The most innovative ideas are those least likely to be funded by grant-making agencies. The Executive Director's Innovation Fund was established in 2005 to implement creative, new, and bold ideas that help us achieve our mission and provide national leadership in conquering depression and bipolar disorder. Innovations in research, treatment, education and public policy are supported by this fund, with a special focus on using the latest information technology, bioengineering, and biomedical advances to address depression and bipolar illness.
Research on Exercise and Depression in Youth; The GREAT Project: Groups Receiving Exercise As Treatment
Evaluating the inkblots videos as an intervention to improve college student mental health
Chronic Care Management Intervention Dissemination
Brain Fitness: Its Role in Counteracting Depression and Related Conditions
E-Minder: Personalizing Self Management
Work is Therapeutic: An integrative approach to addressing depression in the workplace
|2008||Maria Muzik/James Cranford
Teens as Innovators/Peer-to-Peer Depression Awareness Campaign
Peer Support: Improving Depression Management in a Global World
The Cognitive and Physiological Bases of Affective Decision Making in Depression
The Healthy Minds Study
Early Childhood Risk Associated with Maternal Depression
Pilot Testing a Depression Screening and Intervention Innovation in a Primary Care System Serving a Low-Income, Uninsured, Urban Population
Gene Expression Alterations in the Monoaminergic Circuits of Depressed and Bipolar Subjects
Richard Dopp, M.D.
Research on Exercise and Depression in Youth; The GREAT Project: Groups Receiving Exercise As Treatment
Building upon previous projects investigating the effects of individual exercise sessions as treatment for depression in youth, the GREAT Project studied the effects of a group exercise intervention for teens with depression. Thirteen adolescents with depression participated in the 12-week intervention in which they were expected to exercise three times per week, once in a supervised group setting at the University of Michigan Depression Center and twice on their own in their community. Depression levels were significantly reduced during the 12 weeks of the exercise intervention. Physical fitness levels were significantly increased. Participants with greater increases in physical fitness had greater reductions in depression and suicidal ideation. The Director’s Innovation Fund also supported Dr. Dopp’s study of serum biomarkers to further explore the mechanisms through which exercise exerts its antidepressant effects. Interestingly, levels of brain-derived neurotrophic factor (BDNF), known as fertilizer for the brain, was significantly increased from baseline to week 12 in those adolescents with depression who completed the intervention.
Daniel Eisenberg, Ph.D.
Evaluating the inkblots videos as an intervention to improve college student mental health (2012)
This project is evaluating the potential of the inkblots video series to serve as an engaging and accessible medium for delivering evidence-based self-help skills to improve resilience and mental health. Eisenberg’s team is testing the effectiveness of the videos (which are based on Cognitive Behavioral Therapy principles) among college students and will also begin to explore their application for large employer populations.
Amy Kilbourne, Ph.D., M.P.H.
Chronic Care Management Intervention Dissemination (2010)
The goal of this pilot study is to implement an evidence-based Chronic Care Model (CCM) for mood disorders within the National Network of Depression Centers (NNDC), and preliminarily evaluate the feasibility, fidelity, and effectiveness of the CCM over time. The main products of this proposal include 1) a combined, evidence-based consumer toolkit and provider training program for depression and bipolar disorder CCMs that can be further disseminated within the NNDC, and 2) implementation of a common assessment tool to track patient outcomes in NNDC-affiliated clinics over time to facilitate the uptake of evidence-based treatment models, regular outcomes assessment of patients, and, ultimately, development of a business plan for private sector clinical implementation of mood disorder CCMs. Findings from this demonstration pilot program will help inform further dissemination of evidence-based practices and outcomes assessment within NNDC and beyond.
Simon Evans, Ph.D.
