- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT05317481
Reducing Suicide Risk in Adolescents and Young Adults Via a Psychobehavioral Intervention to Regularize Daily Rhythms
Reducing Suicide Risk in Adolescents and Young Adults Via a Psychobehavioral Intervention to Regularize Daily Rhythms and Improve Brain Circuitry Functioning
Study Overview
Status
Intervention / Treatment
Detailed Description
This is a randomized control trial (RCT) with subjects randomized 2:1 (using block randomization) to BE-SMART-DR or a psychoeducational control comparator condition (CC). Participation will include research clinical/behavioral interviews and symptom self-ratings, magnetic resonance imaging (MRI) scanning, actigraphy wearables, and use of smart phones for ecological momentary assessment (EMA). Subjects will participate in 12 weekly sessions and 6-month in person follow-up.
Objectives
- Show pre-post BE-SMART-DR suicidal ideation and propensity (SI/P) decreases associated with DR regularity and quality increases
- Show pre-post BE-SMART-DR improvements in the functioning of a brain system that subserves emotional and other behavioral control (i.e., a hypothalamus-amygdala-ventral prefrontal cortex (vPFC), (HAV), system)
Study Type
Enrollment (Estimated)
Phase
- Not Applicable
Contacts and Locations
Study Contact
- Name: Hilary Blumberg, MD
- Phone Number: 203-785-6180
- Email: hilary.blumberg@yale.edu
Study Contact Backup
- Name: Susan Quatrano, BA
- Phone Number: (203) 785-7875
- Email: susan.quatrano@yale.edu
Study Locations
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Connecticut
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New Haven, Connecticut, United States, 06510
- Recruiting
- Magnetic Resonance Research Center
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New Haven, Connecticut, United States, 06510
- Recruiting
- Mood Disorders Research Program
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-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- with Diagnostic and Statistical Manual 5 (DSM5) Bipolar Disorder (BD) I, II or Otherwise Specified (OS) or Major Depressive Disorder (MDD)
- have a history of 1 or more suicide attempts and/or a score of at least 3 on the SSI
Exclusion Criteria:
- Significant medical or neurologic illness (especially if related to cerebral tissue)
- MRI contraindication,
- pregnancy by urine test
- current moderate or severe alcohol/other substance use disorders except caffeine/nicotine
- positive urine screen for benzodiazepines, cocaine, amphetamines, phencyclidine, opiates, oxycodone; not cannabis as its use is common in this population and it can remain positive for a month
- current evidence-based individual psychotherapy (e.g. cognitive behavioral therapy, dialectical behavioral therapy,) or treatment directly targeting brain regions of interest e.g. transcranial magnetic stimulation or electro-convulsive therapy,
- current psychosis
- inability to provide informed consent, including IQ<70, Young Mania Rating Scale (YMRS) >25, or too symptomatic by PI's judgment
- active suicidal plan or intent or Columbia Suicide Severity Rating Scale (C-SSRS) stage "4" risk (some intent to carry out the plan; as indicated by multisite study assessing suicide risk in randomized clinical trials or if revealed on any rating scale or in judgment of any study clinician.
- homicidal ideation
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Prevention
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Single
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: BE-SMART-DR
Participation will include research clinical/behavioral interviews and symptom self-ratings, magnetic resonance imaging (MRI) scanning, actigraphy wearables, and use of smart phones for ecological momentary assessment (EMA).
Subjects will participate in 12 weekly sessions and 6-month in person follow-up.
|
Therapy that provides self-directed strategies to regularize sleep and other DRs to reduce short-term suicide risk that can be used lifelong to potentially also reduce long-term suicide risk
|
Active Comparator: control comparator condition
Matched for experimental, participation will include research clinical/behavioral interviews and symptom self-ratings, magnetic resonance imaging (MRI) scanning, actigraphy wearables, and use of smart phones for ecological momentary assessment (EMA).
