The first three years of this work were a controlled study of nortriptyline (NT) for 6-12 year olds with major depressive disorder (MDD). The following five years were a prospective, blindly rated study of the NT group and two control groups (newly recruited MDD subjects who had not participated in a drug study and a normal control group). The last year of funding (1/1/93-12/31/93) was awarded for data analyses and planning future direction. Hypotheses of the follow-up study through the early adolescent age group have been supported by the findings to date. These included recovery followed by early relapse of the MDD, impaired psychosocial functioning in multiple areas, and high rate of onset of bipolarity. In addition, the longitudinal course of the placebo-washout responders has not been significantly different from the other NT study groups. Research questions for the proposed study of mid-late adolescent outcome center on the hypotheses that these subjects will be at heightened developmental risk for suicidality; substance abuse and/or dependency; and DSM-III-R conduct disorder. We also expect a continued increase in the number of bipolar subjects based on the Kaplan-Meier estimate curves and that age-specific developmental intrafamilial and peer relationships will be impaired in unrecovered or recurrently mood disordered subjects. A single wave of data collection is proposed. Blind multi-informant assessments of psychopathological, temperament, and psychosocial areas will be obtained from the 75 MDD and 31 normal control subjects. Raters blind to the status of the subjects will obtain Family History-RDC from the mother about the subjects' first degree relatives. Findings from the proposed study will provide families, practitioners, and educators with crucial prognostic information on the outcome of chronic, severe MDD in 6-12 year olds.