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Treatment Resistance in Psychiatric Disorders: the Search for Biological Markers Predictive of Response to Treatment (BIO-INM)

27 juillet 2026 mis à jour par: Centre Hospitalier St Anne

The disruption of immune system is a key candidate in the pathogenesis of psychiatric disorders, especially those resistant to traditional treatments. Involving complex processes within the brain and peripheral immune system, inflammation may lead to imbalance of neurotransmitter systems and synaptic plasticity and directly contribute to the psychiatric symptoms observed in conditions such as depression, bipolar disorder (BD) and schizophrenia (SCZ).

Studies show that treatment-resistant depression (TRD) is associated with elevated levels of inflammatory markers in the blood, which are linked to a lower response to conventional antidepressants. Interventions that modulate this inflammatory response, such as immunomodulatory treatments or therapies targeting pro-inflammatory cytokines, have demonstrated beneficial effects by reducing symptoms and improving patients' quality of life.

A thorough understanding of the links between inflammation and treatment resistance therefore paves the way for innovative therapeutic strategies. These approaches could transform current practices by offering more personalized and effective solutions for patients suffering from chronic and resistant psychiatric disorders.

Aperçu de l'étude

Type d'étude

Interventionnel

Inscription (Estimé)

700

Phase

  • N'est pas applicable

Contacts et emplacements

Cette section fournit les coordonnées de ceux qui mènent l'étude et des informations sur le lieu où cette étude est menée.

Coordonnées de l'étude

Lieux d'étude

      • Paris, France, 75014
        • GHU Paris - Psychiatrie et Neurosciences
        • Contact:

Critères de participation

Les chercheurs recherchent des personnes qui correspondent à une certaine description, appelée critères d'éligibilité. Certains exemples de ces critères sont l'état de santé général d'une personne ou des traitements antérieurs.

Critère d'éligibilité

Âges éligibles pour étudier

  • Adulte
  • Adulte plus âgé

Accepte les volontaires sains

Non

La description

Inclusion Criteria:

  • Patient aged ≥ 18 years old;
  • Patient suffering from a psychiatric disorder according to DSM-5 criteria;
  • Patient with drug-resistant disease according to the definition of the protocol
  • Patient starting a new treatment for his pathology;
  • Patient informed and having signed an informed consent;
  • Patient covered by the social security system.

Exclusion Criteria:

  • Patient with major neurocognitive disorder diagnosed (dementia syndrome)
  • Pregnant, laboring, or breastfeeding female patients
  • Patient deprived of liberty by judicial or administrative decision. Patient in psychiatric care under constraints may be included.
  • For patients accepting the lumbar punction: patients who are unable to control themselves and are likely to engage in physical or violent behavior.

Plan d'étude

Cette section fournit des détails sur le plan d'étude, y compris la façon dont l'étude est conçue et ce que l'étude mesure.

Comment l'étude est-elle conçue ?

Détails de conception

  • Objectif principal: Autre
  • Répartition: Non randomisé
  • Modèle interventionnel: Affectation parallèle
  • Masquage: Aucun (étiquette ouverte)

Armes et Interventions

Groupe de participants / Bras
Intervention / Traitement
Autre: OCD cohort
Patients suffering from OCD resistant to treatments
the biomarker research involves different biological sampling : blood, stool, cerebrospinal fluid, skin
Autre: Catatonia cohort
Patients suffering from resistant catatonia
the biomarker research involves different biological sampling : blood, stool, cerebrospinal fluid, skin
Autre: TRD cohort
Patients suffering from treatment resistant depression (TRD)
the biomarker research involves different biological sampling : blood, stool, cerebrospinal fluid, skin
Autre: BD cohort
Patients suffering from treatment resistant bipolar disorders (BD)
the biomarker research involves different biological sampling : blood, stool, cerebrospinal fluid, skin
Autre: Schizophrenia cohort
Patients suffering from schizophrenia resistant to treatments
the biomarker research involves different biological sampling : blood, stool, cerebrospinal fluid, skin

Que mesure l'étude ?

