Preschool Mood Disorders: Continuity and School Age Outcomes

学龄前情绪障碍：连续性和学龄结果

• 批准号: 7318971
• 负责人: JOAN L. LUBY
• 金额: $ 83.57万
• 依托单位: WASHINGTON UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2002
• 资助国家: 美国
• 起止时间: 2002-12-01 至 2012-11-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7318971
• 关键词: Address; Affect; Age of Onset; Anhedonia; Award; Behavior; Biological; Bipolar Disorder; Caregivers; Characteristics; Child; Childhood; Chronic Disease; Clinical Research; Communities; DSM-IV; Data; Data Analyses; Databases; Depressed mood; Depressive Syndromes; Development; Developmental Diagnostic; Disease; Disease remission; Early Intervention; Early intervention trials; Emotional; Emotions; Event; Family history of; Feeling; Funding; Future; Guilt; Hydrocortisone; Impairment; Intervention; Investigation; Knowledge; Label; Life; Longitudinal Studies; Manic; Measures; Mediating; Mediator of activation protein; Mental Depression; Mental disorders; Mood Disorders; Moods; Morbidity - disease rate; National Institute of Mental Health; Neurobiology; Numbers; Nursery Schools; Outcome; Outcome Measure; Parents; Population; Population Study; Probability; Psychopathology; Public Health; Rate; Recovery; Recurrence; Relapse; Resistance; Resources; Risk; Risk Factors; Sampling; Sampling Studies; School-Age Population; Score; Severities; Stress; Symptoms; Time; Treatment outcome; Validation; aged; base; depressive symptoms; design; early onset; experience; follow-up; teacher

DESCRIPTION (provided by applicant): Building on findings from developmental and exploratory clinical studies, the applicant's K08 study provided empirical validation for a specific and stable preschool depressive syndrome. Alterations in stress cortisol reactivity, and observational evidence of negative affect and anhedonia were found, providing biological as well as objective evidence for the validity of preschool depression. The ongoing R01 aimed to advance these findings by investigating sub-types and developmental characteristics of preschool depression in a large community based study population, over-sampled for mood disorders. An exploratory investigation of mania symptoms was made possible by a NIMH supplement. Replication and extension of findings validating preschool depression were established in this independent sample. Further, preliminary evidence of a valid and robust preschool bipolar disorder also emerged. The ongoing R01 study sample represents the largest developmentally and diagnostically well-characterized population of mood-disordered preschoolers ascertained to date to our knowledge providing a rich resource for longitudinal follow-up. This application proposes to continue this investigation of preschool mood disorders by examining the course and characteristics of N=302 preschoolers for 3 additional diagnostic and developmental assessments annually through school age. The proposed longitudinal study will allow the first investigation of mood disorders, from their earliest known onset during the preschool period, to outcomes at late school- age, compared to disruptive and healthy children. This proposal aims to investigate the effect of age of onset, sub-type and deviations in emotional development on course and outcome of early onset mood disorders. While much is known about the longitudinal course of later childhood mood disorders, there is a gap in the database on the continuities and mediators of outcome from preschool to school age. This developmental transition is critically important to the public health because of the potential for earlier and more effective intervention in these chronic disorders during a period greater developmental and neurobiolgoical change. This study sample containing a high proportion of preschoolers with mood disorders and appropriate controls provides an unprecedented opportunity to bridge this gap in the empirical database. Findings would serve to inform the design of future early intervention trials for mood disorders.

描述（由申请人提供）：基于发展和探索性临床研究的发现，申请人的K08研究为特定稳定的学龄前抑郁综合症提供了经验验证。发现压力皮质醇反应性的改变，以及发现了负面影响和抗抗激素的观察证据，提供了生物学和客观证据，证明了学龄前抑郁症的有效性。正在进行的R01旨在通过研究基于社区的大型研究人群中的子类型和学龄前抑郁症的发展特征来推进这些发现，并因情绪障碍而采样过采样。 NIMH补充剂使躁狂症症状进行了探索性研究。在此独立样本中建立了验证学龄前抑郁症的发现的复制和扩展。此外，还出现了有效且强大的学龄前躁郁症的初步证据。正在进行的R01研究样本代表了迄今为止我们的知识确定的心情有序的学龄前儿童的发育和诊断良好的人群，为纵向随访提供了丰富的资源。该申请建议通过检查n = 302个学龄前儿童的课程和特征来继续对学龄前情绪障碍进行调查，以每年在学龄前每年进行3个额外的诊断和发展评估。与破坏性和健康的孩子相比，拟议的纵向研究将允许首次对情绪障碍的调查，从学龄前时期的最早发作到晚期的结果。该建议旨在研究发作时代，亚型和偏差对情绪发展的影响，对早期发作情绪障碍的过程和结果。尽管对以后的儿童情绪障碍的纵向课程知之甚少，但数据库中存在差距，从学龄前到学龄前到学龄前的结局和调解人。这种发展过渡对公共卫生至关重要，因为在一个时期内有可能对这些慢性疾病进行更早，更有效的干预措施，更大的发育和神经观察变化。这项研究样本包含大量的患有情绪障碍和适当控制的学龄前儿童，这为弥合经验数据库中的差距提供了前所未有的机会。调查结果将为情绪障碍的未来早期干预试验的设计提供信息。