This is the competing renewal application of MH059689, proposing to continue to follow the SWAN Mental Health cohort that was recruited in 1996 through postmenopause. The women are participants in the Pittsburgh site of a multisite longitudinal study of menopause and aging, Study of Women's Health across the Nation (SWAN). Our current sample consists of 352 African American and Caucasian women, aged 52-62 years old. Women are interviewed annually with the Structured Clinical Interview (SCID) for DSM-IV Axis I Disorders. In the proposed continuation, we seek to (1) fully address our primary original aim that women will be more likely to develop a first onset or recurrence of major or minor depression during the menopausal transition than before, (2) identify the multiple risk and protective factors associated with varying patterns of the course of depression over 12 years, specifically, (a) no major or minor depression, (b) minor episodes only, (c) a single episode of major depression, and (d) recurrent or persistent depression; and (3) explore whether African American women compared to White women will have higher rates of a first onset or recurrent major or minor depression and a more persistent course of depression across the menopausal transition and after. To achieve these objectives, we will continue to collect psychiatric data and the annual data on menstrual cycle, biologic, symptom, functioning, psychosocial factors and serum hormones that the Core SWAN will no longer be collecting at the proposed 3 additional annual follow-ups. We will include 3 newly measured factors: specific genetic polymorphisms, family history of depression, and coping with the menopausal transition. Surprisingly little is known about depression during the menopausal transition and early postmenopause years when medical morbidity is increasing and about the effect of the transition on various patterns of depression. Continuing to follow this large, ethnically and socioeconomically diverse cohort will permit observation of the completed menopausal transition and the early postmenopause years in the entire aging cohort. The wealth of unique and valuable data on psychiatric, biologic, lifestyle, demographic, and psychosocial factors will advance our knowledge of the multiple determinants of depression and its course as women age. Increasing knowledge of the risks for depression in aging women and the factors that protect them from depression can identify targets for intervention at the prevention as well as the acute treatment level. ? ? ? ? ?
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