PSYCHOBIOLOGY OF DEPRESSION: CLINICAL STUDIES

美国国立卫生研究院临床研究分会合作计划 抑郁症的心理生物学(“协作性抑郁症” 研究“)是研究病因学、临床病程和随访， 情感性精神障碍的家族遗传和心理社会因素 精神错乱。协作性抑郁症研究样本包括 955名先证者(住院患者和门诊患者)，2252名一级患者 亲属和404名匹配的对照组，以及337名先证者的配偶。 目前，先驱们每年都会被跟踪，有六个- 对亲属、配偶和控制权的重新评估，这一年几乎 完成。 本申请书建议(A)完成为期六年的 重新评价亲属、配偶和控制；(B)完成 对250名高危亲属进行半年度评估；(C) 继续对先证者和相关数据进行数据分析；以及 (D)继续每年对先证者采取后续行动。 对亲属、配偶和控制的重新评估允许 作为家庭功能的个人的前瞻性评估 负荷量、社会人口统计变量和个性。这 样本包括相当数量的没有 在第一次评估前有精神障碍史。这个 因此，六年的重新评估为True提供了机会 首次发病危险因素的前瞻性评估 情感障碍。 对于在此之前有情感障碍病史的受试者 第一次评价，这个样本提供的是优秀的 有机会研究预测因素或未来的情节和 轻度抑郁症的临床病程。最后，主题 非情绪性疾病将被用来研究预测 继发性抑郁症及其与未经治疗的酒精中毒的关系 和焦虑症。 两岁时对终生精神病史的独立评估 时间点正在被确定。此过程允许 量化和提高诊断稳定性。新的 正在开发中的方法将测量 诊断的敏感性和特异性、诊断的有效性、 家族性传播和世俗趋势。 来自家庭的250名高危对象正在接受 每半年重新评估一次，为期3年；预计将有四分之一 来体验严重的抑郁症。最后，盲目地重新评估 之前的3年将允许对物品的有效性进行测量 在对整个亲属样本的随访中进行评估。 此外，轻微和未经治疗的发作将在 与先证者的严重插曲相同，允许更多 对我们的发现进行更广泛的解释。

The NIMH Clinical Research Branch Collaborative Program on the Psychobiology of Depression ("Collaborative Depression Study") is studying the nosology, clinical course and followup, familial and genetic, and psychosocial factors of affective disorders. The Collaborative Depression Study samples include 955 probands (both inpatients and outpatients), 2,252 first-degree relatives and 404 matched controls, and 337 spouses of probands. At present, the probands are being followed annually and a six- year reevaluation of relatives, spouses, and control, is nearly completed. This application proposes (a) completion of the six-year reevaluation of relatives, spouses, and controls; (b) completion of the semi-annual assessment of 250 high-risk relatives; (c) continuation of data analysis of proband and relative data; and (d) continued yearly followup of the probands. Reevaluation of relatives, spouses and controls allows prospective assessment of individuals as a function of familial loading, sociodemographics variables, and personality. This sample included a substantial number of individuals with no history of psychiatric disorder prior to the first evaluation. The six-year reevaluation therefore allows an opportunity for true prospective assessment of risk factors for first onset of affective disorder. For those subjects with a history of affective disorder prior to the first evaluation, this sample provides and excellent opportunity to study the predictors or future episodes and the clinical course of a milder form of depression. Finally, subjects with non-affective illness will be used to study predictors of secondary depression and its relationship to untreated alcoholism and anxiety disorders. Independent assessments of lifetime psychiatric history at two points in time are being made. This procedure allows quantification and improvement of diagnostic stability. New methods that are in the process of being developed will measure sensitivity and specificity of diagnosis, diagnostic validity, familial transmission and secular trends. Two hundred and fifty high risk subjects from families are being re-evaluated semi-annually for 3 years; one-quarter are expected to experience major depression. A final, blind reassessment of the preceding 3 years will permit a measure of validity for items assessed in the follow-up of the entire sample of relatives. Furthermore, mild and untreated episodes will be followed in the same way as the severe episodes in probands permitting more wider interpretation of our findings.