Principaux critères de jugement

Mesure des résultats
Description de la mesure
Délai
Changes from inclusion (V1) in disease scale scores at the end of acute phase therapy (V3)
Délai: Up to 10 weeks
Changes in Positive and Negative Syndrome Scale (PANSS) scores between inclusion (V1) and the end of acute phase therapy (V3). The scale will be used to assess disease severity for Schizophrenia patients. The minimal score is 30. The maximal score is 210.
Up to 10 weeks
Changes from inclusion (V1) in disease scale scores at the end of acute phase therapy (V3)
Délai: Up to 10 weeks
Changes in Montgomery-Åsberg Depression Rating Scale (MADRS) scores between inclusion (V1) and the end of acute phase therapy (V3). The scale will be used to assess disease severity for depression. The minimal score is 0. The maximal score is 60.
Up to 10 weeks
Changes from inclusion (V1) in disease scale scores at the end of acute phase therapy (V3)
Délai: Up to 10 weeks
Changes in Young Mania Rating Scale (YMRS) scores between inclusion (V1) and the end of acute phase therapy (V3). The scale will be used to assess disease severity for bipolar troubles. The minimal score is 0. The maximal score is 60.
Up to 10 weeks
Changes from inclusion (V1) in disease scale scores at the end of acute phase therapy (V3)
Délai: Up to 10 weeks
Changes in Obsessive-Compulsive Inventory-Revised (OCI-R) scores between inclusion (V1) and the end of acute phase therapy (V3). The scale will be used to assess disease severity for obsessive compulsive disorder. The minimal score is 0. The maximal score is 72.
Up to 10 weeks
Changes from inclusion (V1) in disease scale scores at the end of acute phase therapy (V3)
Délai: Up to 10 weeks
Changes in Visual analogic scale for obsessive compulsive disorder (VAS-OCD) scores between inclusion (V1) and the end of acute phase therapy (V3). The scale will be used to assess disease severity for obsessive compulsive disorder. The minimal score is 0 mm. The maximal score is 100 mm.
Up to 10 weeks
Changes from inclusion (V1) in disease scale scores at the end of acute phase therapy (V3)
Délai: Up to 10 weeks
Changes in Bush-Francis Catatonia Rating Scale (BFCRS) scores between inclusion (V1) and the end of acute phase therapy (V3). The scale will be used to assess disease severity for catatonia. The minimal score is 0 mm. The maximal score is 69.
Up to 10 weeks
Changes from inclusion (V1) in biological parameters at the end of acute phase therapy (V3).
Délai: Up to 10 weeks
Changes in biological parameters measured between inclusion (V1) and the end of acute phase therapy (V3). The dosages are : White blood cells, neutrophils, eosinophils, basophils, lymphocytes, monocytes, platelets in G/L
Up to 10 weeks
Changes from inclusion (V1) in biological parameters at the end of acute phase therapy (V3).
Délai: Up to 10 weeks
Changes in biological parameters measured between inclusion (V1) and the end of acute phase therapy (V3). The dosages are : C3, C4, fibrinogen in g/L.
Up to 10 weeks
Changes from inclusion (V1) in biological parameters at the end of acute phase therapy (V3).
Délai: Up to 10 weeks
Changes in biological parameters measured between inclusion (V1) and the end of acute phase therapy (V3). The dosages are : Vitamin B12, IL-1β, IL-6, IL-18 in pg/mL.
Up to 10 weeks
Changes from inclusion (V1) in biological parameters at the end of acute phase therapy (V3).
Délai: Up to 10 weeks
Changes in biological parameters measured between inclusion (V1) and the end of acute phase therapy (V3). The dosages are : Folate, Vitamin B1, B6, D, cortisol in nmol/L.
Up to 10 weeks
Changes from inclusion (V1) in biological parameters at the end of acute phase therapy (V3).
Délai: Up to 10 weeks
Changes in biological parameters measured between inclusion (V1) and the end of acute phase therapy (V3). The dosages are : TSH, prolactin in mUI/L
Up to 10 weeks
Changes from inclusion (V1) in biological parameters at the end of acute phase therapy (V3).
Délai: Up to 10 weeks
Changes in biological parameters measured between inclusion (V1) and the end of acute phase therapy (V3). The dosages are : CRPus, β2 microglobulin, C1q in mg/L.
Up to 10 weeks
Changes from inclusion (V1) in biological parameters at the end of acute phase therapy (V3).
Délai: Up to 10 weeks
Changes in biological parameters measured between inclusion (V1) and the end of acute phase therapy (V3). The dosages are : anti-TPO Ab, anti-TG Ab, CH50 in UI/mL.
Up to 10 weeks

