Major Depressive Episode, Suicidal Behavior
Conditions
Keywords
Psychiatry, Depressive disorder, Suicide, Inflammation
Brief summary
Suicide is a major health problem that causes annually a million death worlwide. In the stress-vulnerability model, suicidal behavior (SB) results from the interaction between an individual's predisposition (personality, family history of SB…) and stressful conditions (early life adversity). Studies show that suicide ideations could favour inflammation and that depression is associated with an elevated inflammation. Recent evidences also suggest that inflammatory mediators play a critical role in SB. The aim of the study is to evaluate the inflammatory markers rate on depressed patients with or without personal history of SB. In the second part of the study, the relations between the rates of inflammatory markers and characteristics of SB, impulsivity, psychological pain, childhood abuse and gene expression of 5HT2B receptor will be investigated.
Detailed description
Over one year, we will recruit 280 patients suffering from a major depressive episode with (n=140) and without any history of suicide attempt (n=140), from a specialized clinic for mood disorders and SB. First visit : clinical, biological and neuropsychological assessment Second visit, at 6 month : Follow-up visit in the department or interview by telephone in order to assess suicidal ideations or suicide attempts since the inclusion.
Interventions
BIOLOGICALBlood sample
Blood sample in order to study inflammatory biomarkers and genetics purpose
Sponsors
University Hospital, Montpellier
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to 65 Years
Healthy volunteers
No
Inclusion criteria
* Ages of 18 and 65 * Main diagnosis of major depressive episode (DSM-IV criteria) * Having signed the informed consent * Able to understand nature, aims, and methodology of the study Specifics Inclusion criteria: * Depressed patients with suicide attempt history : * Have done in his lifetime at least one suicide attempt (however the period of time between inclusion and suicide attempt) * Depressed patients without suicide attempt history : * Had never realized suicide attempt in his lifetime
Exclusion criteria
* Patients suffering from inflammatories pathology * Antibiotic or anti-inflammatory current treatment * Pregnancy * Participation in another clinical trial with an exclusion period * Patient on protective measures (guardianship or trusteeship)
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Rate of interleukin 2 (Il2) in a blood sample | inclusion visit | Comparison of Il2 levels between patients with and without suicidal behaviour |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Rate of inflammation markers and suicide attempt | inclusion visit | Comparison of rate bloodmarkers inflammation (Il1, 4, 6, 8, 10, TNF-a, IFNg, VEGF, kynurenine and CRP) in depressed patients with latest suicide attempt and depressed patients with an history of suicide attempt |
| Rate of inflammation markers and violent suicide attempt | inclusion visit | Comparison of rate bloodmarkers inflammation (Il1, 4, 6, 8, 10, TNF-a, IFNg, VEGF, kynurenine and CRP) in depressed patients with and without violent suicide attempt |
| Rate of inflammation markers and suicide ideations | inclusion visit | Comparison of rate bloddmarkers (Il1, 4, 6, 8, 10, TNF-a, IFNg, VEGF, kynurenine and CRP) in depressed patients with and without current suicide ideation |
| Relation between markers of inflammation and suicidal behavior characteristics | inclusion visit | Studying relations with bloodmarkers inflammation rate (Il1, 4, 6, 8, 10, TNF-a, IFNg, VEGF, kynurenine and CRP) and suicidal behaviour characteristics (the last and the most serious) (intentionality, planification, lethality) |
| Rate of inflammation markers (Interleukin 1, 4, 6, 8, 10, Tumor necrosis factor alpha (TNF-a), Interferon gamma (IFNg), Vascular endothelial growth factor (VEGF), kynurenin and c-reactive protein (CRP) in a blood sample | inclusion visit | Comparison of the levels of theses markers between patients with and without suicidal behaviour |
| Relation between markers of inflammation and psychological pain | inclusion visit | Studying relations with bloodmarkers inflammation rate (Il1, 4, 6, 8, 10, TNF-a, IFNg, VEGF, kynurenine and CRP) and psychological pain (by Likert scale) |
| Relation between markers of inflammation and child abuse | inclusion visit | Studying relations with bloodmarkers inflammation rate (Il1, 4, 6, 8, 10, TNF-a, IFNg, VEGF, kynurenine and CRP) and child abuse |
| Relation between markers of inflammation and gene expression | inclusion visit | Studying relations with bloodmarkers inflammation rate (Il1, 4, 6, 8, 10, TNF-a, IFNg, VEGF, kynurenine and CRP) and gene expression of 5HT2B receptor |
| Markers of inflammation as a risk factor for suicidal behavior | at 6 months | Studying bloodmarkers inflammation rate (Il1, 4, 6, 8, 10, TNF-a, IFNg, VEGF, kynurenine and CRP) as suicidal behaviour risk factor (suicide ideations and/or suicide attempt) with a 6 months follow-up. |
| Relation between markers of inflammation and impulsivity | inclusion visit | Studying relations with bloodmarkers inflammation rate (Il1, 4, 6, 8, 10, TNF-a, IFNg, VEGF, kynurenine and CRP) and impulsivity (by Baratt Impulsivity Scale and neuropsychological tests) |
Countries
France
Outcome results
None listed