of this research study is to reduce psychological distress and improve communication and family centeredness of care for families of Ventilator Dependent Respiratory Failure (VDRF) patients that have undergone inter-ICU transfer by providing them with timely and adequate information about their transfer of care. This will be accomplished by the development and refinement of our Stressors of Inter-ICU Transfer Telehealth Tool (SITT). The study aims to assess reactions to mocked up SITT domains and support resources of 15-20 family members that have undergone inter-ICU transfer as well as 10 clinicians involved in transfer. The data will drive the refinement of the tool to best meet the needs of the families and clinicians.
The purpose of the study is to examine whether an investigational medication called ketamine, which comes in the form of a nasal spray, is able to improve treatment outcomes for concurrent opioid addiction and depression when used in conjunction with buprenorphine treatment. Study medications will be delivered twice per week for four weeks. If you are eligible and you decide to enroll in the study, your participation will last approximately 8 weeks, or 2 months.
The purpose of this study is to determine the effects of a brain stimulation technique known as transcranial direct current stimulation, or tDCS, on the benefits of Prolonged Exposure therapy, or PE, which is an effective treatment for posttraumatic stress disorder, or PTSD. tDCS has been demonstrated to be safe and effective for influencing brain activity by passing a weak electrical current through the scalp. In this study, tDCS is provided in addition to PE treatment, through the National Crime Victim's Research and Treatment Center at MUSC, or the PTSD Clinical Team Clinic within the Ralph H. Johnson VA Medical Center.
Pediatric traumatic injury (PTI) ? defined as unintentional injury requiring hospitalization and, often, extended periods of physical and emotional recovery ? is experienced by 300,000 children in the U.S. annually. Roughly 20-40% of children and caregivers develop posttraumatic stress disorder (PTSD) and/or depression following PTI, yet most U.S. trauma centers fail to provide even basic mental health screening post-injury. It is critical to advance our knowledge of available mental health services in trauma centers for this frequently overlooked population to accelerate their physical and emotional recovery. In this project, trauma center providers across the U.S. will complete a survey and a qualitative interview to assess their current protocols and resources available to screen and treat children and families' mental health in the aftermath of PTI, as well as their opinions regarding feasibility of implementing protocols to better address the emotional health recovery within this population.
Youth with one or more chronic diseases are at increased risk of further complications, disease, or even early death as they enter their adult years. Recent increases in both asthma and obesity among youth have led to high health care utilization, increased health-related complications, and expanded risks of subsequent cardiovascular disease burden. The research team will develop educational content in core areas (e.g., fatigue, physical activity) for Managing AsThma AnD Obesity Related Symptoms (MATADORS), an mHealth technology-enhanced nurse-guided intervention. Youth with asthma and obesity and their primary caregivers will participate in interviews to explore their perspectives on barriers, facilitators, needs, and preferences toward adopting health behaviors, medication adherence, disease awareness, symptom self-management behaviors, and utilization of a mobile smartphone platform. Additional details on content availability, delivery approaches, system needs, and functionality will be explored through semi-structured interview questions. Health care providers (physicians, nurses, nurse practitioners, dietitians, and respiratory and exercise therapists) will be invited to participate in interviews to seek their input on patient-caregiver needs, priority clinical focal areas, recommendations for symptom self-management, and preferences for intervention delivery. Interview findings will be used to inform intervention and app design. Providing youth with strategies to enhance symptom self-management may result in decreased symptom prevalence, improved quality of life, and long-term reduction of cardiovascular morbidity and mortality as they move into adulthood.
PTSD is a prevalent condition for which veterans frequently seek treatment in the VA healthcare system. There are a number of first-line PTSD treatment approaches available, such as Prolonged Exposure and Cognitive Processing Therapy. However, the efficacy rates of these treatments is not as high as what has been observed with civilian populations and approximately 36% of individuals drop out of these treatments prematurely. A proposed alternative to these treatments is Written Exposure Therapy (WET), a brief, 5 session intervention that has been shown to reduce symptoms of PTSD and contribute to lower dropout rates. The goal of this study is to investigate whether WET is as effective compared to Prolonged Exposure (PE) in the treatment of PTSD in a sample of veterans diagnosed with PTSD. It will involve approximately 150 Veterans. This research is funded by the Department of Veterans Affairs.