Epidemiologic approaches to investigating the relationship between insulin resistance and major depressive disorder
Abstract/Contents
- Abstract
- Major depressive disorder (MDD) is one of the most prevalent psychiatric disorders in the United States, with one in five adults experiencing the disorder in their lifetimes.1 Yet more than half of people with MDD do not achieve an adequate response to treatment with existing antidepressants, and a substantial subset of these individuals fails to respond to multiple courses of treatment. Considerable effort has been aimed at uncovering the causes of MDD and developing new strategies for treatment and prevention, but more than 90% of behavioral neuroscience results fail to translate to treatments or other effective clinical strategies to treat people with MDD. This dissertation explores whether epidemiology can facilitate this translational process by introducing strategies to evaluate the nature and plausibility of neurobiological findings before the implementation of randomized controlled trials or other expensive and time-consuming psychiatric research. We undertook this translational question by investigating the relationship between MDD and one modifiable risk factor: insulin resistance (IR). IR has been associated with several somatic disorders, including cardiovascular disease, chronic kidney disease, Alzheimer's disease, and MDD. Yet, little is understood about the nature of the relationship between IR and MDD beyond an association between the prevalence of the two conditions. Is possible that IR plays a role in the development, trajectory or treatment of MDD? Chapter 1 of this dissertation evaluated the biological plausibility of relationship between IR and MDD. Chapters 2 and 3 studied the relationship between IR and characteristics and occurrence of MDD in a Dutch cohort. Chapter 4 attempted to address a key question from Chapter 1: is it possible to intervene on the IR-MDD pathway in order to effect depression treatment response? We conducted two emulated target trials to evaluate the causal relationship between an insulin-sensitizer, pioglitazone, and the one-year risk for treatment-resistant depression. Taken together, these studies aimed to expand our understanding of the relationship between IR and MDD. At the same time, they represent an epidemiology-based strategy for gaining insight into whether promising neuroscientific findings will translate into effective clinical approaches for treating MDD
Description
| Type of resource | text |
|---|---|
| Form | electronic resource; remote; computer; online resource |
| Extent | 1 online resource |
| Place | California |
| Place | [Stanford, California] |
| Publisher | [Stanford University] |
| Copyright date | 2020; ©2020 |
| Publication date | 2020; 2020 |
| Issuance | monographic |
| Language | English |
Creators/Contributors
| Author | Watson, Kathleen Tamara |
|---|---|
| Degree supervisor | Simard, Julia |
| Thesis advisor | Simard, Julia |
| Thesis advisor | Baiocchi, Michael |
| Thesis advisor | Henderson, Victor W |
| Thesis advisor | Rasgon, Natalie L |
| Degree committee member | Baiocchi, Michael |
| Degree committee member | Henderson, Victor W |
| Degree committee member | Rasgon, Natalie L |
| Associated with | Stanford University, Department of Epidemiology |
Subjects
| Genre | Theses |
|---|---|
| Genre | Text |
Bibliographic information
| Statement of responsibility | Kathleen Watson |
|---|---|
| Note | Submitted to the Department of Epidemiology |
| Thesis | Thesis Ph.D. Stanford University 2020 |
| Location | https://purl.stanford.edu/vg021mg8299 |
Access conditions
- Copyright
- © 2020 by Kathleen Tamara Watson
- License
- This work is licensed under a Creative Commons Attribution Non Commercial 3.0 Unported license (CC BY-NC).
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