Dai Lilei, Wang Peng, Zhang Panpan, Guo Qingshan, Du Hui, Li Fen, He Xinfu, Luan Rongrong
Department of Clinical Psychology, Jingmen NO.2 People's Hospital, Jingmen, Hubei.
Department of Psychiatry, The Affiliated Xi'an Central Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi.
Medicine (Baltimore). 2020 Aug 7;99(32):e21493. doi: 10.1097/MD.0000000000021493.
Depression, a common psychiatric disorder in elderly, serves as a remarkable precipitating factor for suicide among the elderly people. Here, a randomized double-blinded study was performed to investigate the efficacy of repetitive transcranial magnetic stimulation (rTMS) on improving the clinical symptoms and reducing suicidal ideation in elderly patients with depression.
In this study, 103 elderly patients with depression and suicidal ideation were randomly divided into 2 groups, 48 cases in the rTMS group and 55 cases in the control group (sham rTMS). Both groups received routine drug therapy with rTMS or sham rTMS. The patients received evaluation by Hamilton depression scale and self-rating idea of suicide scale before treatment and after 2 and 4 weeks of treatment, respectively.
The measurement from the present study demonstrated that Hamilton depression scale and self-rating idea of suicide scale scores decreased to varying degrees in the 2 groups after treatment, and the decrease was more significant in rTMS group. The rate of marked effectiveness was much higher in rTMS group after 2 weeks of treatment compared with the control group. Furthermore, the rate of moderate effectiveness at 4 weeks after treatment was significantly higher in rTMS group compared with the control group.
Together, the present study shows that rTMS with routine drug therapy exhibited effect with quick onset to improve the clinical symptoms and reduce suicidal ideation in elderly patients with depression.
抑郁症是老年人常见的精神障碍,是老年人自杀的重要促发因素。在此,进行了一项随机双盲研究,以探讨重复经颅磁刺激(rTMS)对改善老年抑郁症患者临床症状和降低自杀意念的疗效。
本研究将103例伴有自杀意念的老年抑郁症患者随机分为2组,rTMS组48例,对照组(假rTMS)55例。两组均接受rTMS或假rTMS的常规药物治疗。患者在治疗前、治疗2周和4周后分别接受汉密尔顿抑郁量表和自杀意念自评量表评估。
本研究测量结果表明,两组治疗后汉密尔顿抑郁量表和自杀意念自评量表评分均有不同程度下降,rTMS组下降更显著。治疗2周后,rTMS组的显效率远高于对照组。此外,治疗4周后,rTMS组的有效率显著高于对照组。
本研究表明,rTMS联合常规药物治疗能快速起效,改善老年抑郁症患者的临床症状并降低自杀意念。