Detecting Depression and Bipolar Disorder in Adolescents Using a Biomarker Panel
Study Details
Study Description
Brief Summary
Depression and bipolar disorder are major public health concerns for adolescents today. Teenage depression and bipolar disorder are associated with social isolation, family stress, school failure, substance abuse and suicide. Screening for depression and bipolar disorder so that treatment can be started early in the course of illness is an urgent public health priority. Many teens with bipolar disorder are incorrectly diagnosed as having unipolar depression. It is critical that adolescents receive proper screening and assessment that leads to an accurate diagnosis and treatment. An efficient, cost-effective, blood-based screening program could be performed on an annual or semi-annual basis to potentially detect depression and then differentiate between unipolar and bipolar depression. If this type of screening were able to detect a significant percentage of teens with depression or bipolar disorder, the positive impact on U.S. public health would be substantial. The purpose of this study is to conduct a pilot study to assess the probability of detecting adolescent unipolar and bipolar depression through blood samples.
Condition or Disease | Intervention/Treatment | Phase |
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Study Design
Arms and Interventions
Arm | Intervention/Treatment |
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Major Depressive Disorder Participants
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Other: MDDScoreTM
The child will receive a single blood draw (about 10 mL).
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Bipolar Disorder Participants:
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Other: MDDScoreTM
The child will receive a single blood draw (about 10 mL).
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Healthy Control Participants
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Other: MDDScoreTM
The child will receive a single blood draw (about 10 mL).
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Outcome Measures
Primary Outcome Measures
- Biomarker for Major Depressive Disorder (MDD) and Bipolar Disorder in Adolescents [4 years]
The MDDScore™ will determine the biomarker of Major Depressive Disorder (MDD) and Bipolar Disorder. The MDDScore™ is determined using nine blood based biomarkers (inflammatory markers [4], stress related hormones [2], neuroendocrine [1] and metabolic proteins [2]) on physiological pathways related to MDD. The test results for the MDDScore™ range from 1 to 10. If the patient's score is 1, the patient has a less than 10% likelihood of having MDD. If the patient's MDDScore™ is 10, the patient has a greater than 90% likelihood of having MDD. An MDDScore™ of 5 or less is considered normal or negative and a score of 6 or more is considered "diseased" or positive. This same scoring system would hold true for classifying the likelihood of having bipolar disorder, as well. Test characteristics, such as sensitivity and specificity, are calculated based on this determination.
Eligibility Criteria
Criteria
Inclusion of Major Depressive Disorder Participants:
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Male and female patients between the ages of 13 and 17 years
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Participants must be able to give informed assent, and parent(s)/guardian(s) must be able to give informed permission for study participation
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Diagnosis of MDD or depression not otherwise specified, as defined by Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition-TR criteria (DSM-IV-TR)
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Current mood state depressed for > 2 weeks
Inclusion of Bipolar Disorder Participants:
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Male and female patients between the ages of 13 and 17 years
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Participants must be able to give informed assent, and parent (s)/guardian (s) must be able to give informed permission for study participation
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Diagnosis of Bipolar I Disorder, Bipolar II Disorder, or not otherwise specified, as defined by Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition-TR criteria
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Current mood state depressed for > 2 weeks
Inclusion of Healthy Control Participants:
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Males and females between the ages of 13 and 17 years
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Participants must not meet DSM-IV-TR diagnostic criteria for a psychiatric or substance abuse disorder
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Participants must be able to give informed assent and parent (s)/guardian (s) must be able to give informed permission for study participation
Exclusion Criteria:
Exclusion of Major Depressive Disorder and Bipolar Disorder Participants:
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Meet the DSM-IV criteria for substance abuse or dependence in the last month
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History of fainting or other significant adverse event during blood draws in the past
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Dysthymia
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Daily use of oral or inhaled steroids
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High risk of suicidal behaviors, homicidal behaviors, or self-harm
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A medical condition, such as Addison's Disease, which is highly likely to influence the inflammatory or HPA responses
Exclusion of Healthy Control Participants:
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Clinically significant psychiatric or substance abuse disorder
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Unstable medical or neurological illness
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History of fainting or other significant adverse event during blood draws in the past
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Daily use of oral or inhaled steroids
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A medical condition, such as Addison's Disease, which is highly likely to influence the inflammatory or HPA responses
Contacts and Locations
Locations
Site | City | State | Country | Postal Code | |
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1 | University of Utah | Salt Lake City | Utah | United States | 84108 |
Sponsors and Collaborators
- University of Utah
Investigators
- Principal Investigator: Douglas Kondo, M.D., University of Utah
Study Documents (Full-Text)
None provided.More Information
Publications
- Greden JF. The burden of disease for treatment-resistant depression. J Clin Psychiatry. 2001;62 Suppl 16:26-31. Review.
- Iosifescu DV, Papakostas GI, Lyoo IK, Lee HK, Renshaw PF, Alpert JE, Nierenberg A, Fava M. Brain MRI white matter hyperintensities and one-carbon cycle metabolism in non-geriatric outpatients with major depressive disorder (Part I). Psychiatry Res. 2005 Dec 30;140(3):291-9.
- Kendler KS, Karkowski LM, Prescott CA. Causal relationship between stressful life events and the onset of major depression. Am J Psychiatry. 1999 Jun;156(6):837-41.
- McEwen BS. Effects of adverse experiences for brain structure and function. Biol Psychiatry. 2000 Oct 15;48(8):721-31.
- Murray, CJL, Lopez, AD (Eds), The Global Burden of Disease, Cambridge Mass., Harvard University Press, 1996.
- Pillay SS, Renshaw PF, Bonello CM, Lafer BC, Fava M, Yurgelun-Todd D. A quantitative magnetic resonance imaging study of caudate and lenticular nucleus gray matter volume in primary unipolar major depression: relationship to treatment response and clinical severity. Psychiatry Res. 1998 Dec 14;84(2-3):61-74.
- Renshaw, PF, Bilello, JA , Pi, B. Multianalyte Biomarker Blood Test to Aid in Diagnosis,Treatment and Management of Major Depressive Disorder. Poster NR7-014, American Psychiatric Association Meeting, May 2009.
- Robins LN, Regier DA (Eds). Psychiatric Disorders in America, The Epidemiologic Catchment Area Study, 1990; New York: The Free Press. Items 1 - 20 of 204
- Shelton RC. The molecular neurobiology of depression. Psychiatr Clin North Am. 2007 Mar;30(1):1-11. Review.
- Ridge II