Mesures de résultats secondaires

Mesure des résultats
Description de la mesure
Délai
Changes in CRPus from inclusion (V1) to Day 2 (V2)
Délai: From enrollment to Day 2
Variation in CRPus between inclusion (V1) and Day 2 (V2) in mg/L.
From enrollment to Day 2
Changes in immunity markers from inclusion (V1) to Day 2 (V2)
Délai: From enrollment to Day 2
Variation in IL-1β, IL-6, and IL-18 between inclusion (V1) and Day 2 (V2) in pg/mL.
From enrollment to Day 2
Changes from inclusion (V1) in standardized clinical disease scale scores at Day 2 (V2)
Délai: From enrollment to Day 2
Changes in Bush-Francis Catatonia Rating Scale (BFCRS) scores between inclusion (V1) and Day 2 (V2). The scale will be used to assess disease severity for catatonia. The minimal score is 0 mm. The maximal score is 69.
From enrollment to Day 2
Changes from inclusion (V1) in standardized clinical disease scale scores at Day 2 (V2)
Délai: From enrollment to Day 2
Changes in Positive and Negative Syndrome Scale (PANSS) scores between inclusion (V1) and Day 2 (V2). The scale will be used to assess disease severity for Schizophrenia patients. The minimal score is 30. The maximal score is 210.
From enrollment to Day 2
Changes from inclusion (V1) in standardized clinical disease scale scores at Day 2 (V2)
Délai: From enrollment to Day 2
Changes in Montgomery-Åsberg Depression Rating Scale (MADRS) scores between inclusion (V1) and day 2 (V2). The scale will be used to assess disease severity for depression. The minimal score is 0. The maximal score is 60.
From enrollment to Day 2
Changes from inclusion (V1) in standardized clinical disease scale scores at Day 2 (V2)
Délai: From enrollment to Day 2
Changes in Young Mania Rating Scale (YMRS) scores between inclusion (V1) and Day 2 (V2). The scale will be used to assess disease severity for bipolar troubles. The minimal score is 0. The maximal score is 60.
From enrollment to Day 2
Changes from inclusion (V1) in standardized clinical disease scale scores at Day 2 (V2)
Délai: From enrollment to Day 2
Changes in Visual analogic scale for obsessive compulsive disorder (VAS-OCD) scores between inclusion (V1) and Day 2 (V2). The scale will be used to assess disease severity for obsessive compulsive disorder. The minimal score is 0 mm. The maximal score is 100 mm.
From enrollment to Day 2
Changes from inclusion (V1) in standardized clinical disease scale scores at Day 2 (V2)
Délai: From enrollment to Day 2
Changes in Obsessive-Compulsive Inventory-Revised (OCI-R) scores between inclusion (V1) and Day 2 (V2). The scale will be used to assess disease severity for obsessive compulsive disorder. The minimal score is 0. The maximal score is 72.
From enrollment to Day 2
Changes from inclusion (V1) to end of study (M24) in standardized clinical disease scale scores
Délai: through study completion, an average of 2 years
Changes in Positive and Negative Syndrome Scale (PANSS) scores between inclusion (V1) and the end of study EOS (M24). The scale will be used to assess disease severity for Schizophrenia patients. The minimal score is 30. The maximal score is 210.
through study completion, an average of 2 years
Changes from inclusion (V1) to end of study (M24) in standardized clinical disease scale scores
Délai: through study completion, an average of 2 years
Changes in Montgomery-Åsberg Depression Rating Scale (MADRS) scores between inclusion (V1) and the end of study (M24). The scale will be used to assess disease severity for depression. The minimal score is 0. The maximal score is 60.
through study completion, an average of 2 years
Changes from inclusion (V1) to end of study (M24) in standardized clinical disease scale scores
Délai: through study completion, an average of 2 years

