Results from the NIMH Collaborative Depression Study (CDS) have clearly shown that affective illness is a lifetime disorder and that long-term observation will be necessary to adequately characterize it. Follow-up so far shows high rates of recovery, recurrence, changes in inter- episode psychosocial functioning, co-morbid alcoholism, minor affective syndromes, mortality and suicide. Recoveries are likely even after lengthy periods of illness, the distribution of episode length is relatively constant and unimpaired psychosocial functioning appears to require a complete absence of symptoms. It is essential that this follow-up continue, especially as the probands enter their sixth an seventh decades of life. This application seeks to extend the prospective annual follow-up of the CDS proband sample to at least 22 years for all subjects. The genera aim in doing this is to describe the long-term cause of the affective disorders.
The specific aims are to collect data that will describe more fully: 1.) the cumulative probability of recovery and recurrence, and the changes in polarity, severity, and episode and cycle lengths; 2.) the predictors of long-term course and diagnostic change; 3.) the eventual level of psychosocial functioning, physical health, likelihood of suicide and mental health service utilization; 4.) the influence of naturalistically applied treatments as a mediating variable; 5.) the cause and outcomes of subsyndromal stages of affective disorders; and 6.) the long-term inter-relationships of the affective disorders and other chronic and recurrent disorders such as alcohol and drug use disorders.

Agency
National Institute of Health (NIH)
Institute
National Institute of Mental Health (NIMH)
Type
Research Project (R01)
Project #
2R01MH025430-24
Application #
2763633
Study Section
Special Emphasis Panel (ZMH1-CRB-W (08))
Project Start
1977-07-01
Project End
2003-06-30
Budget Start
1998-07-01
Budget End
1999-06-30
Support Year
24
Fiscal Year
1998
Total Cost
Indirect Cost
Name
Washington University
Department
Psychiatry
Type
Schools of Medicine
DUNS #
062761671
City
Saint Louis
State
MO
Country
United States
Zip Code
63130
Leon, Andrew C; Fiedorowicz, Jess G; Solomon, David A et al. (2014) Risk of suicidal behavior with antidepressants in bipolar and unipolar disorders. J Clin Psychiatry 75:720-7
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Solomon, David A; Fiedorowicz, Jess G; Leon, Andrew C et al. (2013) Recovery from multiple episodes of bipolar I depression. J Clin Psychiatry 74:e205-11
Akhter, Ahmed; Fiedorowicz, Jess G; Zhang, Tao et al. (2013) Seasonal variation of manic and depressive symptoms in bipolar disorder. Bipolar Disord 15:377-84
Fiedorowicz, Jess G; Endicott, Jean; Solomon, David A et al. (2012) Course of illness following prospectively observed mania or hypomania in individuals presenting with unipolar depression. Bipolar Disord 14:664-71
Persons, Jane E; Coryell, William H; Fiedorowicz, Jess G (2012) Cholesterol fractions, symptom burden, and suicide attempts in mood disorders. Psychiatry Res 200:1088-9
Leon, Andrew C; Solomon, David A; Li, Chunshan et al. (2012) Antiepileptic drugs for bipolar disorder and the risk of suicidal behavior: a 30-year observational study. Am J Psychiatry 169:285-91
Fiedorowicz, Jess G; Coryell, William H; Rice, John P et al. (2012) Vasculopathy related to manic/hypomanic symptom burden and first-generation antipsychotics in a sub-sample from the collaborative depression study. Psychother Psychosom 81:235-43
Fiedorowicz, Jess G; Coryell, William H; Akhter, Ahmed et al. (2012) Chryptochrome 2 variants, chronicity, and seasonality of mood disorders. Psychiatr Genet 22:305-6
Leon, Andrew C; Solomon, David A; Li, Chunshan et al. (2011) Antidepressants and risks of suicide and suicide attempts: a 27-year observational study. J Clin Psychiatry 72:580-6

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