This application responds to RFA: MH-01-002, """"""""Research on Depression Comorbid with Externalizing Problems in Children."""""""" The application does two things: first, it brings the strengths of an already-collected longitudinal data set to addressing two of the questions set out in the RFA (page 2): (1) are comorbid conditions etiologically distinct from non-comorbid depressive conditions? and (2) do different patterns of comorbidity represent different subtypes? Second, it requests funding for further follow up of the same sample to address 5 other questions raised by the RFA: (3)does variation in developmental paths depend on age at onset of the comorbid disorder? (4)which children with comorbid conditions are at risk for substance abuse outcomes? (5) what are the mechanisms of risk? (6) what is the developmental course for comorbid children who go on to develop problems with substance abuse? and (7) what predicts long-term difficulties, for peer relationships and success in school, and substance use, abuse, and dependence, rather than more transient problems? The application builds on the Great Smoky Mountains Study (GSMS), a longitudinal epidemiologic study now in its eighth year of data collection. One quarter of the sample is American Indian. The sample has been followed since 1993 to examine the development of psychiatric and substance abuse disorders. To address questions 1 and 2 of the RFA, we are requesting funding for additional statistical and data management support to work on data already collected. Both dimensional and diagnostic data will be used. To answer questions 3 through 7 requires longitudinal data extending into late adolescence. By the end of 2002 we shall have collected data on the 11 year-old cohort (N =497) through age 19 and 20, using existing funds. We are requesting funding to interview the 9 year-old cohort (N=508) as they reach age 19 and 20, in 2003 and 2004. Our third request is for funding to carry out a structured family psychiatric history interview with the parents, in order to be able to co-address family genetic questions about the development of depression/DBD comorbidity.
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