Risks for Insulin Resistance and Metabolic Syndrome Between Major Depressive Disorder (MDD) or MDD With Psychotic Features
10 de febrero de 2017 actualizado por: John D. Matthews, Massachusetts General Hospital
Comparative Risks for Insulin Resistance and Metabolic Syndrome (MS) Among Hospitalized Patients With Major Depressive Disorder With (MDpsy) or Without (MDD) Psychotic Features
Studies have shown that people with certain disorders have an increased risk of developing a condition called Metabolic Syndrome (MS). In this study, the investigators want to learn more about MS among people staying in the hospital for treatment of Major Depressive Disorder (MDD) and also Major Depressive Disorder with Psychotic Features (MDpsy). The investigators also want to learn more about a stress hormone called cortisol that is made in the body. Those who take part in this study will answer some questionnaires, be given some psychiatric interviews, and have some blood taken along with a urine sample.
The investigators believe that patients in the hospital with MDpsy will have higher baseline rates of MS factors, cortisol levels, dexamethasone non-suppression, and insulin resistance, compared with MDD alone.
Descripción general del estudio
Estado
Terminado
Descripción detallada
Metabolic syndrome (MS) is a combination of medical problems that can increase the risk of heart disease and diabetes in some people. People with MS can have some or all of the following:
- High blood glucose
- High blood pressure
- Abdominal obesity
- Low levels of high-density lipoprotein (HDL) cholesterol
- High levels of triglycerides
Some studies have shown that people with certain disorders have a greater risk for developing MS. This may be because of a combination of factors, including but not limited to the type of medications used, age, and whether or not someone smokes. This study will also aim to learn more about a naturally-occurring stress hormone called cortisol that is made in the body.
In order to measure these factors, the following things will occur:
- administer a number of questionnaires
- gather information from medical history
- gather information about current psychiatric mood
- draw blood and collect a urine sample
To study the amount of cortisol in the body, a dexamethasone suppression test (DST) will be given. This test involves taking a single 1mg pill of dexamethasone, a steroid, and numerous blood draws. Like any drug, it has some risks, however it is unlikely any side effects will occur because of the low dose administered.
Tipo de estudio
De observación
Inscripción (Actual)
14
Contactos y Ubicaciones
Esta sección proporciona los datos de contacto de quienes realizan el estudio e información sobre dónde se lleva a cabo este estudio.
Ubicaciones de estudio
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Massachusetts
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Boston, Massachusetts, Estados Unidos, 02114
- Massachusetts General Hospital
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Criterios de participación
Los investigadores buscan personas que se ajusten a una determinada descripción, denominada criterio de elegibilidad. Algunos ejemplos de estos criterios son el estado de salud general de una persona o tratamientos previos.
Criterio de elegibilidad
Edades elegibles para estudiar
18 años a 85 años (Adulto, Adulto Mayor)
Acepta Voluntarios Saludables
No
Géneros elegibles para el estudio
Todos
Método de muestreo
Muestra no probabilística
Población de estudio
Eligible subjects are people who are inpatient in the medical-psychiatric unit at Massachusetts General Hospital.
Included subjects have working diagnosis of major depressive disorder (MDD) or major depressive disorder with psychotic features (MDpsy).
Descripción
Inclusion Criteria:
- Capable of giving informed consent
- DSM-IV TR diagnosis of Major Depressive Disorder with (MDpsy) or without (MDD) Psychotic Features
- Age between 18 and 85, inclusive
- Pre-existing Hyperlipidemia, Hypertension, and Diabetes must be stable with laboratory and clinical results within acceptable range; with or without medication for three months prior to admission
Exclusion Criteria:
- DSM-IV TR diagnosis of: schizophrenia, schizoaffective disorder, delusional disorder, bipolar disorder, organic mental disorder, substance use dependence including alcohol, that has been active within the past 6 months, acute bereavement, and psychotic disorder not elsewhere classified
- Subjects that meet criteria for substance or alcohol dependence more recently than three months prior to entering the study
- Subjects that meet criteria for substance or alcohol abuse more recently than four weeks prior to entering the study
- Pregnancy
- Unstable or inadequately treated pre-existing hyperlipidemia, hypertension, and diabetes
- Subjects who are involuntarily committed.
Plan de estudios
Esta sección proporciona detalles del plan de estudio, incluido cómo está diseñado el estudio y qué mide el estudio.
¿Cómo está diseñado el estudio?
Detalles de diseño
Cohortes e Intervenciones
Grupo / Cohorte |
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Trastorno depresivo mayor
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Major Depressive Disorder with Psychotic Features
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¿Qué mide el estudio?
Medidas de resultado primarias
Medida de resultado |
Medida Descripción |
Periodo de tiempo |
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The primary measure is any change in fasting insulin from admission to discharge while subjects are inpatient.
Periodo de tiempo: Measure fasting insulin at two timepoints; to determine change from baseline (admission) and discharge
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To preserve statistical power, we will measure insulin as a continuous variable rather than dichotomizing participants into insulin sensitive vs insulin resistant.
