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Borderline personality traits do not influence response to TMS.

Heather Burrell Ward1, Agustin Yip2, Rameez Siddiqui3

  • 1Department of Psychiatry, Brigham & Women's Hospital, Boston, MA; Department of Psychiatry, Harvard Medical School, Boston, MA.

Journal of Affective Disorders
|November 24, 2020
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Borderline personality disorder (BPD) did not impact response to transcranial magnetic stimulation (TMS) for major depressive disorder (MDD). However, BPD traits were associated with modestly reduced response to electroconvulsive therapy (ECT).

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Area of Science:

  • Neuroscience
  • Psychiatry
  • Clinical Psychology

Background:

  • Comorbid personality disorders are frequent in patients diagnosed with major depressive disorder (MDD).
  • Previous research indicates individuals with comorbid borderline personality disorder (BPD) may exhibit diminished responsiveness to electroconvulsive therapy (ECT).
  • The impact of BPD on treatment outcomes for transcranial magnetic stimulation (TMS) remains largely uninvestigated.

Purpose of the Study:

  • To examine the association between borderline personality disorder (BPD) and treatment response in patients with major depressive disorder (MDD) undergoing transcranial magnetic stimulation (TMS).
  • To compare the effect of BPD on TMS response with its effect on electroconvulsive therapy (ECT) response.

Main Methods:

  • A retrospective analysis was conducted on 356 individuals receiving TMS and 1434 individuals receiving ECT for MDD.
  • The McLean Screening Instrument for Borderline Personality Disorder (MSI-BPD) was administered at baseline to assess for BPD traits.
  • Treatment response was evaluated using the Quick Inventory of Depression Symptomatology Self-Report (QIDS-SR), with general linear models (GLMs) used for statistical analysis.

Main Results:

  • No significant interaction between BPD status and time was observed for the TMS group, indicating BPD did not affect TMS response.
  • A significant interaction between BPD status and time was found for the ECT group, suggesting BPD impaired response to ECT.
  • The ECT group initially presented with higher depression severity scores (QIDS-SR) compared to the TMS group.

Conclusions:

  • Borderline personality traits do not appear to influence treatment response to TMS in patients with MDD.
  • BPD traits were associated with a modest reduction in ECT response, aligning with existing literature.
  • Further validation through clinical trials is recommended to confirm these findings.