Results from the NIMH Collaborative Depression Study (CDS) have clearly show that affective illness is a lifetime disorder and the 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, comorbid 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 and 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 general aim in doing this is to describe the long-term course 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 services utilization; 4) the influence of naturalistically applied treatments as a mediating variable; 5) the course and outcomes of subsyndromal states 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 us disorders.
| 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 |
| Cobb, Bryan S; Coryell, William H; Cavanaugh, Joseph et al. (2014) Seasonal variation of depressive symptoms in unipolar major depressive disorder. Compr Psychiatry 55:1891-9 |
| 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 |
| 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 |
| 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 |
| 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 |
| 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 |
| Fiedorowicz, Jess G; Endicott, Jean; Leon, Andrew C et al. (2011) Subthreshold hypomanic symptoms in progression from unipolar major depression to bipolar disorder. Am J Psychiatry 168:40-8 |
| Fiedorowicz, J G; Leon, A C; Keller, M B et al. (2009) Do risk factors for suicidal behavior differ by affective disorder polarity? Psychol Med 39:763-71 |
| Fiedorowicz, Jess G; Solomon, David A; Endicott, Jean et al. (2009) Manic/hypomanic symptom burden and cardiovascular mortality in bipolar disorder. Psychosom Med 71:598-606 |
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