Early Developmental Stages of Psychopathology (EDSP) Study
Prospective-longitudinal observations in community samples are essential for an unbiased characterization of the epidemiology and development of mental disorders, which in turn is a prerequisite for the identification of risk factors for these disorders and for the understanding of their aetiology. These data are provided by the Early Developmental Stages of Psychopathology (EDSP) study with a representative sample drawn randomly in 1994 from the governmental registry of residents in Munich. Using the standardized Munich- Composite- International- Diagnostic Interview (M-CIDI) based on DSM-IV criteria, a total of 3021 participants aged 14–24 years were interviewed at baseline (T0: 1995; response rate: 71%). Three follow-up investigations were completed covering an overall period of 10 years (T1: 1996/1997, response rate: 88%; T2: 1998/99, response rate: 83%). In November 2005, the third follow-up (T3) with 2210 interviews was finished (response rate: 73%).
This EDSP data set provides widespread information about prevalence, incidence, psychopathological characteristics, development, and comorbidity of mental disorders in adolescents and young adults. Highest lifetime rates were found, for example, for substance use disorders (lifetime 17.7%), followed by affective disorders (16.8%), and anxiety disorders (14.4%). First results from the third follow-up wave (T3) ten years later show increasing cumulative lifetime rates for substance use disorder (up to 46.9%), affective syndromes (up to 31.9%), and anxiety disorders (up to 30.0%). Furthermore, a broad range of risk factors has been identified to play a role for the development of diverse mental disorders. Childhood separation anxiety disorder, for example, was found to be associated with an increased risk for a wide spectrum of subsequent mental disorders including panic disorder (HR=18.1), bipolar disorder (HR=7.7) and alcohol dependence (HR= 4.2). Further analyses are ongoing.The primary aim of our forthcoming studies is to generate models describing the aetiological pathways into psychopathology (particularly depression and anxiety disorders) including genetic and environmental risk factors as well as their interactions. A combined approach of molecular genetics and analytical epidemiology will be applied. Study participants of the third follow-up wave and their first-degree relatives were asked to participate in a molecular-genetic part of this study including DNA sampling and comprehensive genotyping, which is still ongoing. Our analysis of familial aggregations suggests that genetic factors dramatically contribute to the risk to develop affective disorders at young age. Furthermore, we could demonstrate for MDD a familial aggregation of specific characteristics, namely melancholia, severity, and impairment, indicating subgroups of the disorder that could be of special relevance in this context.
Fig. 2: Clinical characteristics of mothers and their children with Major Depressive Disorder (Schreier et al., 2006)
To identify generic risk factors for the development of depression and anxiety disorders, we will perform family based linkage analyses in triplets of affected study participants and their parents, considering quantitative psychopathological, psychosocial and environmental information. Our longitudinal study design has delivered a unique data base during a period of 10 years not only for the identification of genetic and non-genetic risk factors, but also for the sophisticated investigation of gene-environment interactions involved in the development of mental disorders.
(The project is supported by the BMBF)
Research groups involved:
Hans-Ullrich Wittchen, Clinical Psychology and Psychotherapy, Technical University Dresden
Roselind Lieb, Department of Psychology, University of Basel; Switzerland
Brueckl T.M., Zimmermann P., Schreier, A., Höfler M., Wittchen H.-U. & Lieb R. (submitted) The interplay of maternal psychopathology and separation anxiety for the development of subsequent mental disorders. Journal of the American Academy of Child and Adolescent Psychiatry
Nocon A., Wittchen H.-U. et al. (submitted) Differential familial liability of panic disorder and agoraphobia. Depression and Anxiety
Zimmermann P., Brückl T., Lieb R., Beesdo K., Ising M. & Wittchen H.-U. (in press) The interplay of familial depression liability and adverse life events in predicting the first onset of depression during a ten-year follow-up. Biological Psychiatry
Schreier A., Höfler M., Wittchen H. U., & Lieb R. (2006) Clinical characteristics of major depressive disorder run in families - a community study of 933 mothers and their children. Journal of Psychiatric Research, 40(4), 283-292
Lieb R., Isensee B., Höfler M., Pfister H., & Wittchen H.-U. (2002) Parental major depression and the risk of depression and other mental disorders in offspring. A prospective-longitudinal community study. Archives of General Psychiatry, 59(4), 365-374
Lieb R., Isensee B., von Sydow K. & Wittchen H.-U. (2000) The Early Developmental Stages of Psychopathology Study (EDSP): A methodological update. European Addiction Research, 6 (4), 170-182