iMORE+ Study: A Multi-Omics Cohort Study of Major Depressive Disorder (iMORE+)

July 30, 2026 updated by: Shanghai Mental Health Center

iMORE+ Study: An Enhanced Prospective Observational Cohort Study of Major Depressive Disorder Integrating Longitudinal Clinical Characterization and Multi-Omics Profiling

Major depressive disorder (MDD) is a common mental health condition characterized by substantial clinical heterogeneity and variability in treatment response. Current diagnosis and treatment selection for MDD mainly rely on clinical assessments, and reliable biological markers that can support diagnosis, predict antidepressant treatment response, guide personalized treatment, and improve understanding of disease mechanisms remain limited.

The goal of this prospective observational cohort study is to develop and optimize multi-omics-based models for MDD diagnosis and antidepressant treatment response prediction using longitudinal clinical characteristics and biological data collected from an independent prospective cohort. The study also aims to evaluate the generalizability and predictive performance of existing multi-omics-based models in this independent cohort of participants aged 14-45 years.

The main questions it aims to answer are:

Can integrated clinical and multi-omics features identify biomarkers and develop predictive models for MDD diagnosis and antidepressant treatment response? Can existing multi-omics-based models for MDD diagnosis and treatment response prediction be replicated and validated in an independent prospective cohort?

Participants with MDD and healthy controls will undergo standardized clinical assessments, longitudinal follow-up, and biological sample collection for multi-omics profiling. Clinical and multi-omics data will be integrated to identify biomarkers, develop and validate predictive models for MDD diagnosis, antidepressant treatment response, and long-term outcomes, and explore biological pathways and potential therapeutic targets associated with MDD.

The study is expected to improve understanding of the biological heterogeneity of MDD and contribute to the development of objective approaches for diagnosis, treatment response prediction, personalized care, and future therapeutic discovery.

Study Overview

Status

Status

Indicates the current recruitment status or the expanded access status.
Not yet recruiting

Conditions

Conditions

The disease, disorder, syndrome, illness, or injury that is being studied. On ClinicalTrials.gov, conditions may also include other health-related issues, such as lifespan, quality of life, and health risks.

Study Type

Study Type

Describes the nature of a clinical study. Study types include interventional studies (also called clinical trials), observational studies (including patient registries), and expanded access.
Observational

Enrollment (Estimated)

Enrollment

The number of participants in a clinical study. The "anticipated" enrollment is the target number of participants that the researchers need for the study.
150

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Contact

The name and contact information for the person who can answer enrollment questions for a clinical study. Each location where the study is being conducted may also have a specific contact, who may be better able to answer those questions.

Study Locations

  • China
      • Shanghai, China, 200030
        • Shanghai Mental Health Center
        • Contact:
        • Contact:
        • Principal Investigator:
          • Shen He, Dr.

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Eligibility Criteria

The key requirements that people who want to participate in a clinical study must meet or the characteristics they must have. Eligibility criteria consist of both inclusion criteria (which are required for a person to participate in the study) and exclusion criteria (which prevent a person from participating). Types of eligibility criteria include whether a study accepts healthy volunteers, has age or age group requirements, or is limited by sex.

Ages Eligible for Study

  • Child
  • Adult

Accepts Healthy Volunteers

Yes

Sampling Method

Non-Probability Sample

Study Population

This study enrolls participants aged 14-45 years from outpatient and inpatient psychiatric settings, comprising two cohorts: participants meeting DSM-5 criteria for major depressive disorder (MDD) and demographically matched healthy controls (HCs) without current or lifetime major psychiatric disorders. MDD participants are recruited during an active depressive episode with baseline Montgomery-Åsberg Depression Rating Scale (MADRS) score ≥24 and 17-item Hamilton Depression Rating Scale (HAMD-17) score ≥18. HC participants are frequency-matched to the MDD cohort by age and sex distribution.

Description

Inclusion Criteria:

General criteria:

  • Participants aged 14-45 years.
  • Participants are able to understand the study procedures and provide written informed consent. For participants younger than 18 years, both the participant and their legal guardian must provide consent.

Major Depressive Disorder (MDD) cohort:

  • Meet DSM-5 criteria for major depressive disorder (single or recurrent episode).
  • Have a baseline Montgomery-Åsberg Depression Rating Scale (MADRS) score ≥24 and 17-item Hamilton Depression Rating Scale (HAMD-17) score ≥18.

