Rumination symptoms in treatment-resistant major depressive disorder, and outcomes of repetitive Transcranial Magnetic Stimulation (rTMS) treatment.
Rumination symptoms in treatment-resistant major depressive disorder, and outcomes of repetitive Transcranial Magnetic Stimulation (rTMS) treatment.
复制标题
难治性抑郁症患者的反思症症状和重复经颅磁刺激(RTMS)治疗的结果。
DOI：
10.1038/s41398-023-02566-4
复制
发表时间：
2023-09-08
影响因子：
6.8
通讯作者：
Leuchter, Andrew F.
中科院分区：
文献类型：
--
作者：
Chu, Stephanie A.;Tadayonnejad, Reza;Corlier, Juliana;Wilson, Andrew C.;Citrenbaum, Cole;Leuchter, Andrew F.
沉思是一种调节思想和情绪的不适应方式。它是重度抑郁症（MDD）的常见症状，更严重的反刍与药物和心理治疗效果较差有关，特别是在女性中。目前还不清楚反刍在多大程度上可能影响MDD的重复经颅磁刺激（rTMS）治疗的结果或对其有反应。我们回顾性分析了155例中重度难治性MDD患者（年龄42.52 ± 14.22，79名女性）在rTMS治疗期间收集的数据。反刍和抑郁的严重程度进行了评估之前和期间的30个会话的测量为基础的rTMS治疗使用反刍反应量表（RSS）和患者健康问卷（PHQ-9），分别。使用一系列重复测量线性混合效应模型评估反刍、抑郁和治疗结果的基线水平之间的关系。治疗后抑郁和反刍症状均显著改善，但抑郁的改善并不是反刍改善的重要中介。较高的基线反刍（而不是抑郁症的严重程度）与抑郁症的结果不依赖于抑郁症的严重程度。女性是所有RRS分量表中不良结局的重要预测因素。经颅磁刺激治疗后，抑郁症患者的抑郁和沉思症状均得到改善。这些改善是相关的，但改善反刍并不能完全解释抑郁症状的减少。这些研究结果表明，虽然改善反刍和抑郁症的严重程度在rTMS治疗是相关的，他们是部分独立的过程。未来的研究应检查反刍症状是否应专门针对不同的rTMS治疗参数。
Rumination is a maladaptive style of regulating thoughts and emotions. It is a common symptom of Major Depressive Disorder (MDD), and more severe rumination is associated with poorer medication and psychotherapy treatment outcomes, particularly among women. It is unclear to what extent rumination may influence the outcomes of, or be responsive to, repetitive Transcranial Magnetic Stimulation (rTMS) treatment of MDD. We retrospectively examined data collected during rTMS treatment of 155 patients (age 42.52 ± 14.22, 79 female) with moderately severe treatment-resistant MDD. The severity of rumination and depression was assessed before and during a course of 30 sessions of measurement-based rTMS treatment using the Ruminative Responses Scale (RSS) and the Patient Health Questionnaire (PHQ-9), respectively. Relationships among baseline levels of rumination, depression, and treatment outcome were assessed using a series of repeated measures linear mixed effects models. Both depression and rumination symptoms significantly improved after treatment, but improvement in depression was not a significant mediator of rumination improvement. Higher baseline rumination (but not depression severity) was associated with poorer depression outcomes independently of depression severity. Female gender was a significant predictor of worse outcomes for all RRS subscales. Both depressive and ruminative symptoms in MDD improved following rTMS treatment. These improvements were correlated, but improvement in rumination was not fully explained by reduction in depressive symptoms. These findings suggest that while improvement in rumination and depression severity during rTMS treatment are correlated, they are partly independent processes. Future studies should examine whether rumination symptoms should be specifically targeted with different rTMS treatment parameters.
登录
查看更多内容
影响因子：
6.6
作者：
KESSLER, RC;MCGONAGLE, KA;NELSON, CB
通讯作者：
NELSON, CB
影响因子：
--
作者：
George, Mark S.;Lisanby, Sarah H.;Sackeim, Harold A.
通讯作者：
Sackeim, Harold A.
影响因子：
10.6
作者：
Greicius, Michael D.;Flores, Benjamin H.;Schatzberg, Alan F.
通讯作者：
Schatzberg, Alan F.
影响因子：
4.3
作者：
Johnson DP;Whisman MA
通讯作者：
Whisman MA
影响因子：
10.6
作者：
Hamilton JP;Farmer M;Fogelman P;Gotlib IH
通讯作者：
Gotlib IH