Risks for Insulin Resistance and Metabolic Syndrome Between Major Depressive Disorder (MDD) or MDD With Psychotic Features

Metabolic syndrome (MS) is a combination of medical problems that can increase the risk of
heart disease and diabetes in some people. People with MS can have some or all of the
following:

- High blood glucose

- High blood pressure

- Abdominal obesity

- Low levels of high-density lipoprotein (HDL) cholesterol

- High levels of triglycerides

Some studies have shown that people with certain disorders have a greater risk for
developing MS. This may be because of a combination of factors, including but not limited
to the type of medications used, age, and whether or not someone smokes. This study will
also aim to learn more about a naturally-occurring stress hormone called cortisol that is
made in the body.

In order to measure these factors, the following things will occur:

- administer a number of questionnaires

- gather information from medical history

- gather information about current psychiatric mood

- draw blood and collect a urine sample

To study the amount of cortisol in the body, a dexamethasone suppression test (DST) will be
given. This test involves taking a single 1mg pill of dexamethasone, a steroid, and
numerous blood draws. Like any drug, it has some risks, however it is unlikely any side
effects will occur because of the low dose administered.

Inclusion Criteria:

- Capable of giving informed consent

- DSM-IV TR diagnosis of Major Depressive Disorder with (MDpsy) or without (MDD)
Psychotic Features

- Age between 18 and 85, inclusive

- Pre-existing Hyperlipidemia, Hypertension, and Diabetes must be stable with
laboratory and clinical results within acceptable range; with or without medication
for three months prior to admission

Exclusion Criteria:

- DSM-IV TR diagnosis of: schizophrenia, schizoaffective disorder, delusional
disorder, bipolar disorder, organic mental disorder, substance use dependence
including alcohol, that has been active within the past 6 months, acute bereavement,
and psychotic disorder not elsewhere classified

- Subjects that meet criteria for substance or alcohol dependence more recently than
three months prior to entering the study

- Subjects that meet criteria for substance or alcohol abuse more recently than four
weeks prior to entering the study

- Pregnancy

- Unstable or inadequately treated pre-existing hyperlipidemia, hypertension, and
diabetes

- Subjects who are involuntarily committed.