Abstract:
:Major depressive disorder (MDD) is a prevalent and disabling condition, and many patients do not respond to available treatments. Deep transcranial magnetic stimulation (dTMS) is a new technology allowing non-surgical stimulation of relatively deep brain areas. This is the first double-blind randomized controlled multicenter study evaluating the efficacy and safety of dTMS in MDD. We recruited 212 MDD outpatients, aged 22-68 years, who had either failed one to four antidepressant trials or not tolerated at least two antidepressant treatments during the current episode. They were randomly assigned to monotherapy with active or sham dTMS. Twenty sessions of dTMS (18 Hz over the prefrontal cortex) were applied during 4 weeks acutely, and then biweekly for 12 weeks. Primary and secondary efficacy endpoints were the change in the Hamilton Depression Rating Scale (HDRS-21) score and response/remission rates at week 5, respectively. dTMS induced a 6.39 point improvement in HDRS-21 scores, while a 3.28 point improvement was observed in the sham group (p=0.008), resulting in a 0.76 effect size. Response and remission rates were higher in the dTMS than in the sham group (response: 38.4 vs. 21.4%, p=0.013; remission: 32.6 vs. 14.6%, p=0.005). These differences between active and sham treatment were stable during the 12-week maintenance phase. dTMS was associated with few and minor side effects apart from one seizure in a patient where a protocol violation occurred. These results suggest that dTMS constitutes a novel intervention in MDD, which is efficacious and safe in patients not responding to antidepressant medications, and whose effect remains stable over 3 months of maintenance treatment.
journal_name
World Psychiatryauthors
Levkovitz Y,Isserles M,Padberg F,Lisanby SH,Bystritsky A,Xia G,Tendler A,Daskalakis ZJ,Winston JL,Dannon P,Hafez HM,Reti IM,Morales OG,Schlaepfer TE,Hollander E,Berman JA,Husain MM,Sofer U,Stein A,Adler S,Deutschdoi
10.1002/wps.20199subject
Has Abstractpub_date
2015-02-01 00:00:00pages
64-73issue
1eissn
1723-8617issn
2051-5545journal_volume
14pub_type
杂志文章相关文献
World Psychiatry文献大全abstract::Throughout most of their lives, women are at a greater risk of becoming depressed than men. Some evidence suggests that this heightened risk is associated with increased sensitivity to the hormonal changes that occur across the female reproductive lifecycle. For some women, the peri-menopause and early post-menopausal...
journal_title:World psychiatry : official journal of the World Psychiatric Association (WPA)
pub_type: 杂志文章
doi:10.1002/j.2051-5545.2008.tb00180.x
更新日期:2008-10-01 00:00:00
abstract::The issue of the severity of psychiatric disorders has great clinical importance. For example, severity influences decisions about level of care, and affects decisions to seek government assistance due to psychiatric disability. Controversy exists as to the efficacy of antidepressants across the spectrum of depression...
journal_title:World psychiatry : official journal of the World Psychiatric Association (WPA)
pub_type: 杂志文章
doi:10.1002/wps.20569
更新日期:2018-10-01 00:00:00
abstract::Cognitive behavior therapy (CBT), as exemplified by the model of psychotherapy developed and refined over the past 40 years by A.T. Beck and colleagues, is one of the treatments of first choice for ambulatory depressive and anxiety disorders. Over the past several decades, there have been vigorous efforts to adapt CBT...
journal_title:World psychiatry : official journal of the World Psychiatric Association (WPA)
pub_type: 杂志文章
doi:10.1002/wps.20149
更新日期:2014-10-01 00:00:00
abstract::Metabolic syndrome and other cardiovascular risk factors are highly prevalent in people with schizophrenia. Patients are at risk for premature mortality and overall have limited access to physical health care. In part these cardio-metabolic risk factors are attributable to unhealthy lifestyle, including poor diet and ...
journal_title:World psychiatry : official journal of the World Psychiatric Association (WPA)
pub_type: 杂志文章
doi:10.1002/j.2051-5545.2009.tb00199.x
更新日期:2009-02-01 00:00:00
abstract::A meta-analysis was conducted to explore the risk for cardio-metabolic abnormalities in drug naïve, first-episode and multi-episode patients with schizophrenia and age- and gender- or cohort-matched general population controls. Our literature search generated 203 relevant studies, of which 136 were included. The final...
