- ICH GCP
- Registro degli studi clinici negli Stati Uniti
- Sperimentazione clinica NCT01916824
Effects of Treatment on Decision-making in Major Depression
Panoramica dello studio
Stato
Condizioni
Intervento / Trattamento
Descrizione dettagliata
During episodes of depression patients with major depressive disorder (MDD) may make sub-optimal decisions based on exaggerated negative beliefs about themselves, the future, or the world around them. These disruptions in decision-making contribute adversely to quality of life, in both work and personal realms. Although effective treatments for depression are available, very little work has explored the effects of treatment on how people make decisions. The specific aspects of decision-making that differ between depressed and health control individuals are unknown, and whether any changes in these decision-making features occur as a result of improvement from depression, or whether medication treatment itself can lead to changes in decision-making, even in the absence of clinical improvement.
In this trial, fifty participants with current major depressive disorder who are not receiving an antidepressant medication and fifty healthy controls will complete questionnaires and computerized tasks to assess their decision-making styles. There will be three visits for depressed patients and two for healthy controls (the first and third visits). The first visit will involve interviews and questionnaires to assess the participant's level of depression, medical history and quality of life. Participants will then complete the decision-making tasks, and will earn between $5-40 based on their choices, in order to make the decisions on the computer tasks financially meaningful. At the completion of this visit, depressed patients will be prescribed an FDA-approved antidepressant, chosen in consultation with the treating psychiatrist. Patients will be responsible for paying for the prescription themselves. After two weeks on the medication, the patient will be seen for a follow-up visit to ensure tolerability of the medicine. After six weeks on the medicine, patients and healthy controls will return to repeat the questionnaires and the computer based decision-making tasks, and will again earn between $5-40 based on their performance.
The overall goal of this study will be to identify whether decision-making characteristics in people with major depression is affected by treatment, and whether depressed patients make decisions differently from healthy controls. A total of 4 decision-making tasks and one control task will be administered via computer to eligible subjects. The specific tasks are:
- Risk Task - This task assesses tolerance of risk by having participants decide whether they wish to accept a specific dollar payout, or to play a lottery with an uncertain payout.
- Balloon Analogue Risk Task - The participant is presented with a balloon and offered the chance to earn money by pumping the balloon up by clicking a button. Each click causes the balloon to incrementally inflate and money to be added to a counter up until some threshold, at which point the balloon is over inflated and explodes. Thus, each pump confers greater risk but also greater potential reward. If the participant chooses to cash-out prior to the balloon exploding then they collect the money earned for that trial, but if balloon explodes earnings for that trial are lost. Participants are not informed about the balloons breakpoints; the absence of this information allows for testing both participants' initial responses to the task and changes in responding as they gain experience with the task contingencies.
- Temporal Discounting Task - Participants are initially asked to choose between taking an immediate reward now or a larger reward at some time in the future. Decisions for seven time points over a 10-year time frame are proposed. The task is then repeated using choices between immediate and delayed losses, based on the same seven time points. This task assesses the manner in which subjects value immediate outcomes compared to long-term consequences.
- Ultimatum Game - The ultimatum game (UG) is a well-established game-theoretical paradigm commonly employed in behavioral economics to measure emotional reactions to unfair offers. In the UG, two subjects sequentially exchange real monetary amounts. Specifically, a proposer is provided with a sum of money by the experimenter ($10), and asked to share this amount of money with another player, the responder. The responder then decides whether to accept or reject the offer made by the proposer. If the responder accepts the offer, both players receive the respective amounts from the proposer's offer. If she rejects the offer made by the proposer, both players receive nothing ($0). This is best illustrated via the following two potential scenarios: 1. the proposer offers a fair split of $5 for himself and $5 for the responder. This is an offer that is typically accepted by a great majority of responders. 2. The proposer offers a split of $9 for himself and $1 for the responder. Such offers are commonly rejected by the majority of responders, despite incurring a financial loss of $1.
- Continuous Performance Task - This task involves identifying patterns of numbers briefly displayed on a computer screen. This task will serve as a control variable for attention in analyzing the results of the decision-making tasks.
Tipo di studio
Iscrizione (Effettivo)
Fase
- Fase 4
Contatti e Sedi
Luoghi di studio
-
-
Georgia
-
Atlanta, Georgia, Stati Uniti, 30322
- Emory Mood and Anxiety Disorders Program
-
-
Criteri di partecipazione
Criteri di ammissibilità
Età idonea allo studio
Accetta volontari sani
Sessi ammissibili allo studio
Descrizione
Inclusion Criteria for MDD Subjects:
- Male or female, age 18-65
- Primary Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV TR) Diagnosis of Major Depressive Disorder.
- Has a 17-item Hamilton depression rating scale (HDRS-17) score >=16.
- Ability to visually read and understand English language
- Not currently taking an antidepressant.
- Women of reproductive potential must be willing to take a medically approved form of birth control throughout the duration of the study.
Inclusion Criteria for Healthy Control Subjects:
- Male or female, age 18-65
- No current DSM-IV TR diagnosis of a mental illness.
- No lifetime history of Major Depressive Disorder or Dysthymia.
- Has a 17-item Hamilton depression rating scale (HDRS-17) score ≤7.
- Ability to visually read and understand English language
- Not currently taking any psychoactive medication
Exclusion Criteria for all subjects:
- Has met criteria at any time during their life for bipolar disorder, a primary psychotic disorder (e.g. schizophrenia), or dementia.
- Meet criteria for substance abuse or dependence within three months of the screening visit.
- Presents with a clinically significant suicide risk, as assessed by a study physician.
