Suicidal behavior in treatment resistant major depressive disorder patients treated with transmagnetic stimulation(TMS) and its relationship with cognitive functions. (April 2020)

• Record Type: Journal Article
• Authors: Ozcan, Selma; Gica, Sakir; Gulec, Huseyin
• Is Part Of: Psychiatry research. Volume 286(2020)
• Publication Date: 2020-04
• Subjects: Treatment resistant depression -- Transcranial magnetic stimulation -- Suicide -- Emotion recognition -- Decision-making -- Cognitive flexibility -- Response ınhibition; Psychiatry -- Periodicals; Psychiatry -- periodicals; Psychiatrie -- Périodiques; 616.89
• DOI: 10.1016/j.psychres.2020.112873
• Languages: English
• ISSNs: 0165-1781

Abstract

Highlights: rTMS treatment was found to be useful in reducing depression severity, suicidal thoughts/behaviors and hopelessness in patients with treatment resistant depression. Although there was no negative effect of rTMS treatment on other cognitive functions, the positive effect of rTMS on cognitive function was observed in facial emotion recognition. A significant relationship was found between suicidal ideation/behavior and flexible thinking, decision-making and risk taking skills before treatment. Abstract: The aim of this study is to investigate the effects of rTMS treatment on suicidal thoughts/behaviors and to determine the cognitive mechanisms underlying the effects of rTMS treatment on suicidal thoughts/behaviors in treatment-resistant depression(TRD). Thirty patients with TRD received rTMS 5 sessions per week for 4–6 weeks. Montgomery-Asberg Depression Rating Scale(MADRS), Columbia Suicide Severity Rating Scale(C-SSRS), Suicidal Ideation Scale(SIS), Beck Hopelessness Scale(BHS) and Cambridge Neuropsychological Test Automated Battery(CANTAB) were administered before and after treatment. After rTMS treatment, there was a significant decrease in depressive complaints and suicidal thoughts and improvement in emotional recognition. However, there was no significant change in cognitive functions such as cognitive flexibility, motor response inhibition and decision making. Pre-treatment decision-making and flexible thinking skills were related to the change in suicidal ideation. In TRD patients, rTMS has a positive effect on depressive symptoms and suicidal thoughts/behaviors and emotion recognition abilities. Although there is no negative effect on other cognitive functions, the positive effect of rTMS on cognitive functions is limited. At this point, we think that the TRD would be treated more effectively with treatments targeting specific symptom clusters such as other cognitive functions and suicidal thoughts.