Variation in standardized clinical disease scale scores between inclusion (V1) and EOS (M24).

Changes in Young Mania Rating Scale (YMRS) scores between inclusion (V1) and the end of study (M24). The scale will be used to assess disease severity for bipolar troubles. The minimal score is 0. The maximal score is 60.

through study completion, an average of 2 years
Changes from inclusion (V1) to end of study (M24) in standardized clinical disease scale scores
Délai: through study completion, an average of 2 years
Changes in Obsessive-Compulsive Inventory-Revised (OCI-R) scores between inclusion (V1) and the end of study (M24). The scale will be used to assess disease severity for obsessive compulsive disorder. The minimal score is 0. The maximal score is 72.
through study completion, an average of 2 years
Changes from inclusion (V1) to end of study (M24) in standardized clinical disease scale scores
Délai: through study completion, an average of 2 years

Variation in standardized clinical disease scale scores between inclusion (V1) and EOS (M24).

Changes in Visual analogic scale for obsessive compulsive disorder (VAS-OCD) scores between inclusion (V1) and the end of study (M24). The scale will be used to assess disease severity for obsessive compulsive disorder. The minimal score is 0 mm. The maximal score is 100 mm.

through study completion, an average of 2 years
Changes from inclusion (V1) to end of study (M24) in standardized clinical disease scale scores
Délai: through study completion, an average of 2 years
Changes in Bush-Francis Catatonia Rating Scale (BFCRS) scores between inclusion (V1) and the end of study (M24). The scale will be used to assess disease severity for catatonia. The minimal score is 0 mm. The maximal score is 69.
through study completion, an average of 2 years
Changes from inclusion (V1) to end of study (M24) in CBC components
Délai: through study completion, an average of 2 years
Variation in Complete Blood Count components between inclusion (V1) and End Of Study (M24) : White blood cells, neutrophils, eosinophils, basophils, lymphocytes, monocytes, platelets in G/L.
through study completion, an average of 2 years
Changes from inclusion (V1) to end of study (M24) in Folates, Vitamin B6, Vitamin B1, Vitamin D
Délai: through study completion, an average of 2 years
Changes in biological parameters measured between inclusion (V1) and the End Of Study (M24). The dosages are : Folates, Vitamins B1, B6, D in nmol/L.
through study completion, an average of 2 years
Changes from inclusion (V1) to end of study (M24) in Vitamin B12
Délai: through study completion, an average of 2 years
Changes in Vitamin B12 measured between inclusion (V1) and the End Of Study (M24) in pg/mL.
through study completion, an average of 2 years
Changes from inclusion (V1) to end of study (M24) in TSH, prolactin
Délai: through study completion, an average of 2 years
Changes in biological parameters measured between inclusion (V1) and End Of Study (M24). The dosages are : TSH, prolactin in mUI/L
through study completion, an average of 2 years
Changes from inclusion (V1) to end of study (M24) in drug dosage
Délai: through study completion, an average of 2 years
Variation in drug dosage between inclusion (V1) and End Of Study (M24). Unit could be different according to the drug.
through study completion, an average of 2 years
Changes from inclusion in levels of pro-inflammatory cytokines and other immune biomarkers in cerebrospinal fluid, skin biopsies and/or stool, at end of acute treatment (V3), 6-month follow-up (V4), 12-month follow-up (V5) and 24-month follow-up (V6)
Délai: At inclusion (V1), 10 weeks, 6 months-, 12 months- and 24 months after end of acute treatment
Change in levels of pro-inflammatory cytokines and other immune biomarkers in other biological samples (cerebrospinal fluid (CSF), skin biopsies, stool) between inclusion (V1) , end of acute treatment (V3), 6-month follow-up (V4), 12-month follow-up (V5) and 24-month follow-up (V6). This will enable direct assessment of the efficacy of interventions on immune processes.
At inclusion (V1), 10 weeks, 6 months-, 12 months- and 24 months after end of acute treatment
Changes from inclusion (V1) in functional (Clinical Global Impression, CGI-S and CGI-I) scores to end of acute treatment (V3)
Délai: Up to 10 weeks

