Fatigue Syndrome, ChronicNCT00001479
Study of the Hypothalmic-Pituitary-Adrenal (HPA) Axis and Its Role in Major Depression
An observational study of Fatigue Syndrome, Chronic and Healthy, run by National Institute of Mental Health (NIMH) at 1 site in United States.
Trial summary
Major depression represents a major public health problem worldwide and in the U.S. Fifteen percent of the U.S. population has depression at some point in life (40 million individuals). The condition is more common in women, occurring at a female to male ratio of 5:2. Read more about this study
- Who is it for?
- Any ageHealthy volunteers can take part
- Conditions the study is for
- Fatigue Syndrome, Chronic, Healthy, Mood Disorders
- How many people
- 60 participants
- Where
- 1 siteUnited States
- Study dates
- Jan 1995to May 2000
- Phase
- Observational
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages Any age
- All sexes
- Healthy volunteers accepted
- Child, Adult, Older adult
Who may be able to join
None listed.
Who cannot join
- Subjects on chronic medications, which can not be washed out in one month.
- Subjects with any serious medical illnesses which have been excluded.
- Women who are pregnant, trying to become pregnant or sexually active and not using effective contraception.
- Patients with HIV-1 infection.
- Patients on chronic lithium therapy.
- Subjects unable to discontinue alcohol, tobacco, or illegal drugs.
Trial locations and contacts
1 site in 1 country.
United States1 site
National Institute of Mental Health (NIMH)
Bethesda, Maryland, 20892
About this study
Official title: Intensively Sampled Dynamics of ACTH and Cortisol Affective Disorders
Major depression represents a major public health problem worldwide and in the U.S. Fifteen percent of the U.S. population has depression at some point in life (40 million individuals). The condition is more common in women, occurring at a female to male ratio of 5:2. Presently, 6-8% of all outpatients in primary care meet the diagnostic criteria for major depression. Fifteen percent of untreated patients with depression will commit suicide. Most of the people committing suicide are depressed. Researchers believe that by the year 2020 suicide will be the 10th most common cause of death in the U.S.
In addition to mortality due to suicide, depression is also associated with other severe health conditions. Areas of the brain (hippocampus) begin to deteriorate, heart disease, and decreased bone mineral density (osteoporosis) are all associated with major depression.
Read more
Researchers have believed for years that hormones controlled by the hypothalmus, pituitary gland, and adrenal gland (commonly referred to as the HPA axis or system) are in some way associated with psychiatric illnesses like depression.
According to previous studies, researchers have theorized that increased activity of the HPA axis is associated with depressed patients with typical melancholic features. Melancholia refers to the feelings of anhedonia (absence of pleasure from activites that would normally be thought of as pleasurable), insomnia (inability to sleep), guilt, and psychomotor changes. On the other hand a decrease in activity of the HPA axis may be associated with the atypical features of depression.
This study has already developed and refined studies that have improved the understanding of the HPA axis in healthy humans and depressed patients. Researchers have already identified and plan to continue identifying distinct subtypes of depressive disorders based on the activity of the HPA axis.
Read the detailed description
Major depression represents a major public health problem worldwide and in the U.S. Fifteen percent of the U.S. population has depression at some point in life (40 million individuals), with a female to male ratio 5:2. Presently, 6-8% of all outpatients in primary care meet diagnostic criteria for major depression. Fifteen percent of untreated depressed patients commit suicide-most suicides have depression. In the U.S., in the year 2020 suicide will be the 10th cause of death. In addition to mortality due to suicide, major depression is associated with severe morbidity, that includes decreased hippocampal volume, cardiovascular illness, and decreased bone mineral density. Moreover, after myocardial infarction, patients with depression have a higher mortality rate than those without depression (adjusted risk ratio 4:29). Because such morbidity can be differentially affected either by increased or decreased levels of hypothalamic-pituitary-adrenal (HPA) function, it is necessary to study HPA function in our populations. Additionally, based on our previous data, we have hypothesized that depressed patients with melancholic features would have increase HPA function, while those with atypical features would have decreased HPA function. Using this protocol, over the past four years we have developed, refined, and repeatedly conducted detailed patient-oriented studies that have expanded the frontiers of existing knowledge on HPA regulation in healthy humans and depressed subjects. This protocol has already demonstrated the existence of two distinct biological subtypes of major depression, with the important finding of a decrement of HPA function in patients with atypical features. Thus, the atypical classification is not restricted to phenotype but represents a subtype with specific biological characteristics. This finding shows that there are unique strategies, targets, and potential interventional approaches to patients with either atypical or melancholic features. The elucidation of the neuroendocrinology of major depression has been a key goal of our branch, and this protocol offers the potential to unravel the biology of phenotypically distinct subtypes of major depression. Moreover, the elucidation of the medical consequences of major depression requires the precise longitudinal characterization of HPA function that is accomplished by this study.
