Improving Early Recognition and Intervention in At-risk Stages of Bipolar Disorders

NCT ID: NCT02456545

Last Updated: 2024-08-07

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Total Enrollment

1419 participants

Study Classification

OBSERVATIONAL

Study Start Date

2015-06-03

Study Completion Date

2020-10-30

Brief Summary

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Prospective multicentre observational study for treatment approaches in at-risk individuals. Furthermore the purpose of this study is to test feasibility of a clinical staging model and validate diagnostic tools to identify individuals at risk state for the development of BD.

Detailed Description

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This project is one out of nine projects and four translational platforms forming the core of an interdisciplinary consortium to research on the most important areas of uncertainties and unmet needs in early recognition and diagnostic assessment, prevention of relapse, and therapeutic strategies of BD.

Within this project, currently used diagnostic tools for subthreshold bipolar symptoms (BPSS-P, EPIbipolar, BAR criteria) will be deployed within the first 24 months in defined risk groups. Predictive power of individual risk factors/risk constellations will be determined regarding the manifestation and prodromal development of BD within ≥24 months (follow-up every 6 months). Potential resilience factors are ascertained. Additionally, the diagnostic tools will be used in a representative cohort (IMAGEN, to ascertain the prevalence of clinical/neurobiological at-risk constellations in non-selected youth and young adults, data from previous follow-ups will be used, suffering/help-seeking behavior will be assessed). Regarding treatment, at-risk subjects identified will be staged according to a pilot staging model. Treatment guidance is provided linked to the model, however, the naturalistic setting allows for individual decision making. Reasons for decisions will be ascertained, efficacy will be assessed with respect to symptomatology, psychosocial functioning and conversion to full BD, tolerability/safety will be assessed according to research standard. Outcomes will be assessed within ≥ 24 months. Using the results, the clinical staging model \& guidance will be refined. The long-term goal is to provide a model for research and clinical initiatives.

Synopsis of study goals:

1. Determination of the predictive power of individual risk factors and risk constellations in defined risk groups for BD,
2. Identification of resilience factors,
3. Integration of results for further development of diagnostic tools and harmonization of the diagnostic process across centers,
4. Investigation of the process of treatment decision making, efficacy (acute/preventive effects) and tolerability/safety in at-risk subjects in a naturalistic setting, testing the feasibility of a pilot clinical staging model with treatment guidance,
5. Refinement of the staging model and guidance.

Conditions

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Bipolar Disorder

Study Design

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Observational Model Type

COHORT

Study Time Perspective

PROSPECTIVE

Study Groups

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help-seekers at-risk

persons consulting collaborating Early Recognition Centers presenting with hints for ≥ 1 potential risk factor for BD (e.g. (sub)threshold affective symptomatology, anxiety, sleep disturbances, family history, episodic substance misuse, ADHD)

anticipated n = 500

≥ 1 potential risk factor for BD

Intervention Type OTHER

exposure to ≥ 1 potential risk factors for BD (e.g. (sub)threshold affective symptomatology, anxiety, sleep disturbances, family history, episodic substance misuse)

patients with depressive syndrome

in- and outpatients with depressive syndrome (SCID)

anticipated n = 500

depressive syndrome

Intervention Type OTHER

in- and outpatients with depressive syndrome

patients with ADHD

in- and outpatients with Attention-Deficit/Hyperactivity-Disorder (ADHD)

anticipated n = 150

ADHD

Intervention Type OTHER

in- and outpatients with ADHD

representative population cohort

representative population cohort from the IMAGEN study

anticipated n = 500

No interventions assigned to this group

Interventions

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≥ 1 potential risk factor for BD

exposure to ≥ 1 potential risk factors for BD (e.g. (sub)threshold affective symptomatology, anxiety, sleep disturbances, family history, episodic substance misuse)

Intervention Type OTHER

depressive syndrome

in- and outpatients with depressive syndrome

Intervention Type OTHER

ADHD

in- and outpatients with ADHD

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* Risk group I: help-seeking persons consulting collaborating Early Recognition Centers presenting hints for ≥ 1 potential risk factor for BD (e.g. (sub)threshold affective symptomatology, anxiety, sleep disturbances, family history of bipolar disorder, episodic substance misuse, depressive syndrome)
* Risk group II: in- and outpatients with depressive syndrome (SCID) from the network sites
* Risk group III: in- and outpatients with ADHD already cared for in the Dept. of Child and Adolescent as well as Adult psychiatry in Würzburg
* Representative population cohort: IMAGEN study participants