Variation in Clinical Global Impression (CGI-S and CGI-I) questionnaire scores between inclusion (V1) and end of acute treatment (V3):

  • CGI-Severity (CGI-S) assess global disease severity. The Score min is 1 and Score max is 7.
  • CGI-Improvement (CGI-I) : assess the improvement or deterioration of the disease compared to initial state. The Score min is 1 (highly improved). The Score max is 7 (Highly deteriorated).
Up to 10 weeks
Changes from inclusion (V1) in quality of life (by WHOQOL-BREF questionnaire) scores to end of acute treatment (V3)
Délai: Up to 10 weeks
Variation in WHOQOL-BREF questionnaire scores between inclusion (V1) and end of acute treatment (V3). The minimum score is 16 and the maximum is 80. The higher the score, the better the perceived quality of life in the relevant area.
Up to 10 weeks
Changes from inclusion in quality of life (by WHOQOL-BREF scores), to End Of Study (M24)
Délai: through study completion, an average of 2 years
Variation in quality-of-life questionnaire scores (WHOQOL-BREF) between inclusion (V1) and End Of Study (M24). The minimal score is 16 and the maximal is 80. The higher the score, the better the perceived quality of life in the relevant area.
through study completion, an average of 2 years
Changes from inclusion in functional score (by Clinical Global Impression scale), to End Of Study (M24)
Délai: through study completion, an average of 2 years

Variation in Clinical Global Impression (CGI-S and CGI-I) questionnaire scores between inclusion (V1) and end of study (M24):

