PSYCHOBIOLOGY OF DEPRESSION: CLINICAL STUDIES

NIMH临床研究分支合作项目 抑郁症的心理生物学（“协作性抑郁症 研究”）正在研究疾病分类学、临床病程和随访， 情感障碍的家庭、遗传和心理社会因素 紊乱 合作抑郁研究的样本包括 955名先证者（包括住院患者和门诊患者），2，252名一级 亲属和404名匹配的对照，以及337名先证者的配偶。 目前，先证者每年接受随访，并进行6次- 一年重新评估亲属，配偶和控制，是近 完成 本申请建议（a）完成六年期 重新评估亲属、配偶和控制;（B）完成 每半年对250名高危亲属进行评估;（c） 继续对先证者和亲属数据进行数据分析;以及 (d)每年对先证者进行随访。 对亲属、配偶和控制权的重新评估允许 作为家庭功能的个人前瞻性评估 负荷、社会人口统计变量和个性。 这 样本包括大量的个人，没有 首次评估前有精神疾病史。 的 因此，六年期重新评价提供了一个机会， 首次发病的危险因素的前瞻性评估 情感障碍 对于那些之前有情感障碍史的受试者， 第一次评估，这个样品提供和优秀 研究预测因素或未来事件的机会， 轻度抑郁症的临床过程。 最后，主题 非情感性疾病的患者将被用于研究 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 2岁时终生精神病史的独立评估 时间点正在制定中。 这个过程允许 量化和提高诊断稳定性。 新 正在开发的方法将测量 诊断的敏感性和特异性，诊断的有效性， 家庭传播和长期趋势。 来自家庭的250名高危受试者正在接受 每半年重新评估一次，为期3年;预计每季度评估一次 经历严重的抑郁症 最后，盲目重新评估 前3年将允许项目的有效性措施 在对整个亲属样本的随访中评估。 此外，轻度和未经治疗的发作将在 与先证者的严重发作相同， 更广泛的解释我们的发现。

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.