The overall aim of this study is to determine the continuity between childhood and adult depression by conducting re-interviews with children who were fully evaluated 10 years ago the late J. Puig-Antich. The children are now adults. The original sample includes a total of 447 children, including 204 depressed children, 66 children with mixed anxiety disorders, and 177 normal controls. A 1-year senior investigator NARSAD grant to the P.I. has allowed us to complete all preparatory phases and the first 135 interviews. We are requesting support to complete interviews with the remaining 200 patients and their 200 informants, to conduct a family interview study, and to re-analyze original biologic data collected when the sample were children in light of longitudinal course data. Our preliminary findings show a high rate of suicide in the depressed children grown up as well as high recurrence of depression, and indicate the persistent, serious nature of depressive illness. Specifically, we will determine (1) the continuity between childhood and adult major depression; comparisons will be made with the anxious and normal children grown up; (2) the long-term clinical course of symptoms, suicidal behavior, social functioning, and treatment in depressed children grown up as compared to those with mixed anxiety disorders and the normal controls; (3) the relationship between the course of childhood depression and anxiety states, and the family psychiatric history of patients' biological parents, siblings, and patients' school-age children; and (4) the relationship between depressed and anxious patients' and normal controls' baseline biologic data- including their response to tricyclic antidepressants (imipramine), hormone levels and their response to insulin tolerance tests (growth hormone, prolactin, and cortisol), and sleep EEG studies-and longitudinal course of illness.
These aims will be accomplished by blind diagnostic re-evaluation of the remainder of the original sample of children who are now adults. Diagnostic and course of illness information will also be obtained from one informant per child, and we will collect family psychiatric history information on biological parents and siblings. The following make this a unique sample for follow-up: the availability of (1) all baseline and 10-year follow-up diagnoses made via structured direct-interview methods; (2) extensive baseline data on social functioning and physical health; (3) two controls' groups; (4) biologic data on a sub-samples of children; (5) successful re-location effort (79%) with initial one-third of the sample having completed diagnostic re-interviews. This will be the first study of its kind to have comprehensive, modern diagnostic data in a depressed sample both as children and as adults, and will answer important questions regarding the continuity between childhood and adult depression as well as anxiety disorders.
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