Looking Back, Moving Forward-Reflecting on a Career in Psychiatric Research.

Abstract

The arc of my career has focused on the integration of clinical care, mentoring, and research, leading to meaningful research questions and intervention trials advancing the field. In this Special Communication, I first offer a brief synopsis of my work as an academic psychiatrist, highlighting mission, themes and publications, sponsors, and collaborators. I then discuss activities as a mentor, focusing on 2 National Institute of Mental Health (NIMH)-funded research career development programs. As the past recipient of K01, K02, and K05 awards from the NIMH (1980-2000), I have taken to heart the obligation to pay it forward: to support, advise, instruct, and guide younger colleagues, challenging them academically and professionally. For 20 years, my P30 infrastructure center grant provided a platform for institutional training grants (T32s) and psychiatric research education grants (R25s) to serve as a foundation for training the next generation of clinical scientists in late life mood disorders, as well as a nidus for interdisciplinary collaboration. I have benefitted greatly from having had mentors and wise friends, particularly David Kupfer, MD; Ellen Frank, PhD; and Thomas Detre, MD, of the University of Pittsburgh School of Medicine; colleagues in the Aging Branch of NIMH throughout my 40-year career as a physician scientist; Dilip Jeste, MD, University of California at San Diego; Daniel Blazer, MD, PhD, Duke University School of Medicine; George Alexopoulos, MD, Weill Cornell School of Medicine; John Rush, MD, University of Texas Southwestern School of Medicine; Alan Schatzberg, MD, Stanford University School of Medicine; M. Katherine Shear, MD, Columbia University Schools of Social Work and of Medicine; Helena Kraemer, PhD, Stanford University School of Medicine; and Edmund Ricci, PhD, University of Pittsburgh Graduate School of Public Health. These colleagues are good listeners, flexible, diverse in perspectives, knowledgeable, nonjudgmental, and able to give constructive feedback, network, and help find resources. I have sought to do likewise with many younger colleagues, both men and women, physicians and PhDs, and persons of different professional, racial, and ethnic backgrounds-totaling about 25 K awardees. I conclude with recommendations for future clinical practice and research in late-life depression, describing a broad spectrum of approaches aiming both to reduce its public health burden and to enhance wisdom, resilience, and well-being in later life.