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Repetitive Transcranial Magnetic Stimulation with and without Internet-Delivered Cognitive Behavior Therapy for the Treatment of Resistant Depression: Patient-centered Randomized Controlled Pilot Trial

Published online by Cambridge University Press:  19 July 2023

M. K. Adu ,
R. Shalaby ,
E. Eboreime ,
A. Sapara ,
P. Chue ,
A. Greenshaw  and
V. Agyapong
M. K. Adu*
Affiliation:
Psychiatry, Dalhousie University, Halifax NS, Halifax
R. Shalaby
Affiliation:
Psychiatry, University of Alberta, Edmonton, Canada
E. Eboreime
Affiliation:
Psychiatry, University of Alberta, Edmonton, Canada
A. Sapara
Affiliation:
Psychiatry, University of Alberta, Edmonton, Canada
P. Chue
Affiliation:
Psychiatry, University of Alberta, Edmonton, Canada
A. Greenshaw
Affiliation:
Psychiatry, University of Alberta, Edmonton, Canada
V. Agyapong
Affiliation:
Psychiatry, Dalhousie University, Halifax NS, Halifax
*
*Corresponding author.

Abstract

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Introduction: Background

Treatment-resistant depression (TRD) is considered one of the major clinical challenges in the field of psychiatry. At least 15% of all patients with MDD remain refractory to any treatment intervention. Repetitive transcranial magnetic stimulation (rTMS) is considered a treatment option for patients with TRD. Additionally, iCBT is an evidence-based psychotherapy for the management of TRD.

Objectives

This study aims to evaluate the clinical effectiveness of adding iCBT to rTMS treatment as an innovative combined intervention, exploring the short and long-term outcomes on patients with TRD

Methods

This study is a randomized controlled trial. Participants diagnosed with TRD were randomized to one of two interventions: rTMS alone and rTMS+iCBT. Each group completed evaluation measures at baseline, discharge (6 weeks), and one & three months after discharge. The primary outcome measure was the mean change in the Hamilton depression rating scale (HAMD-17) from baseline to three months.

Results

Preliminary results for the early outcome of the study showed that after adjusting for the baseline scores, there was no significant difference in the mean score of HAMD-17 from baseline to six weeks between the participants of the two groups, (F (1, 53) = 0.15, p = 0.70, partial eta square = 0.003). The result of the long-term effectiveness is underway, forecasting the potential synergism of the two interventions.

Conclusions

This study found the combined treatment of rTMS + iCBT not to be superior to treatment with rTMS alone, in the short term. We hope the long-term results would thoroughly address the effectiveness of the combined therapy in this randomized controlled trial.

Disclosure of Interest

None Declared

Type
Abstract
Information
European Psychiatry , Volume 66 , Special Issue S1: Abstracts of the 31st European Congress of Psychiatry , March 2023 , pp. S416
Creative Commons
Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Copyright
© The Author(s), 2023. Published by Cambridge University Press on behalf of the European Psychiatric Association
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