- Conditions
- Fatigue Syndrome, Chronic, Healthy, Mood Disorders
- Keywords
- ACTH, Adrenocorticotropic Hormone, Antidepressant Treatment, Chaos Theory, Chronic Fatigue Syndrome, Major Depression, Normal Volunteer, Primary Affective Disorder
- Medical subject headings
- Fatigue Syndrome, Chronic, Mood Disorders, Depressive Disorder, Major
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted10 Dec 2002 (estimated)
- Study startJan 1995
- Study completionMay 2000
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (3)Papers the sponsor has linked to this study.
- Other trials for Fatigue Syndrome, ChronicStudies of the same condition, open and under way.
- More trials run by National Institute of Mental Health (NIMH)The sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Observational
- Enrolment
- 60 participants
Sponsor and investigators
- Lead sponsor
- National Institute of Mental Health (NIMH)
- Sponsor type
- US National Institutes of Health
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT00001479
- Sponsor's protocol ID
- 950044
- Other IDs
- 95-M-0044
- Status last verified
- Jun 1999
- First submitted
- 3 Nov 1999
- Last updated
- 4 Mar 2008
- Results posted
- No
Publications
Babloyantz A, Destexhe A. Low-dimensional chaos in an instance of epilepsy. Proc Natl Acad Sci U S A. 1986 May;83(10):3513-7. doi: 10.1073/pnas.83.10.3513.
PubMed 3085091Demitrack MA, Dale JK, Straus SE, Laue L, Listwak SJ, Kruesi MJ, Chrousos GP, Gold PW. Evidence for impaired activation of the hypothalamic-pituitary-adrenal axis in patients with chronic fatigue syndrome. J Clin Endocrinol Metab. 1991 Dec;73(6):1224-34. doi: 10.1210/jcem-73-6-1224.
PubMed 1659582Garfinkel A, Spano ML, Ditto WL, Weiss JN. Controlling cardiac chaos. Science. 1992 Aug 28;257(5074):1230-5. doi: 10.1126/science.1519060.
PubMed 1519060
Study at a glance
From the registry record, last updated by the sponsor on 4 Mar 2008. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Intensively Sampled Dynamics of ACTH and Cortisol Affective Disorders
- ClinicalTrials.gov ID
- NCT00001479
- Acronym / sponsor ID
- 950044
- Conditions
- Fatigue Syndrome, Chronic, Healthy, Mood Disorders
- Keywords
- ACTH, Adrenocorticotropic Hormone, Antidepressant Treatment, Chaos Theory, Chronic Fatigue Syndrome, Major Depression, Normal Volunteer, Primary Affective Disorder
- Study type
- Observational
- Recruitment status
- Completed
- Enrolment
- 60 participants
- Lead sponsor
- National Institute of Mental Health (NIMH)US National Institutes of Health
- Study start
- Jan 1995
- Study completion
- May 2000
- First posted
- 10 Dec 2002 (estimated)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
Major depression represents a major public health problem worldwide and in the U.S. Fifteen percent of the U.S. population has depression at some point in life (40 million individuals). The condition is more common in women, occurring at a female to male ratio of 5:2. Presently, 6-8% of all outpatients in primary care meet the diagnostic criteria for major depression. Fifteen percent of untreated patients with depression will commit suicide. Most of the people committing suicide are depressed. Researchers believe that by the year 2020 suicide will be the 10th most common cause of death in the U.S.
In addition to mortality due to suicide, depression is also associated with other severe health conditions. Areas of the brain (hippocampus) begin to deteriorate, heart disease, and decreased bone mineral density (osteoporosis) are all associated with major depression.
Researchers have believed for years that hormones controlled by the hypothalmus, pituitary gland, and adrenal gland (commonly referred to as the HPA axis or system) are in some way associated with psychiatric illnesses like depression.
According to previous studies, researchers have theorized that increased activity of the HPA axis is associated with depressed patients with typical melancholic features. Melancholia refers to the feelings of anhedonia (absence of pleasure from activites that would normally be thought of as pleasurable), insomnia (inability to sleep), guilt, and psychomotor changes. On the other hand a decrease in activity of the HPA axis may be associated with the atypical features of depression.
This study has already developed and refined studies that have improved the understanding of the HPA axis in healthy humans and depressed patients. Researchers have already identified and plan to continue identifying distinct subtypes of depressive disorders based on the activity of the HPA axis.
