Major Mental Disorders from Childhood to Adulthood

描述（由申请人提供）：目的：拟议的研究旨在 了解四种行为障碍：抑郁症，精神分裂症， 反社会和药物滥用障碍。在所有四种疾病中， 亚型已经被提出来作为一种分割异质性的方法， 阻碍科学理解。我们将研究每一个内部的异质性， 在生命的前三十年，通过分析发病的变化， （早期与晚期）和后续过程（持续性，复发性或有限）。 我们的目标是确定的存在，判别效度，和影响， 疾病中的发育亚组。方法：达尼丁研究追踪了 1972年新西兰出生的1,000名男子的代表性队列的发展 以及出生时和年龄为3、5、7、9、11、13、15、18、21和26岁的女性。新数据 将在31岁时聚集从童年到31岁的精神病学数据将被 分析以确定每种疾病中的发育亚组。假设 地址：（a）不同的儿童风险因素和家庭精神病史 对于发展亚组，（B）工作生活、家庭 生活和身体健康的发展亚组，（c）近端生活事件 （d）时间共病序列，其中 一种类型的疾病可靠地导致另一种疾病，以及（f）研究结果是否适用 男性和女性，或者是否需要特定性别的模型。影响到 诊断：研究结果将改善目前的DSM分类系统， 使临床医生能够使用发育史来了解更多关于 疾病的可能病因和预后。对预防的影响： 调查结果将（a）产生调整干预措施的建议， 发育亚型，（B）阐明预防发病的相对重要性 （c）确定对许多人造成普遍风险的因素 （d）指出了疾病的常见顺序， 这表明治疗病症A可以预防病症B。 遗传和神经科学研究的意义：研究结果将表征 精神病表型更精确，并显示哪些亚型具有家族性 和神经发育的相关性。

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.