Identifying Biological Markers for Severe Depression

Study Overview
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Brief Summary
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The primary objective of this study is to investigate the biological components of major depression. The investigators are particularity interested in genetic variation and how it contributes to cortisol (because cortisol is higher in severe depression than mild depression or healthy controls) and how it contributes to clinical symptoms, especially suicidal ideation/behavior and psychosis.

Official Title
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Identifying Biological Markers for Severe Depression

Conditions
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Major Depressive Disorder

Participation Criteria
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Eligibility Criteria
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Inclusion criteria for depressed patients: Diagnostic and Statistical Manual of Mental Disorders 4th Edition (DSM-IV) diagnosis of Unipolar Major Depressive Disorder with or without psychotic features. 21-item Hamilton Depression Rating Scale (HDRS) score greater than or equal to 21. Thase Core Endogenomorphic Scale score greater than or equal to 8 on the items included in the 21-item HDRS. Between 18 - 70 years of age. If currently taking antipsychotic, antidepressant, anticonvulsant, and/or mood-stabilizing medications, must be stable on the medication for at least one-week prior to entering the study. Pre-existing (current) primary treating psychiatrist for subjects with psychotic features. Any secondary diagnoses from the anxiety disorder spectrum is acceptable. Primary pre-existing chronic Obsessive-Compulsive Disorder (OCD) will be an exclusion criteria. Inclusion criteria for healthy controls: Between 18 - 70 years of age. Have a HAM-D score of less than or equal to 5. Exclusion Criteria for depressed patients: Electroconvulsive Therapy (ECT) in the 6 months prior to the study. Abuse of drugs or alcohol in the 6 months prior to study. Unstable or untreated hypertension or cardiovascular disease. Use of additional prescription medications, street drugs, or alcohol during the week before the study. Any Axis II diagnosis or traits which would make participation in the study difficult. Current pregnancy or lactation. Post-partum depression Diagnosis of obsessive-compulsive disorder History of significant cognitive decline Exclusion criteria for healthy controls: Personal history of Axis I or Axis II disorders. Active unstable medical problems. Abuse of drugs or alcohol in the 6 months prior to study. Use of additional prescription medications, street drugs, or alcohol during the week before the study. Currently pregnant or lactating. History of significant cognitive decline

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 70 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Major Depressive Disorder<br> | |
| Healthy Control<br> | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Genetics | Blood will be drawn for gene expression, which includes genetics and metallothionein assessments. Blood will also be drawn for later assay of immune function/measures and neurotophins, and for future studies. | 1 year |