Healthy Control (HC) cohort:

- Healthy participants without a current or lifetime diagnosis of major psychiatric disorders.

Exclusion Criteria:

For all participants:

- Severe or unstable medical conditions, pregnancy or breastfeeding, or other conditions considered unsuitable for study participation.

For the MDD cohort:

  • Current or lifetime diagnosis of other major psychiatric disorders, including schizophrenia spectrum disorders, schizoaffective disorder, or bipolar disorder.
  • Substance use disorder within 12 months prior to screening.
  • Depression secondary to medical or neurological conditions.
  • Regular antidepressant treatment within 2 weeks prior to enrollment.
  • Electroconvulsive therapy (ECT), repetitive transcranial magnetic stimulation (rTMS), vagus nerve stimulation (VNS), or immunosuppressive therapy during the current depressive episode.
  • Current active suicidal plan or recent suicidal behavior considered unsuitable for participation.

For the HC cohort:

  • Current or lifetime diagnosis of any psychiatric disorder.
  • Significant depressive, anxiety, manic, or psychotic symptoms.
  • Previous treatment with antidepressants, antipsychotics, or mood stabilizers.
  • Significant family history of major psychiatric disorders.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

Cohorts and Interventions

Group / Cohort

Group / Cohort

A group or subgroup of participants in an observational study that is assessed for biomedical or health outcomes.
Major Depressive Disorder (MDD) Cohort
Participants with major depressive disorder (MDD) aged 14-45 years will be enrolled in this cohort. Participants will undergo standardized clinical assessments, biological sample collection, and longitudinal follow-up during antidepressant treatment. Clinical data and biological samples will be collected at predefined time points for multi-omics profiling, including genomics, transcriptomics (bulk and single-cell), proteomics, metabolomics, immune cell phenotyping, and gut microbiome analyses, among others.
Healthy Control (HC) Cohort
Healthy participants aged 14-45 years will be enrolled as a comparison cohort. Participants will undergo baseline clinical assessments and biological sample collection for comparison with individuals with major depressive disorder.

What is the study measuring?

Primary Outcome Measures

Primary Outcome Measures

In a clinical study's protocol, the planned outcome measure that is the most important for evaluating the effect of an intervention/treatment. Most clinical studies have one primary outcome measure, but some have more than one.
Outcome Measure
Measure Description
Time Frame
Change in Montgomery-Åsberg Depression Rating Scale (MADRS) Total Score From Baseline to Week 8
Time Frame: Baseline to Week 8
The primary outcome is the change in Montgomery-Åsberg Depression Rating Scale (MADRS) total score from baseline to Week 8 after antidepressant treatment. The MADRS is a clinician-rated scale assessing depressive symptom severity. The total score ranges from 0 to 60, with higher scores indicating greater depressive symptom severity (worse outcome). Change in MADRS total score from baseline to Week 8 will be assessed as the primary clinical endpoint.
Baseline to Week 8