Exclusion Criteria

* bipolar disorder
* schizaffective disorder
* schizophrenia
* dominating anxiety disorder, obsessive-compulsive disorder
* dominating substance-related disorder
Minimum Eligible Age

15 Years

Maximum Eligible Age

35 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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German Federal Ministry of Education and Research

OTHER_GOV

Sponsor Role collaborator

Charite University, Berlin, Germany

OTHER

Sponsor Role collaborator

Ruhr University of Bochum

OTHER

Sponsor Role collaborator

Goethe University

OTHER

Sponsor Role collaborator

Universitätsklinikum Hamburg-Eppendorf

OTHER

Sponsor Role collaborator

Philipps University Marburg

OTHER

Sponsor Role collaborator

University Hospital Tuebingen

OTHER

Sponsor Role collaborator

Vivantes Hospital am Urban, Berlin

UNKNOWN

Sponsor Role collaborator

Technische Universität Dresden

OTHER

Sponsor Role lead

Responsible Party

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Andrea Pfennig

Prof. Dr. med. Andrea Pfennig

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Andrea Pfennig, Dr. med.

Role: PRINCIPAL_INVESTIGATOR

University Hospital Dresden, Technische Universität Dresden

Michael Bauer, Dr. rer. nat.

Role: PRINCIPAL_INVESTIGATOR

University Hospital Dresden, Technische Universität Dresden

Martin Lambert, Dr. med.

Role: PRINCIPAL_INVESTIGATOR

Universitätsklinikum Hamburg-Eppendorf

Locations

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Charite University Berlin

Berlin, , Germany

Site Status

Vivantes Hospital am Urban

Berlin, , Germany

Site Status

Ruhr University of Bochum

Bochum, , Germany

Site Status

University Hospital Dresden, Präventionsambulanz mit Früherkennungszentrum

Dresden, , Germany

Site Status

University Hospital Frankfurt

Frankfurt a.M., , Germany

Site Status

University Hospital Hamburg-Eppendorf

Hamburg, , Germany

Site Status

Philipps University of Marburg Medical Center

Marburg, , Germany

Site Status

Ruppiner Kliniken, Klinik für Psychiatrie, Psychotherapie und Psychosomatik

Neuruppin, , Germany

Site Status

University Hospital Tuebingen

Tübingen, , Germany

Site Status

Countries

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Germany

References

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Bechdolf A, Ratheesh A, Wood SJ, Tecic T, Conus P, Nelson B, Cotton SM, Chanen AM, Amminger GP, Ruhrmann S, Schultze-Lutter F, Klosterkotter J, Fusar Poli P, Yung AR, Berk M, McGorry PD. Rationale and first results of developing at-risk (prodromal) criteria for bipolar disorder. Curr Pharm Des. 2012;18(4):358-75. doi: 10.2174/138161212799316226.

Reference Type BACKGROUND
PMID: 22239567 (View on PubMed)

Correll CU, Olvet DM, Auther AM, Hauser M, Kishimoto T, Carrion RE, Snyder S, Cornblatt BA. The Bipolar Prodrome Symptom Interview and Scale-Prospective (BPSS-P): description and validation in a psychiatric sample and healthy controls. Bipolar Disord. 2014 Aug;16(5):505-22. doi: 10.1111/bdi.12209. Epub 2014 May 8.

Reference Type BACKGROUND
PMID: 24807784 (View on PubMed)

Leopold K, Ritter P, Correll CU, Marx C, Ozgurdal S, Juckel G, Bauer M, Pfennig A. Risk constellations prior to the development of bipolar disorders: rationale of a new risk assessment tool. J Affect Disord. 2012 Feb;136(3):1000-10. doi: 10.1016/j.jad.2011.06.043. Epub 2011 Jul 30.

Reference Type BACKGROUND
PMID: 21802741 (View on PubMed)

Related Links

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https://www.bipolife.org/

further patient information

http://www.imagen-europe.com/

Project providing participants from representational cohort

Other Identifiers

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BipoLife-A1

Identifier Type: -

Identifier Source: org_study_id

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