How urban stress patterns relate to mental illness in adults

Is this trial a fit for you?

A plain-English reading of the study's rules. Only the study team can confirm whether you qualify.

What this trial studies

This is a prospective longitudinal cohort study conducted in real-world urban settings to explore how dynamic environmental stressors—such as air pollution, noise, and reduced green space—may influence the onset, progression, and relapse of major depressive disorder, generalized anxiety disorder, and alcohol use disorder. Participants include adults with these conditions and healthy controls, with data collected via wearable devices and a smartphone app to monitor physiological signals and daily exposure. The study uses continuous, multidimensional measurements rather than single-time assessments to examine associations between environmental stress and psychiatric symptoms over time. Inclusion requires stable SSRI use for depressive or anxiety disorders when applicable, smartphone access, and willingness to wear the wrist device and upload data. The primary aim is to better understand whether urban stress patterns contribute to symptom fluctuations in real-world settings.

Why it matters

Who can join: the full rules

Inclusion Criteria:

1. Diagnosis: The primary diagnosis meets the DSM-IV criteria for depressive disorder, generalized anxiety disorder, or alcohol use disorder, and comorbid conditions may be present;
2. Patients with mental disorders aged 18-60 years, with a balanced gender ratio;
3. Normal intelligence and ability to use a smartphone running the Android operating system;
4. Willingness to wear a wristband equipped with physiological monitoring functions (such as heart rate and electrodermal activity), download the study application, and upload data during the study period;
5. Participants with depression or generalized anxiety disorder who are taking medication must be on a single stable dose of a selective serotonin reuptake inhibitor (SSRI), specifically citalopram or escitalopram, and this medication regimen must have been maintained for at least 5 days. Participants with alcohol use disorder who are taking medication have no restriction on the type of drug, but the medication regimen should also have been maintained for at least 5 days. At baseline assessment, patients with depression or anxiety disorders should have a Hamilton Depression Rating Scale (HAMD-17) score \>7 or a Hamilton Anxiety Rating Scale (HAMA-14) score \>7.;
6. Voluntary participation in this study and signing of informed consent;
7. For patients with alcohol use disorder (AUD): AUD patients must have successfully completed alcohol withdrawal, confirmed by clinical standards or relevant healthcare professionals.

Inclusion Criteria for Healthy Control Group

1. Healthy subjects aged 18-60 years, with a balanced gender ratio;
2. Normal intelligence and ability to use a smartphone running the Android operating system;
3. Willingness to wear a wristband equipped with physiological monitoring functions (such as heart rate and electrodermal activity), download the study application, and upload data during the study period;
4. Voluntary participation in this study and signing of informed consent.

Exclusion Criteria:

1. Currently taking opioid medications;
2. Receiving any form of brain stimulation therapy within the past 1 month (including transcranial magnetic stimulation (TMS), electroconvulsive therapy (ECT), or other similar treatments);
3. Skin infection or severe skin damage on the wrist or upper limbs that may affect the normal use of monitoring devices;
4. Recent use (within 30 days) of medications that may interfere with drug metabolism, such as strong CYP450 inhibitors/inducers;
5. Severe physical diseases (such as brain tumors or injuries) or special conditions (such as current pregnancy or lactation) that may affect the study protocol;
6. HAMD-17 item 3 (suicide) \>3 points (severe suicidal behavior);

Exclusion Criteria for Healthy Control Group

1. Currently using benzodiazepines or opioid medications;
2. Currently receiving any form of brain stimulation therapy (including transcranial magnetic stimulation (TMS), electroconvulsive therapy (ECT), or other similar treatments);
3. Skin infection or severe skin damage on the wrist or upper limbs that may affect the normal use of monitoring devices;
4. Recent use (within 30 days) of medications that may interfere with drug metabolism, such as strong CYP450 inhibitors/inducers, or not reaching steady-state drug concentration before the study;
5. Severe physical diseases (such as brain tumors or injuries) or special conditions (such as current pregnancy or lactation) that may affect the study protocol.

Where it's running

• Peking University Sixth Hospital
  Beijing, China Recruiting
• Huashan Hospital Affiliated to Fudan University
  Shanghai, China Recruiting
• Shanghai Mental Health Center
  Shanghai, China Recruiting

Study contacts

• Study coordinator: Yanqun Zheng Dr
• Email: zhengyanqun@fudan.edu.cn
• Phone: +8613651748730

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How to take part

1. Review the eligibility criteria above with your treating physician.
2. Check the official listing on ClinicalTrials.gov for the latest contact details and recruitment status.
3. Contact the study coordinator or principal investigator to ask for pre-screening. Pre-screening is free and never obligates you to enroll.