Secondary Outcome Measures

Secondary Outcome Measures

In a clinical study's protocol, a planned outcome measure that is not as important as the primary outcome measure for evaluating the effect of an intervention but is still of interest. Most clinical studies have more than one secondary outcome measure.
Outcome Measure
Measure Description
Time Frame
Antidepressant Treatment Response Rate Based on Montgomery-Åsberg Depression Rating Scale (MADRS) at Week 8
Time Frame: Baseline to Week 8
Treatment response is defined as a ≥50% reduction from baseline in Montgomery-Åsberg Depression Rating Scale (MADRS) total score at Week 8. The MADRS score ranges from 0 to 60, with higher scores indicating greater depressive symptom severity (worse outcome). The outcome measure is the percentage of participants achieving treatment response.
Baseline to Week 8
17-item Hamilton Depression Rating Scale (HAMD-17)-Defined Treatment Response at Week 8
Time Frame: Baseline to Week 8
Treatment response is defined as a ≥50% reduction from baseline in 17-item Hamilton Depression Rating Scale (HAMD-17) total score at Week 8. The HAMD-17 total score ranges from 0 to 52, with higher scores indicating greater depressive symptom severity (worse outcome). The outcome measure is the percentage of participants achieving treatment response.
Baseline to Week 8
Montgomery-Åsberg Depression Rating Scale (MADRS)-Defined Antidepressant Treatment Remission at Week 8
Time Frame: Baseline to Week 8
Remission is defined as a total score ≤10 on the Montgomery-Åsberg Depression Rating Scale (MADRS) at Week 8. The MADRS score ranges from 0 to 60, with higher scores indicating greater depressive symptom severity (worse outcome). The outcome measure is the percentage of participants achieving remission.
Baseline to Week 8
17-item Hamilton Depression Rating Scale (HAMD-17)-Defined Antidepressant Treatment Remission at Week 8
Time Frame: Baseline to Week 8
Remission is defined as a total score ≤7 on the 17-item Hamilton Depression Rating Scale (HAMD-17) at Week 8. The HAMD-17 score ranges from 0 to 52, with higher scores indicating greater depressive symptom severity (worse outcome). The outcome measure is the percentage of participants achieving remission.
Baseline to Week 8
Change in Hamilton Anxiety Rating Scale (HAMA) Score From Baseline to Week 8
Time Frame: Baseline to Week 8
The Hamilton Anxiety Rating Scale (HAMA) is a clinician-rated scale assessing anxiety symptom severity. The total score ranges from 0 to 56, with higher scores indicating greater anxiety severity (worse outcome).
Baseline to Week 8
Change in Biological Rhythms Interview of Assessment in Neuropsychiatry (BRIAN) Score From Baseline to Week 8
Time Frame: Baseline to Week 8
The Biological Rhythms Interview of Assessment in Neuropsychiatry (BRIAN) assesses biological rhythm disruption. The total score range from 18 to 72, with higher scores indicating greater circadian rhythm disturbance (worse outcome).
Baseline to Week 8
Change in Clinical Global Impression-Severity (CGI-S) Score From Baseline to Week 8
Time Frame: Baseline to Week 8
The Clinical Global Impression-Severity (CGI-S) scale assesses overall illness severity as rated by the clinician. Scores range from 1 to 7, with higher scores indicating greater illness severity (worse outcome). Change in CGI-S score from baseline to Week 8 will be assessed.
Baseline to Week 8
Clinical Global Impression-Improvement (CGI-I) Score at Week 8
Time Frame: Baseline to Week 8
The Clinical Global Impression-Improvement (CGI-I) scale assesses overall clinical improvement after treatment. Scores range from 1 to 7, with lower scores indicating greater improvement (better outcome).
Baseline to Week 8
Number of Participants With Suicidal Ideation or Suicidal Behavior Assessed by the Columbia Suicide Severity Rating Scale (C-SSRS) From Baseline to Week 8
Time Frame: Baseline to Week 8
Number of participants with suicidal ideation or suicidal behavior assessed by the Columbia Suicide Severity Rating Scale (C-SSRS)
Baseline to Week 8
Change in Snaith-Hamilton Pleasure Scale (SHAPS) Score From Baseline to Week 8
Time Frame: Baseline to Week 8
The Snaith-Hamilton Pleasure Scale (SHAPS) is a self-reported scale assessing anhedonia. The total score ranges from 0 to 14, with higher scores indicating greater anhedonia severity (worse outcome). Change in SHAPS score from baseline to Week 8 will be assessed.
Baseline to Week 8
Change in Sheehan Disability Scale (SDS) Score From Baseline to Week 8
Time Frame: Baseline to Week 8
The Sheehan Disability Scale (SDS) is a self-reported scale assessing functional impairment in work/school, social life, and family life. The total score ranges from 0 to 30, with higher scores indicating greater functional impairment (worse outcome). Change in SDS score from baseline to Week 8 will be assessed.
Baseline to Week 8
Incidence of Depressive Relapse During 1-Year Follow-up
Time Frame: Baseline to 1 year
Depressive relapse during 1-year follow-up will be assessed according to DSM-5 criteria and clinically relevant clinical events. The number and percentage of participants experiencing relapse will be reported.
Baseline to 1 year
Longitudinal Trajectory of Montgomery-Åsberg Depression Rating Scale (MADRS) Score Over 1-Year Follow-up
Time Frame: Baseline, Week 2, Week 4, Week 8, Month 3, Month 6, and Year 1
The Montgomery-Åsberg Depression Rating Scale (MADRS) assesses depressive symptom severity. Total scores range from 0 to 60, with higher scores indicating greater depressive symptom severity (worse outcome). Longitudinal changes in MADRS scores from baseline will be assessed at predefined assessment time points (Baseline, Week 2, Week 4, Week 8, Month 3, Month 6, and Year 1) to characterize trajectories of depressive symptom change over the 1-year follow-up period.
Baseline, Week 2, Week 4, Week 8, Month 3, Month 6, and Year 1
Longitudinal Trajectory of Sheehan Disability Scale (SDS) Score Over 1-Year Follow-up
Time Frame: Baseline, Week 8, Month 6, and Year 1
The Sheehan Disability Scale (SDS) assesses functional impairment in work/school, social life, and family life. The total score ranges from 0 to 30, with higher scores indicating greater functional impairment (worse outcome). Changes in SDS scores from baseline will be assessed at Week 8, Month 6, and Year 1 to characterize trajectories of functional recovery over the 1-year follow-up period.
Baseline, Week 8, Month 6, and Year 1

