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，以更好地了解重度抑郁症（MOD）的长期病程和结果。OADP是一个多代人的项目，包括在一个大的社区样本中研究青少年精神病理学的患病率和风险因素；先证者诊断过程和心理社会结局的纵向随访研究一级亲属的家庭研究；以及对他们孩子的纵向研究。我们试图通过解决使用最先进的数据分析技术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：成长。预测因素和结果。人们对抑郁症状和心理社会功能的不同病程和结果知之甚少。我们将确定这些区域在青年时期的不同生长轨迹和相互关系，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. 国防部:合并症。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伤升高有关，但对其病因和长期影响知之甚少。我们将根据风险和保护因素的模式以及单纯和共病疾病的长期结果来检查MDD-SUD和MDD-ANX共病模型。确定合并症的前瞻性预测因素和长期结果将改善分类学，并为筛查和预防策略提供信息。3. 代际结果：精神病理在三代之间的传递。有证据表明，MOD是家族性的，但MOD在什么情况下以及通过什么机制在几代人之间传播仍然未知。我们将研究祖父母、父母和孩子之间传播的适度和中介模型，并研究精神病理学代际传播的诊断特异性。我们还将根据家族性重度抑郁症模式检查风险和保护因素概况。揭示重度抑郁症跨代传播的条件、机制、风险和保护因素，将对识别患有该疾病的风险人群和指出潜在的干预目标具有重要意义。

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.