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

27 de julho de 2026 atualizado por: 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.

Visão geral do estudo

Tipo de estudo

Intervencional

Inscrição (Estimado)

700

Estágio

  • Não aplicável

Contactos e Locais

Esta seção fornece os detalhes de contato para aqueles que conduzem o estudo e informações sobre onde este estudo está sendo realizado.

Contato de estudo

Locais de estudo

      • Paris, França, 75014
        • GHU Paris - Psychiatrie et Neurosciences
        • Contato:

Critérios de participação

Os pesquisadores procuram pessoas que se encaixem em uma determinada descrição, chamada de critérios de elegibilidade. Alguns exemplos desses critérios são a condição geral de saúde de uma pessoa ou tratamentos anteriores.

Critérios de elegibilidade

Idades elegíveis para estudo

  • Adulto
  • Adulto mais velho

Aceita Voluntários Saudáveis

Não

Descrição

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.

Plano de estudo

Esta seção fornece detalhes do plano de estudo, incluindo como o estudo é projetado e o que o estudo está medindo.

Como o estudo é projetado?

Detalhes do projeto

  • Finalidade Principal: Outro
  • Alocação: Não randomizado
  • Modelo Intervencional: Atribuição Paralela
  • Mascaramento: Nenhum (rótulo aberto)

Armas e Intervenções

Grupo de Participantes / Braço
Intervenção / Tratamento
Outro: OCD cohort
Patients suffering from OCD resistant to treatments
the biomarker research involves different biological sampling : blood, stool, cerebrospinal fluid, skin
Outro: Catatonia cohort
Patients suffering from resistant catatonia
the biomarker research involves different biological sampling : blood, stool, cerebrospinal fluid, skin
Outro: TRD cohort
Patients suffering from treatment resistant depression (TRD)
the biomarker research involves different biological sampling : blood, stool, cerebrospinal fluid, skin
Outro: BD cohort
Patients suffering from treatment resistant bipolar disorders (BD)
the biomarker research involves different biological sampling : blood, stool, cerebrospinal fluid, skin
Outro: Schizophrenia cohort
Patients suffering from schizophrenia resistant to treatments
the biomarker research involves different biological sampling : blood, stool, cerebrospinal fluid, skin

O que o estudo está medindo?

Medidas de resultados primários

Medida de resultado
Descrição da medida
Prazo
Changes from inclusion (V1) in disease scale scores at the end of acute phase therapy (V3)
Prazo: 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)
Prazo: 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)
Prazo: 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)
Prazo: 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)
Prazo: 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)
Prazo: 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).
Prazo: 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).
Prazo: 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).
Prazo: 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).
Prazo: 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).
Prazo: 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).
Prazo: 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).
Prazo: 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

Medidas de resultados secundários

Medida de resultado
Descrição da medida
Prazo
Changes in CRPus from inclusion (V1) to Day 2 (V2)
Prazo: 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)
Prazo: 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)
Prazo: 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)
Prazo: 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)
Prazo: 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)
Prazo: 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)
Prazo: 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)
Prazo: 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
Prazo: 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
Prazo: 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
Prazo: 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
Prazo: 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
Prazo: 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
Prazo: 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
Prazo: 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
Prazo: 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
Prazo: 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
Prazo: 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
Prazo: 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)
Prazo: 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)
Prazo: 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)
Prazo: 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)
Prazo: 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)
Prazo: 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)
Prazo: 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
Prazo: 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)
Prazo: 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
Prazo: 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
Prazo: 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
Prazo: 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
Prazo: 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
Prazo: 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
Prazo: 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
Prazo: 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

Colaboradores e Investigadores

É aqui que você encontrará pessoas e organizações envolvidas com este estudo.

Investigadores

  • Diretor de estudo: Anne-Cécile PETIT, MD, PhD, GHU Paris Psychiatry & Neurosciences

Datas de registro do estudo

Essas datas acompanham o progresso do registro do estudo e os envios de resumo dos resultados para ClinicalTrials.gov. Os registros do estudo e os resultados relatados são revisados ​​pela National Library of Medicine (NLM) para garantir que atendam aos padrões específicos de controle de qualidade antes de serem publicados no site público.

Datas Principais do Estudo

Início do estudo (Estimado)

15 de julho de 2026

Conclusão Primária (Estimado)

1 de outubro de 2036

Conclusão do estudo (Estimado)

1 de agosto de 2038

Datas de inscrição no estudo

Enviado pela primeira vez

29 de junho de 2026

Enviado pela primeira vez que atendeu aos critérios de CQ

27 de julho de 2026

Primeira postagem (Real)

3 de agosto de 2026

Atualizações de registro de estudo

Última Atualização Postada (Real)

3 de agosto de 2026

Última atualização enviada que atendeu aos critérios de controle de qualidade

27 de julho de 2026

Última verificação

1 de junho de 2026

Mais Informações

Essas informações foram obtidas diretamente do site clinicaltrials.gov sem nenhuma alteração. Se você tiver alguma solicitação para alterar, remover ou atualizar os detalhes do seu estudo, entre em contato com register@clinicaltrials.gov. Assim que uma alteração for implementada em clinicaltrials.gov, ela também será atualizada automaticamente em nosso site .

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