The Oregon Adolescent Depression Project (OADP) consists of a cohort of 1,507 randomly selected adolescents (ages 14-18) who were carefully diagnosed and assessed on a host of psychosocial and diagnostic measures at T1 (1987-1989) and, approximately one year later, at T2 (1988-1990) (Adolescent Depression: Prevalence and Psychosocial Aspects, MH40501). We are currently conducting a third (T3) assessment with the sample during the year of their 24th birthday (The Natural History of Depression in Adolescents, MH50522; 05/01/93-04/30/96). The T3 assessment includes a diagnostic interview (modified K-SADS/LIFE and PDE Axis II interview) to determine each subject' psychiatric status since T2. Annual mailer questionnaires, which included the CES-D, measures of stress, social support, treatment utilization, response style, and if appropriate, measures of martial adjustment and parenting skills, are also administered. Our goals for Years 01-03 were to achieve a high participation rate, pilot our T3 diagnostic procedures, and demonstrate the comparability of telephone vs. in-person diagnostic interviews. We have accomplished these goals. Therefore, we are now requesting funding to complete the study. Specifically, during Years 04-07, we interview 351 subjects with a lifetime history of major depression at T2, 258 subjects with a T2 DSM-III-R diagnosis other than major depression, and 457 subjects with no history of mental disorder at T2. In addition, all OADP subjects will complete mailer questionnaires annually until completion of the T3 interview. Also, at the time of the T3 interview, spouses of the OADP subjects will be recruited into the study to complete the marriage and (if applicable) parenting questionnaires. The goals of this study are to (a) describe the longitudinal course of adolescent affective disorders, assessing factors that predict good and poor prognosis; (b) examine the consequences of an episode of affective disorder during adolescence on psychosocial functioning in early adulthood (e.g., social support, stress, marital functioning, parenting skills, and occupational/educational functioning); and (c) contribute to a number of important issues in child psychiatry in addition to depression (e.g., alcohol/drug abuse and dependence, anxiety, disruptive behavior, smoking, physical morbidity, and suicidal behavior). According to the recent report by the Institute of Medicine (1994, page 116), """"""""The transition to adulthood is poorly understood in spite of the fact that it is probably the age period when most adult disorders have their peak rates of incidence."""""""" The report also states (page 117), """"""""Prospective epidemiological studies that estimate incidents of specific risk factors and disorders in childhood, adolescents, and during the transition to adulthood, from age 15-25, are greatly needed."""""""" The proposed study is entirely consistent with these recommendations.
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