Major Mental Disorders from Childhood to Adulthood

描述(由申请者提供)：目的：拟议的研究旨在 建立关于四种行为障碍的知识：抑郁症，分裂样， 反社会和药物滥用障碍。在所有四种疾病中，发育 现在，亚型已经被提出作为一种分割异质性的方法 妨碍科学理解的。我们将研究每个组件中的异质性 通过分析发病的变化，研究出生后前三十年的精神障碍 (早期与晚期)和后续病程(持续性、复发性或局限性)。 我们的目标是确定存在、判别效度和含义。 障碍内的发育亚群。方法：达尼丁的研究追溯了 1972年具有代表性的1000名新西兰男性出生队列的研究 以及出生时以及3、5、7、9、11、13、15、18、21和26岁的女性。新数据 将在31岁时聚集在一起。从儿童到31岁的精神病学数据将是 分析以确定每个疾病中的发育亚群。假设 地址：(A)不同的儿童风险因素和家庭精神病病史 对于发育亚组，(B)不同的成年人在工作、生活、家庭方面的结果 发展亚组的生命和身体健康，(C)最近的生活事件 导致成人起病的疾病，(D)时间共病序列，其中 一种类型的障碍可靠地导致另一种类型的障碍，以及(F)研究结果是否适用 给男人和女人，或者如果需要特定性别的模特。对以下方面的影响 诊断：调查结果将通过以下方式改进当前的DSM分类系统 使临床医生能够利用发育史更多地了解 疾病的可能病因和预后。对预防的影响： 调查结果将(A)提出调整干预措施以适应 发展亚型，(B)阐明预防发病的相对重要性 与复发相比，(C)确定对许多人构成普遍风险的因素 将障碍作为最高预防优先事项，(D)指出常见的 障碍，这表明治疗障碍A可以预防障碍B。 对遗传和神经科学研究的影响：研究结果将成为 更准确的精神表型，并显示哪些亚型有家族性 和神经发育相关。

DESCRIPTION (provided by applicant): Objective: The proposed research aims to build knowledge about four behavior disorders: depression, schizophreniform, antisocial, and substance abuse disorders. In all four disorders, developmental subtypes have been proposed as a way forward to carve up the heterogeneity now hindering scientific understanding. We will study heterogeneity within each disorder over the first three decades of life, by analyzing variation in onset (early versus later) and subsequent course (persistent, recurrent, or limited). We aim to ascertain the existence, discriminant validity, and implications of developmental subgroups within disorders. Methods: The Dunedin Study has traced the development of a representative 1972 birth cohort of 1,000 New Zealand men and women at birth and ages 3, 5, 7, 9, 11, 13, 15, 18, 21, and 26. New data will be gathered at age 31. Psychiatric data from childhood to age 31 will be analyzed to identify developmental subgroups within each disorder. Hypotheses address: (a) different childhood risk factors and family psychiatric histories for developmental subgroups, (b) different adult outcomes in work life, family life, and physical health for developmental subgroups, (c) proximal life events that precipitate adult-onset disorder, (d) temporal comorbid sequences in which one type of disorder reliably leads to another, and (f) whether findings apply to men and women, or if sex-specific models are needed. Implications for diagnosis: Findings will improve the current DSM classification system by enabling clinicians to use developmental history to know more about a disorder's probable etiology and prognosis. Implications for prevention: Findings will (a) yield recommendations for tailoring interventions to fit developmental subtypes, (b) clarify the relative importance of preventing onset versus recurrence, (c) identify factors posing pervasive risk for many disorders as top prevention priorities, (d) point to common sequences of disorders, which suggest that treatment of disorder A may prevent disorder B. Implications for genetic and neuroscience research: Findings will characterize psychiatric phenotypes more precisely, and show which subtypes have familial and neuro-developmental correlates.