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经颅磁刺激(TMS)治疗重度抑郁症:临床实践中生活质量评估指标的多中心、自然观察性研究。

Transcranial magnetic stimulation (TMS) for major depression: a multisite, naturalistic, observational study of quality of life outcome measures in clinical practice.

机构信息

1 Psychiatric Clinical Research Center and Transcranial Magnetic Stimulation Center, Rush University, Chicago, Illinois, USA.

出版信息

CNS Spectr. 2013 Dec;18(6):322-32. doi: 10.1017/S1092852913000357. Epub 2013 Jul 30.

DOI:10.1017/S1092852913000357
PMID:23895940
Abstract

BACKGROUND

Transcranial magnetic stimulation (TMS) is an effective and safe therapy for major depressive disorder (MDD). This study assessed quality of life (QOL) and functional status outcomes for depressed patients after an acute course of TMS.

METHODS

Forty-two, U.S.-based, clinical TMS practice sites treated 307 outpatients with a primary diagnosis of MDD and persistent symptoms despite prior adequate antidepressant pharmacotherapy. Treatment parameters were based on individual clinical considerations and followed the labeled procedures for use of the approved TMS device. Patient self-reported QOL outcomes included change in the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36) and the EuroQol 5-Dimensions (EQ-5D) ratings from baseline to end of the acute treatment phase.

RESULTS

Statistically significant improvement in functional status on a broad range of mental health and physical health domains was observed on the SF-36 following acute TMS treatment. Similarly, statistically significant improvement in patient-reported QOL was observed on all domains of the EQ-5D and on the General Health Perception and Health Index scores. Improvement on these measures was observed across the entire range of baseline depression symptom severity.

CONCLUSION

These data confirm that TMS is effective in the acute treatment of MDD in routine clinical practice settings. This symptom benefit is accompanied by statistically and clinically meaningful improvements in patient-reported QOL and functional status outcomes.

摘要

背景

经颅磁刺激(TMS)是一种有效且安全的治疗重度抑郁症(MDD)的方法。本研究评估了接受急性 TMS 治疗后抑郁患者的生活质量(QOL)和功能状态结果。

方法

在美国,42 个临床 TMS 实践基地治疗了 307 名患有 MDD 且尽管先前有充分的抗抑郁药治疗但仍持续出现症状的门诊患者。治疗参数基于个体临床考虑,并遵循批准的 TMS 设备使用的标签程序。患者自我报告的 QOL 结果包括从基线到急性治疗阶段结束时医疗结局研究 36 项简短健康调查(SF-36)和欧洲五维健康量表(EQ-5D)评分的变化。

结果

在急性 TMS 治疗后,SF-36 上广泛的心理健康和身体健康领域的功能状态均观察到统计学上显著改善。同样,EQ-5D 的所有领域以及一般健康感知和健康指数评分的患者报告 QOL 也观察到统计学上显著改善。这些措施的改善在整个基线抑郁症状严重程度范围内均有观察到。

结论

这些数据证实,TMS 在常规临床实践环境中对 MDD 的急性治疗有效。这种症状改善伴随着患者报告的 QOL 和功能状态结果的统计学和临床意义上的显著改善。

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