Brain Fitness: Its Role in Counteracting Depression and Related Conditions (2008)
Research shows that quality nutrition, sufficient exercise and adequate sleep may be beneficial in the treatment of depression and bipolar disorder. Dr. Evans’ project aims to promote healthy behavior in people with psychiatric illness and those at increased risk of such illness. The proposed approach included building an online social network where patients, caregivers and health care providers could learn about the role of healthy lifestyles in psychiatric illness, provide social support and interact with each other. At the onset of this project, online social networks promised to be useful in such an application.
When this project began in late 2008, Facebook had a global reach of about 10% of internet users. A few years later, Facebook was the second-most popular internet site in the world (behind Google) and reached nearly 40% of internet users on a daily basis. Therefore, rather than try to attract users to a new social network, the project changed directions to use Facebook and other popular sites to drive traffic to the U-M Depression Center’s online toolkit . Using many of the same strategies originally proposed, the project is now utilizes article marketing to disseminate non-technical summaries of scientific studies on the broad topic of the role of healthy lifestyles in mental health, in order to help patients and caregivers make informed decisions that may help them recover from psychiatric illness.
Kevin Kerber, M.D.
E-Minder: Personalizing Self Management (2008)
The overall goal of Dr. Kerber’s project is to help patients achieve remission by reminding them of their personal strategies for self-management, their personalized sources of support and, after they achieve remission, reminding them of their original symptoms of depression so that they can monitor for recurrence. This would be accomplished through personalized email reminders (“E-Minders”) that would be sent to the patent at predetermined intervals, established jointly by the therapist and patient, and would include key elements that may help with treatment continuity, self-management and support. In addition, the e-mail will serve as a link to the MSTRIDES system outcomes system so that patients can monitor their symptoms. Findings from a needs assessment suggest that patients would be interested in using the E-minder program; however, the program should serve as a supplement to their current depression treatment regimen and should not replace any aspect of their regimens.
Philip Margolis, M.D.
Work is Therapeutic: An Integrative Approach to Addressing Depression in the Workplace (2008)
Work is a central facet of modern life, and depressive disorders can significantly impact an individual’s ability to find, retain, and regain meaningful employment. Facilitating the development of employer and institutional policies aimed at helping individuals with depressive disorders find employment, stay employed, contribute to their fullest potential, and/or regain employment was this study’s aim. This project involved collaborating with employers through a process of “mutual education” by investigating how social stigma and workplace policies can be changed to improve the lives of depressed workers. The mutual education included interviews and qualitative group discussions with stakeholders from several regional employers (large and small, innovative and traditional) to elucidate thinking or percepts about depression in general, and about the costs/benefits, and economic, personal, and social implications of policy options regarding mental health problems at the workplace; dissemination of educational materials on depression, and the development of a “toolkit” with employers concerning depression in the workplace, and a symposium of mental health professionals and employer representatives held at the Depression Center focused on disseminating the “lessons learned” from this project to other stakeholders.
Maria Muzik, M.D., M.S.
James Cranford, Ph.D.
Teens as Innovators (2008)
The Teens as Innovators project was built on the premise that teens are more likely to listen to their friends than to well-meaning adults. The project aims to reduce stigma, raise awareness, and ultimately promote the early detection of depression, bipolar disorder, and related illnesses.
The project provides the education and resources necessary to support teams of students from each of the six Ann Arbor public high schools to develop innovative new ideas to effectively reach their peers with depression awareness and stigma reduction messages. After attending a day-long educational conference at the Depression Center, student teams develop plans for their public awareness campaigns, which the students then implement during the school year. Read more about the innovative public awareness campaigns here.
The project team hopes that creating the awareness campaigns is a learning experience for those involved, and that participating students will spread their knowledge and understanding to others in their school, increasing the likelihood of early detection of depression among those who are at greatest risk of experiencing the first onset of a depressive episode. This collaboration between the Depression Center and the Ann Arbor Public Schools, now known as the Peer-to-Peer (P2P) Depression Awareness Campaign and led by James Cranford, Ph.D., continues under funding from the Michigan Institute for Clinical & Health Research.
Marcia Valenstein, M.D.