  • CGI-Severity (CGI-S) assess global disease severity. The Score min is 1 and Score max is 7.
  • CGI-Improvement (CGI-I) : assess the improvement or deterioration of the disease compared to initial state. The Score min is 1 (highly improved). The Score max is 7 (Highly deteriorated).
through study completion, an average of 2 years
Number of side-effects (type, intensity, severity) in total population and by cohort between study inclusion (V1) and end of study (M24)
Délai: through study completion, an average of 2 years
Side-effects (type, intensity, severity) in total population and by cohort between study inclusion and End Of Study (M24)
through study completion, an average of 2 years
Number and characteristics of biomarkers identified in the retrospectively and prospectively included populations
Délai: through study completion, an average of 2 years
The number and characteristics of biomarkers identified in the retrospectively and prospectively included populations throughout the study
through study completion, an average of 2 years
Changes from inclusion (V1) in fibrinogen, C3, C4 to End Of Study (M24)
Délai: through study completion, an average of 2 years
Changes in biological parameters measured between inclusion (V1) and the end of study (M24). The dosages are : C3, C4, fibrinogen in g/L.
through study completion, an average of 2 years
Changes from inclusion (V1) to End Of Study (M24) in IL-1β, IL-6, IL-18
Délai: through study completion, an average of 2 years
Changes in biological parameters measured between inclusion (V1) and the End Of Study (M24). The dosages are : IL-1β, IL-6, IL-18 in pg/mL.
through study completion, an average of 2 years
Changes from inclusion (V1) to End Of Study (M24) in cortisol dosage
Délai: through study completion, an average of 2 years
Changes in cortisol measured between inclusion (V1) and the end of study (M24) in nmol/L.
through study completion, an average of 2 years
Changes from inclusion (V1) to End Of Study (M24) in CRPus, β2 microglobulin, C1q
Délai: through study completion, an average of 2 years
Changes in biological parameters measured between inclusion (V1) and End Of Study (M24). The dosages are : CRPus, β2 microglobulin, C1q in mg/L.
through study completion, an average of 2 years
Changes from inclusion (V1) to End Of Study (M24) in anti-TPO Ab, anti-TG Ab, CH50
Délai: through study completion, an average of 2 years
Changes in biological parameters measured between inclusion (V1) and the End Of Study (M24). The dosages are : anti-Peroxidase Antibodies, anti-thyroglobulin Antibodies, Hemolytic Complement 50 in UI/mL.
through study completion, an average of 2 years
Changes from inclusion (V1) to End Of Study (M24) in anti-TRAK Ab
Délai: through study completion, an average of 2 years
Variation in anti TSH receptor specific Antibodies (anti-TRAK Ab) between inclusion (V1) and End Of Study (M24)
through study completion, an average of 2 years
Changes from inclusion (V1) to End Of Study (M24) in neuronal Ab
Délai: through study completion, an average of 2 years
Number of positive neuronal antibodies between inclusion (V1) and End Of Study (M24)
through study completion, an average of 2 years
Changes from inclusion (V1) to End Of Study (M24) in interferon signature score
Délai: through study completion, an average of 2 years
Variation in interferon signature score between inclusion (V1) and End Of Study (M24)
through study completion, an average of 2 years

Collaborateurs et enquêteurs

C'est ici que vous trouverez les personnes et les organisations impliquées dans cette étude.

Les enquêteurs

  • Directeur d'études: Anne-Cécile PETIT, MD, PhD, GHU Paris Psychiatry & Neurosciences

Dates d'enregistrement des études

Ces dates suivent la progression des dossiers d'étude et des soumissions de résultats sommaires à ClinicalTrials.gov. Les dossiers d'étude et les résultats rapportés sont examinés par la Bibliothèque nationale de médecine (NLM) pour s'assurer qu'ils répondent à des normes de contrôle de qualité spécifiques avant d'être publiés sur le site Web public.

Dates principales de l'étude

Début de l'étude (Estimé)

15 juillet 2026

Achèvement primaire (Estimé)

1 octobre 2036

Achèvement de l'étude (Estimé)

1 août 2038

Dates d'inscription aux études

Première soumission

29 juin 2026

Première soumission répondant aux critères de contrôle qualité

27 juillet 2026

Première publication (Réel)

3 août 2026

Mises à jour des dossiers d'étude

Dernière mise à jour publiée (Réel)

3 août 2026

Dernière mise à jour soumise répondant aux critères de contrôle qualité

27 juillet 2026

Dernière vérification

1 juin 2026

Plus d'information

Termes liés à cette étude

Plan pour les données individuelles des participants (IPD)

Prévoyez-vous de partager les données individuelles des participants (DPI) ?

NON

Informations sur les médicaments et les dispositifs, documents d'étude

Étudie un produit pharmaceutique réglementé par la FDA américaine

Non

Étudie un produit d'appareil réglementé par la FDA américaine

Non

Ces informations ont été extraites directement du site Web clinicaltrials.gov sans aucune modification. Si vous avez des demandes de modification, de suppression ou de mise à jour des détails de votre étude, veuillez contacter register@clinicaltrials.gov. Dès qu'un changement est mis en œuvre sur clinicaltrials.gov, il sera également mis à jour automatiquement sur notre site Web .

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