Subjects will participate in 12 weekly sessions and 6-month in person follow-up.
|
Structured sessions, matched for BE-SMART-DR session number and time, that will emphasize established strategies to manage health and well being
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What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Change from baseline in BE-SMART-DR Suicidal Ideation/Propensity (SI/P) using Concise Health Risk Tracking Scale (CHRT)
Time Frame: baseline, week 1, week 7, week 12 and month 6
|
Change from baseline in Suicidal Ideation/Propensity (SI/P) using Concise Health Risk Tracking Scale (CHRT), a brief self report measure.
The CHRT Propensity score (9 items) covers the domains of pessimism, helplessness, despair and perceived lack of social support.
Items are scored on a five-point Likert scale with responses ranging from "strongly disagree" (zero) to "strongly agree" (four), thereby creating a total propensity score that ranges from 0-36, with higher scores showing higher levels of suicidal propensity and suicidal thoughts.
|
baseline, week 1, week 7, week 12 and month 6
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Change from baseline in BE-SMART-DRs Daily Rhythms (DR) using the Brief Social Rhythm Scale (BSRS)
Time Frame: baseline, week 1, week 7, week 12 and month 6
|
Change from baseline in BE-SMART-DRs Daily Rhythms (DR) will be assessed using the Brief Social Rhythm Scale (BSRS).
This is a measure of DR regularity for 10 activities that include social contexts.
It uses a scale ranging from 1 (very regularly) to 6 (very irregularly), with high mean scores indicating high irregularity.
Summary scores are the average across all 10 items with higher scores indicating higher irregularity.
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baseline, week 1, week 7, week 12 and month 6
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Change from baseline in BE-SMART-DRs Daily Rhythms (DR) using the Pittsburgh Sleep Quality Index (PSQI)
Time Frame: baseline, week 1, week 7, week 12 and month 6
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Change from baseline in BE-SMART-DRs Daily Rhythms (DR) using the Pittsburgh Sleep Quality Index (PSQI), a self-reported survey.
The 10 items in the PSQI relate to usual sleep habits over the last month, including time it takes to fall asleep, usual bedtime, hours of sleep per night, as well as questions about the frequency of sleep issues (not during the past month, less than once per week, once or twice per week, or three or more times per week).
Each of the sleep components yields a score ranging from 0 to 3, with 3 indicating the greatest dysfunction.
The sleep component scores are summed to yield a total score ranging from 0 to 21 with the higher total score (referred to as global score) indicating worse sleep quality.
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baseline, week 1, week 7, week 12 and month 6
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Change in the experimental group from baseline in BE-SMART-DR Suicidal Ideation/Propensity (SI/P) using Beck Scale for Suicide Ideation (SSI)
Time Frame: baseline, week 1, week 7, week 12 and month 6
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Change in the experimental group from baseline in BE-SMART-DR Suicidal Ideation/Propensity (SI/P) using the interviewer assessed Beck Scale for Suicide Ideation (SSI), one of the most widely used measures to assess suicidal ideation.
This is a 19 item scale with scores ranging from 0 to 38, with higher values indicating a greater risk of suicide.
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baseline, week 1, week 7, week 12 and month 6
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Change in the experimental group from baseline in BE-SMART-DRs Daily Rhythm (DR) using the Social Rhythm Metric (SRM)
Time Frame: up to 6 months
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Change in the experimental group from baseline in Daily Rhythms (DR) regularity using the Social Rhythm Metric (SRM).
This is a five-item measure to assess the stability of social rhythms.
Its interpretation can be qualitative and it can also be used as a therapy tool.
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up to 6 months
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Collaborators and Investigators
Sponsor
Collaborators
Investigators
- Principal Investigator: Hilary Blumberg, MD, Yale University
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Estimated)
Study Completion (Estimated)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- 2000032361
- STR-1-002-20 (Other Grant/Funding Number: American Foundation for Suicide Prevention)
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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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