Al-Ruhaili Intisar, Al-Huseini Salim, Al-Kaabi Said, Mahadevan Sangeetha, Al-Sibani Nasser, Al Balushi Naser, Islam M Mazharul, Jose Sachin, Mehr Gilda Kiani, Al-Adawi Samir
Psychiatry Residency Program, Oman Medical Specialty Board, Muscat 130, Oman.
Department of Psychiatry, Al Masarra Hospital, Ministry of Health, Muscat 113, Oman.
Brain Sci. 2023 Sep 6;13(9):1289. doi: 10.3390/brainsci13091289.
Depressive illnesses in non-Western societies are often masked by somatic attributes that are sometimes impervious to pharmacological agents. This study explores the effectiveness of repetitive transcranial magnetic stimulation (rTMS) for people experiencing treatment-resistant depression (TRD) accompanied by physical symptoms. Data were obtained from a prospective study conducted among patients with TRD and some somatic manifestations who underwent 20 sessions of rTMS intervention from January to June 2020. The Hamilton Rating Scale for Depression (HAMD) was used for clinical evaluation. Data were analysed using descriptive and inferential techniques (multiple logistic regression) in SPSS. Among the 49 participants (mean age: 42.5 ± 13.3), there was a significant reduction in posttreatment HAMD scores compared to baseline (t = 10.819, < 0.0001, and 95% CI = 8.574-12.488), indicating a clinical response. Approximately 37% of the patients responded to treatment, with higher response rates among men and those who remained in urban areas, had a history of alcohol use, and were subjected to the standard 10 HZ protocol. After adjusting for all extraneous variables, the rTMS protocol emerged as the only significant predictor of response to the rTMS intervention. To our knowledge, this is the first study to examine the effectiveness of rTMS in the treatment of somatic depression.
在非西方社会，抑郁症往往被躯体症状所掩盖，而这些症状有时对药物治疗无反应。本研究探讨重复经颅磁刺激（rTMS）对伴有躯体症状的难治性抑郁症（TRD）患者的有效性。数据来自一项前瞻性研究，该研究对2020年1月至6月期间接受20次rTMS干预的TRD患者及一些躯体症状患者进行。采用汉密尔顿抑郁量表（HAMD）进行临床评估。数据在SPSS中使用描述性和推断性技术（多元逻辑回归）进行分析。在49名参与者（平均年龄：42.5±13.3）中，与基线相比，治疗后HAMD评分显著降低（t = 10.819，<0.0001，95%CI = 8.574 - 12.488），表明有临床反应。约37%的患者对治疗有反应，男性、居住在城市地区、有饮酒史且接受标准10赫兹方案的患者反应率较高。在调整所有外部变量后，rTMS方案成为rTMS干预反应的唯一显著预测因素。据我们所知，这是第一项研究rTMS治疗躯体性抑郁症有效性的研究。