Other Outcome Measures

Other Outcome Measures

For clinical trials, a planned measurement described in the protocol that is used to determine the effect of an intervention/treatment on participants. For observational studies, a measurement or observation that is used to describe patterns of diseases or traits, or associations with exposures, risk factors, or treatment. Types of outcome measures include primary outcome measure and secondary outcome measure.
Outcome Measure
Measure Description
Time Frame
Area Under the Receiver Operating Characteristic Curve (AUROC) of Multi-Omics-Based Models for Discriminating Major Depressive Disorder From Healthy Controls
Time Frame: Baseline
A multivariable model integrating clinical characteristics and multi-omics data, including immune profiling (CyTOF and cytokine profiling), genomics, epigenomics, bulk transcriptomics, single-cell transcriptomics, proteomics, metabolomics, and microbiome profiling, will be developed to discriminate participants with major depressive disorder from healthy controls. Model discrimination performance will be primarily assessed by the area under the receiver operating characteristic curve (AUROC). Sensitivity, specificity, and predictive accuracy will be reported as supportive metrics.
Baseline
Area Under the Receiver Operating Characteristic Curve (AUROC) of Multi-Omics-Based Models for Predicting MADRS-Defined Antidepressant Treatment Response at Week 8
Time Frame: Baseline to Week 8 (baseline predictors and Week 8 treatment response assessment)
A multivariable model integrating baseline clinical characteristics and multi-omics data, including immune profiling (CyTOF and cytokine profiling), genomics, epigenomics, bulk transcriptomics, single-cell transcriptomics, proteomics, metabolomics, and microbiome profiling, will be developed to predict antidepressant treatment response at Week 8. Treatment response will be defined as a ≥50% reduction from baseline in Montgomery-Åsberg Depression Rating Scale (MADRS) total score at Week 8. Model predictive performance will be primarily assessed by the area under the receiver operating characteristic curve (AUROC), with internal validation performed using bootstrap resampling. Calibration, sensitivity, specificity, and predictive accuracy will be reported as supportive metrics.
Baseline to Week 8 (baseline predictors and Week 8 treatment response assessment)
Area Under the Receiver Operating Characteristic Curve (AUROC) of Multi-Omics-Based Models Integrating Baseline Profiles and Week 4 Molecular Changes for Predicting MADRS-Defined Antidepressant Treatment Response at Week 8
Time Frame: Baseline to Week 8
A longitudinal multivariable model integrating baseline clinical characteristics, baseline multi-omics profiles, and multi-omics changes from baseline to Week 4 will be developed to predict MADRS-defined antidepressant treatment response at Week 8. Treatment response will be defined as a ≥50% reduction from baseline in Montgomery-Åsberg Depression Rating Scale (MADRS) total score at Week 8. Multi-omics data will include immune profiling (CyTOF and cytokine profiling), genomics, epigenomics, bulk transcriptomics, single-cell transcriptomics, proteomics, metabolomics, and microbiome profiling. Model predictive performance will be primarily assessed by the area under the receiver operating characteristic curve (AUROC), with internal validation performed using bootstrap resampling. Calibration, sensitivity, specificity, and predictive accuracy will be reported as supportive metrics.
Baseline to Week 8
Number of Significantly Altered Multi-Omics Features From Baseline to Week 8 of Antidepressant Treatment
Time Frame: Baseline to Week 8
Longitudinal changes in multi-omics profiles from baseline to Week 8 will be analyzed to identify molecular features significantly altered following antidepressant treatment. Multi-omics analyses will include immune profiling (CyTOF and cytokine profiling), genomics, epigenomics, bulk transcriptomics, single-cell transcriptomics, proteomics, metabolomics, and microbiome profiling. Statistically significant features will be identified based on predefined statistical thresholds, and the number of significantly altered features will be reported.
Baseline to Week 8
Predictive Performance of Multi-Omics-Based Models for Predicting One-Year Sheehan Disability Scale (SDS) Score
Time Frame: Baseline to Year 1
A multivariable model integrating baseline clinical characteristics and multi-omics data will be developed to predict the Sheehan Disability Scale (SDS) total score at 1-year follow-up. The SDS is a self-reported scale assessing functional impairment. The SDS total score ranges from 0 to 30, with higher scores indicating greater functional impairment (worse outcome). Model predictive performance will be assessed using predefined regression metrics, including coefficient of determination (R²), root mean square error (RMSE), and mean absolute error (MAE). Internal validation will be performed using bootstrap resampling.
Baseline to Year 1

