Treating anxious depression using repetitive transcranial magnetic stimulation.

Area of Science:

• Neuroscience
• Psychiatry
• Clinical Psychology

Background:

• Major depressive disorder (MDD) can present with
• anxious depression,
• which may indicate a poorer response to some treatments.
• Repetitive transcranial magnetic stimulation (rTMS) is an FDA-approved MDD treatment.

Purpose of the Study:

• To investigate if anxious depression is linked to a reduced response to rTMS in MDD patients.
• To assess the impact of anxious depression on both depression and anxiety symptom improvement during rTMS therapy.

Main Methods:

• 32 treatment-resistant MDD outpatients undergoing rTMS were evaluated.
• Anxious depression was defined using the Hamilton Rating Scale for Depression (HAMD) anxiety/somatization factor (score ≥7).
• Treatment response was assessed by HAMD total scores pre- and post-rTMS.

Main Results:

• Overall, significant improvements in depression and anxiety symptoms were observed post-rTMS.
• Patients with and without anxious depression showed comparable rates of depression symptom improvement.
• Individuals with anxious depression experienced greater improvements in anxiety symptoms compared to those without.

Conclusions:

• Anxious depression was not associated with a diminished treatment response to rTMS in this cohort.
• rTMS appears effective for both depression and anxiety symptoms, irrespective of anxious depression presentation.
• Limitations include a small sample size and lack of structured diagnostic interviews or independent anxiety measures.