Repetitive Transcranial Magnetic Stimulation (rTMS) in Treatment Resistant Depression: Retrospective Data Analysis from Clinical Practice

Chris Griffiths, Ksenija Da Silva, Robert de Vail, Alex O'Neill-Kerr

Research output: Contribution to JournalArticlepeer-review

Abstract

Objective:
The aim of this paper is to present the service data results from a clinical repetitive Transcranial Magnetic Stimulation (rTMS) service treating treatment resistant depression (TRD).

Methods
The study was a retrospective investigation of routinely collected data on patients receiving rTMS between 2015 and 2018. Measures used were the clinician-rated Clinical Global Impression (CGI) and Hamilton Depression Rating Scale (HAM-D), and patient rated Physical Health Questionnaire (PHQ-9) and Generalised Anxiety Disorder 7 (GAD-7). The outcome data of 144 patients with TRD was analysed. The sample included patients with co-morbid psychiatric diagnosis.

Results
Response and remission rates respectively were 34.6% and 20.6% for the HAM-D; 10% and 28.6% for the PHQ-9; 31% and 31.8% for the CGI; and 24.6% and 28.8% for GAD-7. Effect sizes were mostly medium (0.48, 0.27, 0.51, 0.43 respectively). GAD-7 reliable change improvement was 56.1% and PHQ-9 reliable change improvement was 40%. There was a medium positive correlation between anxiety (GAD-7) and depression recovery (HAM-D), r = .31, n = 46, p = .039, with lower pre-treatment anxiety associated with lower post-treatment HAM-D scores.

Conclusions
TRD patients with low pre-treatment anxiety levels respond to treatment better than those with high pre-treatment anxiety. The results show that a clinical rTMS service can have a significant impact on symptoms of depression and anxiety in TRD. The findings support wider availability of rTMS as a treatment option for people with TRD.
Original languageEnglish
Pages (from-to)16-28
Number of pages13
Journal Open Journal of Depression
Volume8
Issue number1
DOIs
Publication statusPublished - 17 Jan 2019

Keywords

  • Repetitive Transcranial Magnetic Stimulation (rTMS)
  • treatment resistant depression
  • service delivery
  • anxiety

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