Longitudinal Course and Impact of Depression

描述（由申请人提供）：我们寻求支持，以分析现有的数据从俄勒冈州青少年抑郁症项目（OADP），以更好地了解长期的过程和结果的严重抑郁症（MOD）。OADP是一个多代项目，包括在大型社区样本中研究青少年精神病理学的患病率和风险因素;对先证者的诊断过程和心理社会结果进行纵向随访，直至成年;对其一级亲属进行家庭研究;对其子女进行纵向研究。我们试图通过解决三个广泛的问题，使用最先进的数据分析技术，整合这些组件，扩展以前的工作与此数据集。1.心理社会功能和抑郁症状：成长。预测者和结果。关于抑郁症状和心理社会功能的不同过程和结果知之甚少。我们将通过青年期确定这些领域的不同增长轨迹和相互关系，并研究不同轨迹的前瞻性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少抑郁症的长期负担具有重要的筛查，预防和治疗意义。2. MOD：科摩罗。增长和长期结果。MOD通常与其他精神疾病共同发生，特别是物质使用障碍（SUD）和焦虑症（ANX）。虽然MOD合并症与许多领域的损害增加有关，但对其病因和长期影响知之甚少。我们将根据单纯疾病和共病疾病的风险和保护因素以及长期结局的模式，研究MDD-SUD和MDD-ANX共病模型。确定合并症的前瞻性预测因子和长期结局将改善疾病分类学，并为筛查和预防策略提供信息。3.代际结果：三代人之间的精神病病理学传播。有证据表明，MOD是家族性的，但MOD跨代传播的情况和机制仍不清楚。我们将检验祖父母、父母和子女之间的适度和中介传播模型，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。揭示MDD跨代传播的条件、机制、风险和保护因素，将对识别那些有这种疾病风险的人产生重要影响，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.