Longitudinal Course and Impact of Depression

描述(由申请人提供)：我们寻求支持来分析俄勒冈州青少年抑郁项目(OADP)的现有数据，以更好地了解严重抑郁障碍(MOD)的长期过程和结果。OADP是一个跨越多代人的项目，其中包括在一个大的社区样本中研究青少年精神病的患病率和风险因素；对先证者在成年前的诊断过程和心理社会结果进行纵向跟踪；对他们的一级亲属进行家庭研究；以及对他们的子女进行纵向研究。我们寻求通过使用最先进的数据分析技术解决集成这些组件的三个广泛问题来扩展此数据集的先前工作。1.心理社会功能和抑郁症状：发育。预测因素和结果。关于抑郁症状和心理社会功能的不同过程和结果，人们知之甚少。我们将确定这些地区在青春期的不同增长轨迹以及它们之间的相互关系，并检查不同轨迹的预期预测因素和长期结果。识别独特的生长模式、其风险因素及其结果将对减轻抑郁症的长期负担具有重要的筛查、预防和治疗意义。2.多器官功能障碍：共病。增长和长期结果。MOD通常与其他精神障碍并存，特别是物质使用障碍(SUDS)和焦虑症(ANX)。虽然MOD共病与许多领域的损伤增加有关，但对其病因和长期影响知之甚少。我们将检查MDD-SUD和MDD-ANX共病模型，基于风险和保护因素的模式以及单纯和合并疾病的长期结果。确定合并症的预期预测因素和长期结果将改善病因学，并为筛查和预防策略提供信息。3.代际结果：Psv病理学在三代人之间的传播。有证据表明MOD是家族性的，但MOD代际传播的情况和机制尚不清楚。我们将研究祖父母、父母和孩子之间传播的调节和调节模型，并检验精神病理学代际传播的诊断特异性。我们还将根据家族性MDD模式检查风险和保护因素概况。揭示MDD跨代传播的条件、机制以及风险和保护因素将对识别MDD疾病的风险人群具有重要意义，并指出潜在的干预目标。

DESCRIPTION (provided by applicant): We seek support to analyze existing data from the Oregon Adolescent Depression Project (OADP) to better understand the long-term course and outcome of major depressive disorder (MOD). The OADP is a multi-generational project that includes a study of prevalence and risk factors for adolescent psychopathology in a large community sample; a longitudinal follow-up of probands' diagnostic course and psychosocial outcomes through young adulthood; a family study of their 1st-degree relatives; and a longitudinal study of their children. We seek to extend prior work with this data set by addressing three broad issues that integrate these components using state of the art data analytic techniques. 1. Psychosocial Functioning and Depressive Symptoms: Growth. Predictors, and Outcomes. Little is known about distinct courses and outcomes of depressive symptoms and psychosocial functioning. We will identify distinct growth trajectories in and reciprocal relations between these areas through young adulthood, and examine prospective predictors and long-term outcomes of distinct trajectories. Identification of unique growth patterns, their risk factors, and their outcomes will have important screening, prevention, and treatment implications for reducing the long-term burden of depression. 2. MOD: Comorbidity. Growth, and Long-term Outcomes. MOD often co-occurs with other psychiatric disorders, particularly substance use disorders (SUDs) and anxiety disorders (ANX). Although MOD comorbidity is associated with elevated impairment in numerous domains, little is known about its etiology and long-term impact. We will examine MDD-SUD and MDD-ANX comorbidity models based upon patterns of risk and protective factors and long-term outcomes of pure and comorbid disorders. Identification of prospective predictors and long-term outcomes of comorbidity will improve nosology and inform screening and prevention strategies. 3. Intergenerational Outcomes: Transmission of Psvchopathology across Three Generations. Evidence indicates that MOD is familial, yet the circumstances under which and mechanisms by which MOD is transmitted across generations remain unknown. We will examine moderational and mediational models of transmission between grandparents, parents, and children, and examine the diagnostic specificity of intergenerational transmission of psychopathology. We will also examine risk and protective factor profiles according to familial MDD patterns. Uncovering the conditions, mechanisms of, and risk and protective factors for MDD transmission across generations will have important implications for identifying those at risk for the disorder and point to potential targets for intervention.