Repetitive Transcranial Magnetic Stimulation (rTMS) in treatment Resistant Depression

Retrospective Data Analysis from Clinical Practice

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

Research output: Contribution to journalArticleResearchpeer-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
JournalOpen Journal of Depression
Publication statusAccepted/In press - 18 Jan 2019

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Treatment-Resistant Depressive Disorder
Transcranial Magnetic Stimulation
Anxiety Disorders
Anxiety
Depression
Therapeutics
Mental Disorders
Health

Cite this

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title = "Repetitive Transcranial Magnetic Stimulation (rTMS) in treatment Resistant Depression: Retrospective Data Analysis from Clinical Practice",
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).MethodsThe 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.ResultsResponse 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.ConclusionsTRD 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.",
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Repetitive Transcranial Magnetic Stimulation (rTMS) in treatment Resistant Depression : Retrospective Data Analysis from Clinical Practice. / Da Silva, Ksenija; Griffiths, Chris; O'Neill-Kerr, Alex; de Vail, Robert.

In: Open Journal of Depression, 18.01.2019.

Research output: Contribution to journalArticleResearchpeer-review

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AU - Griffiths, Chris

AU - O'Neill-Kerr, Alex

AU - de Vail, Robert

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N2 - 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).MethodsThe 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.ResultsResponse 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.ConclusionsTRD 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.

AB - 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).MethodsThe 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.ResultsResponse 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.ConclusionsTRD 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.

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JO - Open Journal of Depression

JF - Open Journal of Depression

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