- Presence of any unstable or central nervous system-related medical illness that would interfere with cognition or participation.
- Women who are currently pregnant or lactating, or plan to become pregnant during the study.
Piano di studio
Come è strutturato lo studio?
Dettagli di progettazione
- Scopo principale: Altro
- Assegnazione: Non randomizzato
- Modello interventistico: Assegnazione parallela
- Mascheramento: Nessuno (etichetta aperta)
Armi e interventi
Gruppo di partecipanti / Arm |
Intervento / Trattamento |
---|---|
Sperimentale: Participants with Major Depressive Disorder
Persons with a primary diagnosis of Major Depressive Disorder who start taking any FDA-approved antidepressant prescribed within standard dose range for 6 weeks
|
Any FDA-approved antidepressant prescribed within standard dose range to treat Major Depressive Disorder will be taken for 6 weeks.
Psychiatric follow-up will be performed during the study participation.
At the end of the study, these participants will receive assistance in transitioning their care to another provider, depending on their individual circumstances.
Altri nomi:
|
Nessun intervento: Healthy Controls
Persons without a history of Major Depressive Disorder and without a current diagnosis of any mental illness
|
Cosa sta misurando lo studio?
Misure di risultato primarie
Misura del risultato |
Misura Descrizione |
Lasso di tempo |
---|---|---|
Money Earned
Lasso di tempo: Baseline, Week 6
|
Change in amount of money earned between baseline and after 6 weeks of antidepressant treatment is determined through a summary score from a variety of decision-making tasks. Participants received between $5 and $40 per visit, depending on the outcomes of the decisions made on the computerized tasks. Variable payment ensured that the decision-making tasks were approached realistically, as opposed to using hypothetical "points" that do not have meaning in the real world. Greater earnings indicate better financial decision-making. The specific tasks were:
|
Baseline, Week 6
|
Collaboratori e investigatori
Sponsor
Studiare le date dei record
Studia le date principali
Inizio studio
Completamento primario (Effettivo)
Completamento dello studio (Effettivo)
Date di iscrizione allo studio
Primo inviato
Primo inviato che soddisfa i criteri di controllo qualità
Primo Inserito (Stima)
Aggiornamenti dei record di studio
Ultimo aggiornamento pubblicato (Effettivo)
Ultimo aggiornamento inviato che soddisfa i criteri QC
Ultimo verificato
Maggiori informazioni
Termini relativi a questo studio
Parole chiave
Termini MeSH pertinenti aggiuntivi
- Sintomi comportamentali
- Disordini mentali
- Disturbi dell'umore
- Depressione
- Disordine depressivo
- Disturbo depressivo, maggiore
- Effetti fisiologici delle droghe
- Antagonisti adrenergici
- Agenti adrenergici
- Agenti neurotrasmettitori
- Meccanismi molecolari dell'azione farmacologica
- Depressori del sistema nervoso centrale
- Agenti del sistema nervoso periferico
- Inibitori enzimatici
- Analgesici
- Agenti del sistema sensoriale
- Agenti tranquillanti
- Psicofarmaci
- Inibitori dell'assorbimento della serotonina
- Inibitori dell'assorbimento dei neurotrasmettitori
- Modulatori di trasporto a membrana
- Agenti serotoninergici
- Agenti dopaminergici
- Antagonisti del recettore della serotonina 5-HT2
- Antagonisti della serotonina
- Agenti anti-ansia
- Inibitori dell'enzima del citocromo P-450
- Agenti antidepressivi, seconda generazione
- Inibitori della ricaptazione della serotonina e della noradrenalina
- Inibitori del citocromo P-450 CYP2D6
- Antagonisti del recettore della serotonina 5-HT3
- Inibitori dell'assorbimento della dopamina
- Antagonisti H1 dell'istamina
- Antagonisti dell'istamina
- Agenti di istamina
- Alfa-antagonisti adrenergici
- Antagonisti del recettore adrenergico alfa-2
- Sertralina
- Duloxetina cloridrato
- Citalopram
- Paroxetina
- Bupropione
- Desvenlafaxina succinato
- Venlafaxina cloridrato
- Mirtazapina
- Fluoxetina
- Agenti antidepressivi
Altri numeri di identificazione dello studio
- IRB00066705
Queste informazioni sono state recuperate direttamente dal sito web clinicaltrials.gov senza alcuna modifica. In caso di richieste di modifica, rimozione o aggiornamento dei dettagli dello studio, contattare register@clinicaltrials.gov. Non appena verrà implementata una modifica su clinicaltrials.gov, questa verrà aggiornata automaticamente anche sul nostro sito web .
Prove cliniche su Disturbo depressivo maggiore
-
National Institute of Allergy and Infectious Diseases...CompletatoVariola Major (vaiolo)Stati Uniti
-
National Institute of Allergy and Infectious Diseases...Completato
-
China Medical University HospitalCompletato
-
bluebird bioCompletato
-
CorrectSequence Therapeutics Co., LtdReclutamento
-
Memorial Sloan Kettering Cancer CenterAttivo, non reclutanteDiagnosi confermata di ß-talassemia MajorStati Uniti
-
Tanta UniversitySconosciutoNigella sativa con beta talassemia majorEgitto
-
Tanta UniversitySconosciutoAL-Hijama nella Thalassmia MajorEgitto
-
Hamad Medical CorporationTerminatoOsteoporosi | Talassemia Majors (Beta-talassemia Major)Qatar
-
Affiliated hospital of guangxi medical university...Zhongshan Hospital Xiamen University; The Affiliated Nanjing Drum Tower Hospital... e altri collaboratoriSconosciuto