Principal Investigator/Program Director (Last, First, Middle): StfOber, Michael A DESCRIPTION: State the application's broad, long-term objectives and specific aims, making reference to the health relatedness of the project. Describe concisely the research design and methods for achieving these goals. Avoid summaries of past accomplishments and the use of the first person. This abstract is meant to serve as a succinct and accurate description of the proposed work when separated from the application. If the application is funded, this description, as is, will become public information. Therefore, do not include proprietary/confidential information. DO NOT This competing continuation of the study 'Course and Outcome of Bipolar Youth' (COBY) will extend the follow- up of the sample to 6 to 10 years. COBY is a collaborative undertaking by the University of Pittsburgh, Brown University, and UCLA to investigate the prospective and longitudinal course of pediatric bipolar disease. As of 10/1/2004, 392 subjects (168 children and 224 adolescents) were enrolled in COBY, with a projected enrollment of 481 by the time of grant renewal, which surpasses the expected total enrollment proposed in the original application (n=420). Subjects at intake range in age from 7-17 years and have a diagnosis of Bipolar I, II, or NOS disorder. While the current wisdom assumes pediatric bipolar disorder to be a severe, chronic illness, a multitude of scientifically and clinically compelling questions regarding its course and outcome remain unanswered. Limited data exists on how illness course, phenomenology, and treatment responsiveness are influenced by the developmental transition between childhood and adolescence, and between adolescence and adulthood. The unprecedented scientific and public health implications of COBY are that we will accrue ten years of observational data on a large, clinically diverse cohort of rigorously diagnosed subjects in order to: (1) describe the extended naturalistic course of recovery and recurrence patterns; (2) identify predictors of long-term outcome and course trajectories; (3) describe psychosocial outcomes from childhood to early young adulthood; and (4) describe treatments received and their effects in mediating course patterns. Continued follow-up of the COBY sample will make it possible to develop more comprehensive knowledge on these aims given its large size, ascertainment from multiple sites, demographic and clinical diversity, and inclusion of subjects across the broad range of disease severity. Subjects are assessed at 6- month intervals using adaptations of instruments from the successful adult Collaborative Depression Study (CDS). An additional 5 years of follow-up of this unique sample is necessary to observe a sufficient number of new recoveries, recurrences, and state transitions to more definitively depict the long-term psychopathologic course, predictors, psychosocial outcomes and treatment effects of early onset bipolar illness, and to characterize developmental transformations in disease expression as the subjects make the transition from childhood to adolescence and from adolescence to young adulthood. PERFORMANCE SITE ========================================Section End===========================================
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