DEPRESSION, VULNERABILITY, AND CATECHOLAMINE DEFICIENCY

描述（改编自申请人摘要）：标记物检索 与发展成严重抑郁症的风险相关（即，关联 有重度抑郁症（MDD）个人史，或有家族史 一级亲属中的MDD病史）相对不成功 迄今 此外，缺乏可靠的性状标记， 单相抑郁症 来自研究小组的初步数据显示， 情绪正常、未用药且有重度抑郁症个人史的受试者 通常经历明显的，但短暂的，抑郁反应引起的 儿茶酚胺耗竭;然而，历史对照没有个人或 家族史患者在接受治疗时不会出现明显的情绪变化。 儿茶酚胺耗竭 因此，抑郁反应是由 儿茶酚胺耗竭可能是一个可靠的标志， 先前的抑郁症，一个脆弱的标志，为发展的后果， 抑郁症和/或先前治疗的标志物。 以下目标将 开始阐明上述发现的意义。 目的：证明儿茶酚胺耗竭引起抑郁症， 在情绪正常的未用药受试者中发生频率和强度的反应 这反映了未来抑郁发作的相对风险： 有MDD个人病史的受试者>无MDD个人病史的受试者 MDD病史，但有MDD一级阳性家族史 亲属>无MDD个人或家族史的受试者。 这一目标是对初步调查结果的复制和推广。 初步数据收集：初步观察是否应进一步 此外，这项研究还将提供初步数据，以确定 诱导复发的临床相关因素（例如，数量的先前 发作、发病年龄、缓解持续时间和既往使用 抗抑郁药物或电休克治疗）。 此外，委员会认为， 初步数据将被收集，以评估这一预后效用。 挑战范例（即，与未来临床复发的相关性）。 在 为了评估后一个目标的可行性，每组的受试者将 在研究期间进行前瞻性随访。

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.