Phenotype Depression Study

NCT ID: NCT01426997

Last Updated: 2016-06-22

Basic Information

• Recruitment Status: COMPLETED
• Total Enrollment: 279 participants
• Study Classification: OBSERVATIONAL
• Study Start Date: 2010-07-31
• Study Completion Date: 2016-05-31

Brief Summary

To facilitate the development of a personalized approach to the treatment of patients with major depression, this study is designed to elaborate the clinical and neurobiological phenotype of depressed patients with increased inflammation. The data obtained in this proposal will allow the investigators to test the hypothesis that depression and inflammation interact to elaborate a relatively discreet phenotype that warrants an individualized approach to diagnosis and treatment of patients with depression. Moreover, the identification of specific environmental risk factors for inflammation will foster the elaboration of preventative strategies for patients at risk.

Detailed Description

One hundred and thiry-five patients with major depression diagnosed based on DSM-IV TR criteria between the ages of 21 and 65 (males, females and minorities) will be recruited. Forty-five patients with high inflammation as defined by a CRP >3 mg/L will be enrolled along with 45 depressed patients with medium inflammation (CRP=1-3mg/L) and 45 depressed patients with low inflammation (CRP<1mg/L) will complete a 2 night inpatient stay in Emory University Hospital's research unit, the Atlanta Clinical and Translational Science Institute (ACTSI). Participants will undergo psychiatric and neurocognitive assessments, sleep studies and blood and cerebral spinal fluid (CSF) sampling.

Conditions

Major Depressive Disorder

Study Design

• Observational Model Type: CASE_CONTROL
• Study Time Perspective: CROSS_SECTIONAL

Study Groups

High inflammation group (CRP>3 mg/L)

Forty-five participants each with a diagnosis of major depressive disorder and a CRP level \>3 mg/L

No interventions assigned to this group

Medium inflammation group (CRP=1-3 mg/L)

Forty-five participants each with a diagnosis of major depressive disorder and a CRP level = 1-3 mg/L

No interventions assigned to this group

Low inflammation group (CRP<1 mg/L).

Forty-five participants each with a diagnosis of major depressive disorder and a CRP level \<1 mg/L

No interventions assigned to this group

Eligibility Criteria

Inclusion Criteria

• age 21-65 years including males, females and minorities
• diagnosis of DSM-IV major depression or Bipolar I or II with current episode of depression
• HDRS-17 > 20 and HDRS-24 > 24
• negative pregnancy test for women of childbearing potential
• not breast feeding
• stable on current dose of psychotropic medication or free from all psychotropic medications for 4 weeks prior to EUH CIN admission (8 weeks for fluoxetine)
• no suicide attempt within six months of screening

Exclusion Criteria

• evidence of untreated or poorly controlled endocrine, cardiovascular, pulmonary, hematological, renal, or neurological disease
• history of CNS trauma or active seizure disorder requiring medication unless otherwise approved by principle investigator
• autoimmune or inflammatory disorder of any kind
• chronic infection (e.g. hepatitis B or C or HIV)
• chronic use of agents known to affect the immune system including glucocorticoid therapy within the past 1 year, methotrexate within the past 1 year, chemotherapy of any kind (past or present), immunotherapy of any kind (past or present), aspirin or non-steroidal anti-inflammatory drugs (NSAIDs) (within the past 2 weeks) and statins (within the past 1 month) unless otherwise approved by principle investigator
• hemoglobinopathies (e.g. thalassemia)
• a positive pregnancy test
• organ transplants
• cancer of any type
• a score of <28 on the Mini Mental Status Exam (MMSE)unless otherwise approved by principle investigator
• meets criteria for schizophrenia (Given overlap of generalized anxiety disorder (GAD) with major depression, GAD will not be exclusionary)
• current eating disorders
• active abuse of alcohol or illicit/prescription drugs within the past year unless otherwise approved by principle investigator.
• MGH-S >3 unless otherwise approved by principle investigator
• BMI >40 unless otherwise approved by the principle investigator
• active suicidal intent or plan and a score >2 on the HDRS suicide item (item #3).
• any other condition which in the opinion of the investigator would make the patient unsuitable for enrollment, or could interfere with participating in or completing the protocol

• Minimum Eligible Age: 21 Years
• Maximum Eligible Age: 65 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

National Institute of Mental Health (NIMH)

NIH

Sponsor Role: collaborator

Emory University

OTHER

Sponsor Role: lead

Responsible Party

Andrew H Miller

Professor, Psychiatry and Behavioral Sciences

Responsibility Role: PRINCIPAL_INVESTIGATOR

Principal Investigators

Andrew H. Miller, MD

Role: PRINCIPAL_INVESTIGATOR

Emory University

Locations

Emory University Department of Psychiatry and Behavioral Sciences

Atlanta, Georgia, United States

Countries

United States

Other Identifiers

1R01MH087604-01A1

Identifier Type: NIH

Identifier Source: secondary_id

View Link

IRB00039107

Identifier Type: -

Identifier Source: org_study_id