Psychological Outcomes in Isolated GnRH Deficiency

Psychological Outcomes in Isolated GNRH Deficiency

Background:

- Isolated (or Congenital) GnRH Deficiency (IGD) is a rare disease. People who have this go through puberty late. Some never reach puberty or don t complete it without treatment. They also may have an impaired sense of smell or other health problems. Research shows that disorders like this can have a negative effect on a person s psychological profile.

Objective:

- To understand the psychological outcomes in people with IGD. These can include depression, anxiety, poor health, and poor social function.

Eligibility:

• Adults age 18 and over with IGD. They must be currently on a full dose of hormone replacement therapy for at least 3 months.
• Healthy adult volunteers.

Design:

• Participants will get a username and password. This will give them access to questions online. They can do this from any computer connected to the Internet.
• Participants will log in and complete the questionnaires. There are 5 total, but they will appear as 1 continuous set of questions. Answering them takes about 1 hour or less.
• The first set is about the participant s disorder. The rest ask about depression, anxiety, global health, and social function.
• All answers will be used for research and to better understand reproductive disorders. Only researchers from the NIH Unit on Genetics of Puberty and Reproduction and from this study will know which answers belong to which participant.

Study Overview

• Status: Terminated
• Conditions: Hypogonadism

Detailed Description

Isolated GnRH Deficiency (IGD) is a rare disorder characterized by decreased secretion of GnRH, resulting in impaired gonadotropin secretion and subsequent impaired sex-steroid production. Patients with this rare clinical syndrome present with absent, delayed, or stalled pubertal development by eighteen years of age. In addition, non-reproductive phenotypes of this spectrum have been identified in some individuals, including anosmia, auditory and ocular defects, and skeletal, neurological, and renal anomalies.

Due to the complex heterogeneity among affected individuals and the rarity of the disease itself, the phenotypic spectrum has not been fully investigated. The relationship between psychological disorders and IGD remains largely unexplored as a phenotypic association, despite evidence that disorders of puberty and reproduction can have a negative impact on the psychological profile.

This study aims to conduct a preliminary investigation into the association between psychological symptoms and IGD. We plan to recruit adult patients with a diagnosis of IGD to complete online assessments that measure psychological health outcomes from the patient perspective in order to gauge the prevalence of negative emotional states among affected individuals, compared to healthy controls. This will determine whether further studies are necessary to investigate psychiatric disease as part of the phenotypic spectrum of the disorder, and will improve our understanding of this complex disorder as a whole. Greater knowledge of the psychological impact of IGD may impact the current standards of evaluation and treatment of patients with delayed pubertal maturation.

• Study Type: Observational
• Enrollment (Actual): 48

Contacts and Locations

Study Locations

• United States
  • Maryland
    • Bethesda, Maryland, United States, 20892
      • National Institute of Child Health and Human Development (NICHD), 9000 Rockville

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years to 200 years (Adult, Older Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

Description

• ELIGIBILITY CRITERIA FOR IGD PATIENTS:

INCLUSION CRITERIA:

Males or females with clinical findings consistent with IGD who are greater than or equal to 18 years old and treated with hormone replacement therapy for IGD at the full adult replacement dose for at least 3 months. Clinical findings of IGD will be confirmed by a nurse or physician associated with this protocol, and include: clinical presentation consistent with a diagnosis of IGD, such as delayed, incomplete, or absent pubertal development, and a record of serum hormone levels demonstrating low total testosterone (males) or estradiol (females) in association with low or inappropriately normal gonadotropin levels in a clinic note or history and physical, and individuals with records demonstrating failure to undergo normal puberty. Anosmia may or may not be present. Since IGD presents as a phenotypic spectrum, there are no specific exclusion criteria for this study, except as noted below.

EXCLUSION CRITERIA:

• Patients with a diagnosis of IGD who are <18 years old;
• Patients with a diagnosis of IGD who are not on a full adult replacement dose of sex hormone therapy for at least 3 months;
• Patients who do not have a diagnosis of IGD as indicated by the inclusion criteria above;
• Patients without access to a computer connected to the internet;
• Patients who cannot read, write, and understand English at an eighth grade level or above.

ELIGIBILITY CRITERIA FOR HEALTHY CONTROLS:

INCLUSION CRITERIA:

Healthy males or females who are greater than or equal to 18 years old.

EXCLUSION CRITERIA:

• Subjects with any chronic medical condition, other than seasonal/environmental allergies;
• Subjects with a BMI < 18.5 or > 29.9;
• Subjects with prior history of abnormal pubertal development, infertility, or anosmia;
• Subjects with a family history of IGD;
• Subjects without access to a computer connected to the internet;
• Subjects who cannot read, write, and understand English at an eighth grade level or above.

Study Plan

How is the study designed?

Number of groups / cohorts

2

Cohorts and Interventions

Group / Cohort
Healthy Controls; Healthy males or females who are greater than or equal to 18 years old.
Patients; Males or females with a diagnosis of IGD (Isolated GnRH Deficiency) who are greater than or equal to 18 years old.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
The primary outcome is to identify whether patients with Isolated GnRH Deficiency have a higher prevalence of negative emotional states, including depression, anxiety, poor social function and quality of life, than healthy controls.	In analysis phase	At enrollment

Collaborators and Investigators

• Sponsor: Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD)
• Investigators: Principal Investigator: Angela Delaney Freedman, M.D., Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD)

Study record dates

Study Major Dates

• Study Start: February 4, 2015
• Primary Completion (Actual): June 1, 2017
• Study Completion (Actual): July 16, 2019

Study Registration Dates

• First Submitted: February 4, 2015
• First Submitted That Met QC Criteria: February 4, 2015
• First Posted (Estimate): February 5, 2015

Study Record Updates

• Last Update Posted (Actual): July 18, 2019
• Last Update Submitted That Met QC Criteria: July 17, 2019
• Last Verified: July 16, 2019

More Information

Terms related to this study

• Keywords: Depression; Quality of Life; Hypogonadotropic Hypogonadism; Kallmann Syndrome
• Additional Relevant MeSH Terms: Endocrine System Diseases; Gonadal Disorders; Hypogonadism
• Other Study ID Numbers: 999915077; 15-CH-N077