Shalvata Mental Health Center, Hod Hasharon, Israel.
J ECT. 2012 Jun;28(2):104-7. doi: 10.1097/YCT.0b013e318250058c.
Comprehensive assessment of new treatments in psychiatry should include evaluation of their acceptability to patients, and in the case of children and adolescents, this must extend to acceptability for parents. The views of young patients and their parents in relation to repetitive transcranial magnetic stimulation (rTMS) for adolescent depression have not been previously studied.
We sought to (1) describe the experience, knowledge, and attitudes regarding rTMS among young people who had been treated with rTMS for depression as adolescents; (2) report the views of their parents; and (3) compare these to opinions about pharmacotherapy among a group who had been treated with fluoxetine for adolescent depression.
Eight of 9 subjects who had participated in an open-label rTMS study, 13 of their parents, and an age-matched group of 8 subjects who had been treated with fluoxetine for depression as adolescents were assessed using detailed questionnaires.
Repetitive TMS recipients and their parents found rTMS largely acceptable in terms of adverse effects and treatment experience, but most considered it ineffective. In contrast, most patients who had been treated with fluoxetine viewed their treatment as effective.
Transcranial magnetic stimulation is relatively well tolerated by depressed adolescents, but it is also perceived as mostly unhelpful by them and their parents. This is at odds with emerging studies suggesting that rTMS can be an effective and safe treatment in this age group, indicating that further research is required to confirm our findings and understand reasons for any disparity.
全面评估精神病学中的新疗法应包括对患者可接受性的评估,对于儿童和青少年而言,这必须扩展到对其父母的可接受性。以前尚未研究过青少年抑郁症患者及其父母对重复经颅磁刺激(rTMS)的看法。
我们试图(1)描述接受 rTMS 治疗的青少年抑郁症患者的经验、知识和态度;(2)报告其父母的观点;(3)并将这些观点与接受氟西汀治疗的一组青少年抑郁症患者的观点进行比较。
9 名接受过开放标签 rTMS 研究的患者中有 8 名,其父母中有 13 名,以及年龄匹配的接受氟西汀治疗的青少年抑郁症患者中有 8 名,均使用详细的问卷进行评估。
rTMS 受者及其父母认为 rTMS 在副作用和治疗体验方面基本可以接受,但大多数人认为其无效。相比之下,大多数接受氟西汀治疗的患者认为他们的治疗有效。
经颅磁刺激对抑郁青少年的耐受性较好,但他们及其父母也认为它大多没有帮助。这与新兴研究表明 rTMS 可能是该年龄段有效且安全的治疗方法相矛盾,表明需要进一步研究来证实我们的发现并理解任何差异的原因。