Detailed description
Major depression represents a major public health problem worldwide and in the U.S. Fifteen percent of the U.S. population has depression at some point in life (40 million individuals), with a female to male ratio 5:2. Presently, 6-8% of all outpatients in primary care meet diagnostic criteria for major depression. Fifteen percent of untreated depressed patients commit suicide-most suicides have depression. In the U.S., in the year 2020 suicide will be the 10th cause of death. In addition to mortality due to suicide, major depression is associated with severe morbidity, that includes decreased hippocampal volume, cardiovascular illness, and decreased bone mineral density. Moreover, after myocardial infarction, patients with depression have a higher mortality rate than those without depression (adjusted risk ratio 4:29). Because such morbidity can be differentially affected either by increased or decreased levels of hypothalamic-pituitary-adrenal (HPA) function, it is necessary to study HPA function in our populations. Additionally, based on our previous data, we have hypothesized that depressed patients with melancholic features would have increase HPA function, while those with atypical features would have decreased HPA function. Using this protocol, over the past four years we have developed, refined, and repeatedly conducted detailed patient-oriented studies that have expanded the frontiers of existing knowledge on HPA regulation in healthy humans and depressed subjects. This protocol has already demonstrated the existence of two distinct biological subtypes of major depression, with the important finding of a decrement of HPA function in patients with atypical features. Thus, the atypical classification is not restricted to phenotype but represents a subtype with specific biological characteristics. This finding shows that there are unique strategies, targets, and potential interventional approaches to patients with either atypical or melancholic features. The elucidation of the neuroendocrinology of major depression has been a key goal of our branch, and this protocol offers the potential to unravel the biology of phenotypically distinct subtypes of major depression. Moreover, the elucidation of the medical consequences of major depression requires the precise longitudinal characterization of HPA function that is accomplished by this study.
Study design
Who may qualify
- Sex
- All
- Healthy volunteers
- Accepted
- Age groups
- Child, Adult, Older adult
Key inclusion criteria (0 listed)
Key exclusion criteria (6 listed)
- Subjects on chronic medications, which can not be washed out in one month.
- Subjects with any serious medical illnesses which have been excluded.
- Women who are pregnant, trying to become pregnant or sexually active and not using effective contraception.
- Patients with HIV-1 infection.
- Patients on chronic lithium therapy.
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Primary outcome
Not reported in the source record.
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 4 Mar 2008.
- Background: PubMed 3085091Babloyantz A, Destexhe A. Low-dimensional chaos in an instance of epilepsy. Proc Natl Acad Sci U S A. 1986 May;83(10):3513-7. doi: 10.1073/pnas.83.10.3513.
- Background: PubMed 1659582Demitrack MA, Dale JK, Straus SE, Laue L, Listwak SJ, Kruesi MJ, Chrousos GP, Gold PW. Evidence for impaired activation of the hypothalamic-pituitary-adrenal axis in patients with chronic fatigue syndrome. J Clin Endocrinol Metab. 1991 Dec;73(6):1224-34. doi: 10.1210/jcem-73-6-1224.
- Background: PubMed 1519060Garfinkel A, Spano ML, Ditto WL, Weiss JN. Controlling cardiac chaos. Science. 1992 Aug 28;257(5074):1230-5. doi: 10.1126/science.1519060.
Related trials for Fatigue Syndrome, Chronic
Enrolling by invitationEarly Phase 1
Truway Diagnostic Tools in Primary Care
Chronic Disease, Type 2 Diabetes Mellitus (T2DM), Obesity, Overweight
Recruiting
Whole-body Cryotherapy in Those With Chronic Fatigue: A Feasibility Study
ME/CFS, Fibromyalgia (FM)
Recruiting
ME/CFS Brain Fog: Cognitive Rehabilitation Trial
ME/CFS, ME/CFS Following EBV-associated Infectious Mononucleosis
Enrolling by invitation
Fareon Open Label Device Clinical Trial
Cognitive Dysfunction, Acquired Brain Injury
Active, not recruiting
The Association Between CBT-I Dose, Sleep Duration, and Fatigue in Breast Cancer Patients
Chronic Insomnia, Cancer-related Problem/Condition
Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
The record lists no contact. Use the official record to reach the sponsor.
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
An observational study of Fatigue Syndrome, Chronic and Healthy, run by National Institute of Mental Health (NIMH) at 1 site in United States.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 0 inclusion and 6 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 4 Mar 2008. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in United States. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT00001479, which also lists 3 linked publications.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 4 Mar 2008.