Peer Support: Improving Depression Management in a Global World (2008)
Dr. Valenstein’s project aims to pilot test and internet telephone-based peer support intervention in which patients in treatment for depression are matched with local and international “peer partners” to allow 24-7 availability of support interactions – a potential key element in enhancing peer support effectiveness. Peer partners will receive communications training, an online manual outlining depression management and mood-enhancing behaviors, and will be asked to call local or international partners during appropriate local hours. The project will be a first step in forming longer-term relationships across national boundaries with depression health services groups interested in efforts to activate, educate, and link individuals with depressive disorders in a global world. Dr. Valenstein and her team have developed the interactive website and have completed human subjects applications in all three international sites, and are now awaiting resolution with contracting.
Melynda Casement, Ph.D.
The Cognitive and Physiological Bases of Affective Decision Making in Depression (2006)
Dr. Casement’s work continues as part of a larger study with Drs. Patricia Deldin and Roseanne Armitage at U-M. The project addresses hypothesized interactions between affective processing and chronophysiology in depression. The specific aim of the research is to assess whether working memory updating and sleep measures predict decision-making skill in controls and individuals with Major Depressive Disorder (MDD).Ultimately, the studies in this project may lead to therapeutically beneficial integration of two leading treatments for depression, cognitive therapy and chronotherapy.
First, extensive evidence suggests that depression is associated with biased attention and memory for affective events, biases in expectations for future affective events are largely unexamined. Thus, the first study measured anticipation for future affective events in both individuals with dysthymia (DYS) and healthy controls during a computerized task. The results demonstrated that healthy controls and individuals with DYS exhibit different behavioral and neurophysiological biases in anticipation for future affective events, lending experimental support to leading cognitive models of depression that emphasize the role of future-oriented affective biases.
Secondly, depression is associated with chronophysiological disruption and difficulty making decisions, but the relationship between circadian-homeostatic processes and decision making is not well understood. The second study examined the impact of time of day, sleep duration, and participant sex on decision making skill. Results highlighted the interaction between chronophysiology and participant sex in studies of incentive-based decision making.
Third, disruptions in chronophysiology contribute to the onset and maintenance of depression, and rhythmic oscillations in brain activity during sleep may influence affective processing. However, ultradian sleep rhythms in depression have not been fully characterized. Thus, the third study examined the rhythmicity of bursts of fast- and slow-frequency activity during sleep in individuals with major depressive disorder (MDD) and healthy controls. Results suggested that the amount of beta-frequency activity, rather than the organization of this activity across the night, is pathological in MDD.
These three studies in this project address critical gaps in the literature on affective bias in depression, circadian-homeostatic effects on affective processing, and organization of brain activity during sleep in MDD. Further research on depression-related cognition and chronophysiology may ultimately benefit existing therapies for depression. Chronotherapies, which organize circadian rhythms and adjust the sleep-wake homeostat, may benefit affective processing and/or goal-directed behavior. Consequently, cognitive therapy for depression may be maximally effective when it both targets specific processing biases (e.g., affective memory) and capitalizes on the benefits of circadian rhythms and sleep. Research that delineates the relationship between affective processing and chronophysiology may result in greater synthesis between depression treatments and ultimately reduce the profound personal and socioeconomic repercussions of this pernicious illness.
Daniel Eisenberg, Ph.D.
The Healthy Minds Study (2006)
Dr. Eisenberg’s Innovation Fund project, the Healthy Minds Study, has successfully evolved in to an annual national survey of college students about mental health, help-seeking behavior, and related issues which has expanded to over 50 campuses across the county. The original aims of the project were learn more about how college student depression and mental health evolves over time and, more broadly, to learn more about depression in college students on a national scale. The pilot funding has served as the key bridge between the pilot study (conducted in 2005) and the expansion of the study into a major research agenda. Data from the Healthy Minds study has helped support new projects funded by NIMH (RC1 and R34 awards) and the William T. Grant Foundation. This research is leading to new understanding of the returns—in terms of health, academic success, and economic productivity – from investing in the mental health of college students, and how to achieve those returns most efficiently.