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Measure fasting insulin at two timepoints; to determine change from baseline (admission) and discharge
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Medidas de resultado secundarias
Medida de resultado |
Medida Descripción |
Periodo de tiempo |
|---|---|---|
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The first secondary measure is a fasting lipid panel, including fasting total cholesterol, fasting LDL, fasting HDL, and fasting triglycerides; we want to measure a change in data from admission to discharge
Periodo de tiempo: Two separate timepoints during inpatient hospitalization; first within 5 days of admission, and second within 72 hours of scheduled discharge
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Two separate timepoints during inpatient hospitalization; first within 5 days of admission, and second within 72 hours of scheduled discharge
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Fasting glucose will be a separate secondary outcome measure; we want to measure a change in data from admission to discharge
Periodo de tiempo: Two separate timepoints during inpatient hospitalization; first within 5 days of admission, and second within 72 hours of scheduled discharge
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Two separate timepoints during inpatient hospitalization; first within 5 days of admission, and second within 72 hours of scheduled discharge
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Waist Circumference; we want to measure a change in data from admission to discharge
Periodo de tiempo: Two separate timepoints during inpatient hospitalization; first within 5 days of admission, and second within 72 hours of scheduled discharge
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Waist circumference will be measured once at admission and once at discharge to determine if any changes have occurred throughout time of inpatient hospitalization
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Two separate timepoints during inpatient hospitalization; first within 5 days of admission, and second within 72 hours of scheduled discharge
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Urine microalbumin; we want to measure a change in data from admission to discharge
Periodo de tiempo: Two separate timepoints during inpatient hospitalization; first within 5 days of admission, and second within 72 hours of scheduled discharge
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Two separate timepoints during inpatient hospitalization; first within 5 days of admission, and second within 72 hours of scheduled discharge
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C-reactive Protein; we want to measure a change in data from admission to discharge
Periodo de tiempo: Two separate timepoints during inpatient hospitalization; first within 5 days of admission, and second within 72 hours of scheduled discharge
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Two separate timepoints during inpatient hospitalization; first within 5 days of admission, and second within 72 hours of scheduled discharge
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Homocysteine; we want to measure a change in data from admission to discharge
Periodo de tiempo: Two separate timepoints during inpatient hospitalization; first within 5 days of admission, and second within 72 hours of scheduled discharge
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Two separate timepoints during inpatient hospitalization; first within 5 days of admission, and second within 72 hours of scheduled discharge
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Blood pressure (supine & standing as available)
Periodo de tiempo: We will be measuring this continuously throughout inpatient hospitalization, beginning at time of admission
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We will be measuring this continuously throughout inpatient hospitalization, beginning at time of admission
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Cortisol; we want to measure a change in data from admission to discharge
Periodo de tiempo: Two separate timepoints during inpatient hospitalization; first within 5 days of admission, and second within 72 hours of scheduled discharge
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Cortisol levels will be measured before and after a dexamethasone suppression test is administered at admission and discharge
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Two separate timepoints during inpatient hospitalization; first within 5 days of admission, and second within 72 hours of scheduled discharge
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Colaboradores e Investigadores
Aquí es donde encontrará personas y organizaciones involucradas en este estudio.
Patrocinador
Fechas de registro del estudio
Estas fechas rastrean el progreso del registro del estudio y los envíos de resultados resumidos a ClinicalTrials.gov. Los registros del estudio y los resultados informados son revisados por la Biblioteca Nacional de Medicina (NLM) para asegurarse de que cumplan con los estándares de control de calidad específicos antes de publicarlos en el sitio web público.
Fechas importantes del estudio
Inicio del estudio (Actual)
1 de enero de 2011
Finalización primaria (Actual)
1 de septiembre de 2012
Finalización del estudio (Actual)
1 de septiembre de 2012
Fechas de registro del estudio
Enviado por primera vez
15 de febrero de 2011
Primero enviado que cumplió con los criterios de control de calidad
4 de marzo de 2011
Publicado por primera vez (Estimar)
8 de marzo de 2011
Actualizaciones de registros de estudio
Última actualización publicada (Actual)
13 de febrero de 2017
Última actualización enviada que cumplió con los criterios de control de calidad
10 de febrero de 2017
Última verificación
1 de febrero de 2017
Más información
Términos relacionados con este estudio
Palabras clave
Términos MeSH relevantes adicionales
- Síntomas de comportamiento
- Procesos Patológicos
- Trastornos del metabolismo de la glucosa
- Enfermedades metabólicas
- Trastornos del estado de ánimo
- Espectro de esquizofrenia y otros trastornos psicóticos
- Hiperinsulinismo
- Depresión
- Desorden depresivo
- Síndrome
- Enfermedad
- Desórdenes psicóticos
- Síndrome metabólico
- Desordenes mentales
- Resistencia a la insulina
- Trastorno Depresivo Mayor
Otros números de identificación del estudio
- 2009-P-002723
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