DEPRESSION, VULNERABILITY, AND CATECHOLAMINE DEFICIENCY

描述(摘自申请者的摘要)：寻找标记 与罹患严重抑郁症的风险相关(即，与 有严重抑郁障碍(MDD)个人病史，或有家族史 一级亲属的MDD病史)相对较不成功 到目前为止。此外，还缺乏可靠的性状标记 单相重度抑郁症。 来自调查员小组的初步数据，在此提供，显示 精神愉悦、无药物治疗、有严重抑郁症个人病史的受试者 通常会有明显的但短暂的抑郁反应 儿茶酚胺缺乏；然而，历史对照没有个人或 家族病史在接受治疗时情绪没有明显变化 儿茶酚胺耗竭。因此，由以下因素引起的抑郁反应 儿茶酚胺耗竭可能是一种可靠的标记物 既往抑郁是后遗症发生的易感性标志 抑郁，和/或既往治疗的标志。以下目标将 开始澄清上述发现的意义。 目的：证明儿茶酚胺缺乏会导致抑郁。 未服用药物的受试者的反应频率和强度 这反映了未来发生抑郁发作的相对风险： 有MDD&>个人病史的受试者没有个人 MDD病史，但有一级MDD阳性家族史 既没有MDD个人病史也没有家族病史的亲属。 这一目标是对初步调查结果的复制和扩展。 初步数据收集：是否应该进一步进行初步观察 如果得到证实，这项研究还将提供初步数据以确定 诱发复发的临床相关性(例如，既往 发作次数、发病年龄、缓解期和既往服用 抗抑郁药物或电惊厥治疗)。此外， 将收集初步数据来评估这一预测的实用性。 挑战范式(即与未来临床复发的相关性)。在……里面 为了评估后一目标的可行性，每组受试者将 在研究期间被前瞻性地跟踪。

DESCRIPTION (Adapted from applicant's abstract): The search for markers associated with the risk of developing major depression (i.e., associated with a personal history of Major Depressive Disorder (MDD), or a family history of MDD in first-degree relatives) has been relatively unsuccessful to date. Furthermore, there is a lack of reliable trait markers for unipolar major depression. Preliminary data from the investigator's group, presented herein, shows that euthymic, unmedicated subjects with a personal history of major depression commonly experience marked, but transient, depressive reactions induced by catecholamine depletion; whereas, historical controls without a personal or family history do not experience significant mood changes when undergoing catecholamine depletion. Therefore, a depressive reaction induced by catecholamine depletion may represent a reliable marker for a history of prior depression, a vulnerability marker for the development of a consequent depression, and/or a marker of previous treatment. The following aim will begin clarifying the significance of the above findings. Aim: To demonstrate that catecholamine depletion induces a depressive reaction in euthymic, unmedicated subjects with a frequency and intensity that reflects the relative risk of developing a future depressive episode: subjects with a personal history of MDD > subjects without a personal history of MDD but with a positive family history of MDD in first-degree relatives > subjects with neither a personal nor family history of MDD. This aim represents a replication and extension of preliminary findings. Preliminary Data Gathering: Should initial observations be further substantiated, this study will also provide preliminary data for determining the clinical correlates of an induced relapse (e.g., number of previous episodes, age of onset, duration of remission, and, previous use of antidepressant medications or electroconvulsive therapy). Furthermore, preliminary data will be gathered to assess the prognostic utility of this challenge paradigm (i.e., correlation with future clinical relapse). In order to assess feasibility of the latter aim, subjects from each group will be followed prospectively for the duration of the study.