Heather Flynn, Ph.D.
Early Childhood Risk Associated with Maternal Depression (2006)
The purpose of this pilot project was to begin to investigate possible mechanisms of transmission of risk to offspring of mothers with perinatal depression, with the overall goal of depression prevention. The study was designed to test the hypothesis that children of mothers who were depressed around the time of pregnancy will have significantly poorer behavioral, medical, and sleep related outcomes than children of non-depressed mothers. Each of these hypothesized factors has been linked to greater risk for the development of depression, other psychiatric illnesses, and behavioral problems in childhood (e.g. substance abuse). This pilot work was concurrently used to begin a registry of women with a history of MDD and a control group of non-depressed women and their children. Comprehensive psychosocial and biologic measures which were initiated in pregnancy in the mothers can be collected longitudinally in the children throughout childhood and adolescence. This data set will better elucidate the psychosocial antecedents and biologic predictors of risk in children of depressed women. These predictors, in turn, can better identify youth at risk so that appropriate interventions can be designed.
Leslie Hollingsworth, Ph.D., M.S.W.
Pilot Testing a Depression Screening and Intervention Innovation in a Primary Care System Serving a Low-Income, Uninsured, Urban Population (2006)
Interest in depression in primary care patients has been followed by a number of randomized clinical trials testing depression screening and intervention. However, these have involved private medical settings or multi-session interventions. This study aimed to pilot a project helping improve the care of low income, uninsured persons in the City of Detroit who suffer from depression.
Data collection aimed to establish the prevalence of depression in an urban population of low income, uninsured patients with chronic medical conditions enrolling for care management, identify rates of common co-morbid mental and physical health disorders, provide initial assessment of perceived barriers to depression, establish receptiveness to treatment, strengthen linkages with available community mental health specialists, and assess the effectiveness of one approach to increasing rates of participation in a depression- and other chronic illness-focused care management program.
This study sought to increase depression detection and intervention in the study population and ultimately yield information that primary care providers could use to enhance their depression services.
Ilan Kerman, M.D., Ph.D.
Gene Expression Alterations in the Monoaminergic Circuits of Depressed and Bipolar Subjects (2006)
Dr. Kerman’s Innovation Fund award project resulted in high-throughput analyses of gene expression alterations in depression in the locus coeruleus and dorsal raphe, two brain regions that provide much of the norepinephrine and serotonin, respectively, in the brain. The long term objective of this research was to improve understanding of the pathophysiology of depression, and develop new leads for novel targets for pharmacological interventions.
The initial efforts focused on developing a precise method for harvesting tissue from these discrete brain regions in the human post-mortem brain. To this end, Dr. Kerman and his team developed a novel approach that utilizes in situ hybridization-guided laser capture microdissection method to harvest high quality mRNA that is compatible with downstream high throughput gene expression analyses. Using this approach, the research team documented alterations in the expression of glial and glutamate genes in the locus coeruleus in major depression. These systems interact to determine the level of neuronal activation, and these changes, therefore, may represent alterations in the excitability of norepinephrine-synthesizing cells in depression.
In the serotonergic system, Dr. Kerman and his team observed complex interactions among age, suicidality, depression, and antidepressant drug treatment in their impact on the expression of key serotonergic genes. Such complex interactions suggest that different depressive states (e.g. depression in older vs. younger individuals, or depression with and without suicidality) may be due to distinct neurochemical profiles. Finally, the data also point to the dysregulation of multiple transcription factors in the serotonin system in depression. These genes regulate expression of multiple other downstream genes, and thus have the potential to impact a number of biological systems. The transcription factors that were identified can potentially impact neuronal plasticity, neuronal excitability, and brain development, thus providing clues for novel neurobiological mechanisms underlying depression as well as potential new targets for pharmacological interventions.
This research led to the successful funding of a NARSAD Young Investigator Award and a K-99 training grant from NIMH.