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Sponsor

The organization or person who initiates the study and who has authority and control over the study.
Shanghai Mental Health Center

Collaborators

Collaborators

An organization other than the sponsor that provides support for a clinical study. This support may include activities related to funding, design, implementation, data analysis, or reporting.
LinGang Laboratory

Investigators

Investigators

A researcher involved in a clinical study. Related terms include site principal investigator, site sub-investigator, study chair, study director, and study principal investigator.
  • Principal Investigator: Shen He, Shanghai Mental Health Center

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Estimated)

Study Start

The actual date on which the first participant was enrolled in a clinical study. The "anticipated" study start date is the date that the researchers think will be the study start date.
September 1, 2027

Primary Completion (Estimated)

Primary Completion

The date on which the last participant in a clinical study was examined or received an intervention to collect final data for the primary outcome measure. Whether the clinical study ended according to the protocol or was terminated does not affect this date. For clinical studies with more than one primary outcome measure with different completion dates, this term refers to the date on which data collection is completed for all the primary outcome measures. The "anticipated" primary completion date is the date that the researchers think will be the primary completion date for the study.
December 31, 2027

Study Completion (Estimated)

Study Completion

The date on which the last participant in a clinical study was examined or received an intervention/treatment to collect final data for the primary outcome measures, secondary outcome measures, and adverse events (that is, the last participant's last visit). The "anticipated" study completion date is the date that the researchers think will be the study completion date.
February 1, 2028

Study Registration Dates

First Submitted

First Submitted

The date on which the study sponsor or investigator first submitted a study record to ClinicalTrials.gov. There is typically a delay of a few days between the first submitted date and the record's availability on ClinicalTrials.gov (the first posted date).
July 20, 2026

First Submitted That Met QC Criteria

First Submitted That Met QC Criteria

The date on which the study sponsor or investigator first submits a study record that is consistent with National Library of Medicine (NLM) quality control (QC) review criteria. The sponsor or investigator may need to revise and submit a study record one or more times before NLM's QC review criteria are met. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
July 26, 2026

First Posted (Actual)

First Posted

The date on which the study record was first available on ClinicalTrials.gov after National Library of Medicine (NLM) quality control (QC) review has concluded. There is typically a delay of a few days between the date the study sponsor or investigator submitted the study record and the first posted date.
July 29, 2026

Study Record Updates

Last Update Posted (Actual)

Last Update Posted

The most recent date on which changes to a study record were made available on ClinicalTrials.gov. There may be a delay between when the changes were submitted to ClinicalTrials.gov by the study's sponsor or investigator (the last update submitted date) and the last update posted date.
August 3, 2026

Last Update Submitted That Met QC Criteria

Last Update Submitted That Met QC Criteria

The most recent date on which the study sponsor or investigator submitted changes to a study record that are consistent with National Library of Medicine (NLM) quality control (QC) review criteria. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
July 30, 2026

Last Verified

Last Verified

The most recent date on which the study sponsor or investigator confirmed the information about a clinical study on ClinicalTrials.gov as accurate and current. If a study with a recruitment status of recruiting; not yet recruiting; or active, not recruiting has not been confirmed within the past 2 years, the study's recruitment status is shown as unknown.
July 1, 2026

More Information

Terms related to this study

Additional Relevant MeSH Terms

Other Study ID Numbers

Other Study ID Numbers

Identifiers or ID numbers other than the NCT number that are assigned to a clinical study by the study's sponsor, funders, or others. These numbers may include unique identifiers from other trial registries and National Institutes of Health grant numbers.
  • iMORE PLus-MDD-01

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

UNDECIDED

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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