investigators' abstract): This revised application is for a research grant to expand the goals of the parent grant which has involved a longitudinal, controlled investigation of the presentation, clinical course and long-term outcome of various depressive disorders (as compared to one another and non-depressive disorders) among school-age psychiatrically referred children. Under the FIRCA application the investigators plan to assess 450 outpatients (8 to 17 years of age), accessed through three psychiatric facilities in Budapest, Hungary, as Phase I of an eventual and more extensive diagnostically oriented longitudinal investigation of childhood-onset effective disorders among Hungarian youth. This FIRCA study will entail a cross-sectional, single assessment design, and use of an already developed standardized clinical interview schedule that has a comprehensive coverage of psychiatric symptoms, psychosocial characteristics and background variables. Cases will be recruited over an appropriately 30- month period from among eligible, sequentially referred new patients according to a predetermined sampling procedure. Given the lack of information about the characteristics of child psychiatric outpatients in Hungary, the FIRCA study will provide crucial descriptive data on the rates of depressive and nondepressive symptoms and suicidal behaviors across multiple clinic sites in Budapest and about pertinent clinical developmental, life stress, family related and demographic variables. These data will be the foundation for designing the later Phase II study. In this FIRCA study, psychiatric criterion- based symptom clusters will be used to estimate the sample specific point prevalence of depressive and nondepressive disorders. The association between depression, suicidal behaviors, and non- psychiatric factors will be determined. Attempts will be made to identify variables that increase the odds of depressive versus other conditions, as well as suicidality. While providing useful information about Hungarian clinic-referred youths, the findings will serve primarily to identify the best subpatient population targets for subject selection and the most feasible control group for the Phase II diagnostically-oriented, longitudinal study of childhood-onset affective disorders in Hungary along the lines of the parent grant.