journal_title:World psychiatry : official journal of the World Psychiatric Association (WPA)
pub_type: 杂志文章
doi:10.1002/wps.20069
更新日期:2013-10-01 00:00:00
abstract::Depression is widely acknowledged to be a heterogeneous entity, and the need to further characterize the individual patient who has received this diagnosis in order to personalize the management plan has been repeatedly emphasized. However, the research evidence that should guide this personalization is at present fra...
journal_title:World psychiatry : official journal of the World Psychiatric Association (WPA)
pub_type: 杂志文章
doi:10.1002/wps.20771
更新日期:2020-10-01 00:00:00
abstract::This paper summarizes the current situation of mental health services in the Arab world. Out of 20 countries for which information is available, six do not have a mental health legislation and two do not have a mental health policy. Three countries (Lebanon, Kuwait and Bahrain) had in 2007 more than 30 psychiatric bed...
journal_title:World psychiatry : official journal of the World Psychiatric Association (WPA)
pub_type: 杂志文章
doi:10.1016/j.wpsyc.2012.01.008
更新日期:2012-02-01 00:00:00
abstract::There is an enormous gap between the burden of mental disorders and mental health resources in low- and middle-income countries. The Mental Health: Global Action Programme of the World Health Organization (WHO) envisions an active role for research in the multidimensional efforts required to change the current mental ...
journal_title:World psychiatry : official journal of the World Psychiatric Association (WPA)
pub_type: 杂志文章
doi:
更新日期:2004-06-01 00:00:00
abstract::Although the construct of dissociation was introduced into psychiatry at the end of the 19th century by Pierre Janet, the term still lacks a coherent conceptualization, which is partially reflected by differences in the classification of dissociative and conversion disorders in ICD-10 and DSM-IV. Given the clinical si...
journal_title:World psychiatry : official journal of the World Psychiatric Association (WPA)
pub_type: 杂志文章
doi:
更新日期:2006-06-01 00:00:00
abstract::The objective of this study was to examine mental disorders and treatment use among bereaved siblings in the general population. Siblings (N=7243) of all deceased children in the population of Manitoba, Canada who died between 1984 and 2009 were matched 1:3 to control siblings (N=21,729) who did not have a sibling die...
journal_title:World psychiatry : official journal of the World Psychiatric Association (WPA)
pub_type: 杂志文章
doi:10.1002/wps.20293
更新日期:2016-02-01 00:00:00
abstract::A rather large body of literature now exists on the use of telemental health services in the diagnosis and management of various psychiatric conditions. This review aims to provide an up-to-date assessment of telemental health, focusing on four main areas: computerized CBT (cCBT), Internet-based CBT (iCBT), virtual re...
journal_title:World psychiatry : official journal of the World Psychiatric Association (WPA)
pub_type: 杂志文章
doi:10.1002/wps.20218
更新日期:2015-06-01 00:00:00
abstract::Disastrous events in the country and the region caused a 13.5% increase in the prevalence of mental and behavioral disorders in Serbia in the last few years, thus making them the second largest public health problem. Due to prolonged adversities, the health system has deteriorated and is facing specific challenges. Ho...
journal_title:World psychiatry : official journal of the World Psychiatric Association (WPA)
pub_type: 杂志文章
doi:
更新日期:2007-06-01 00:00:00
abstract::The reporting of child sexual abuse (CSA) and physician-patient sexual relationships (PPSR) are currently the focus of professional, legal and media attention in several countries. This paper briefly reviews mental health policies on these issues and reports on a WPA survey of them. While the WPA Madrid Declaration pe...
journal_title:World psychiatry : official journal of the World Psychiatric Association (WPA)
pub_type: 杂志文章
doi:10.1002/j.2051-5545.2009.tb00210.x
更新日期:2009-02-01 00:00:00
abstract::Uganda has passed through political and bloody civil strife stretching over 40 years. Since 1987 the HIV/AIDS pandemic has compounded the problems of the country. The present paper describes some initiatives to develop mental health services in one district of the country. A bottom-up approach in the district resulted...
journal_title:World psychiatry : official journal of the World Psychiatric Association (WPA)
pub_type: 杂志文章
doi:
更新日期:2007-02-01 00:00:00
abstract::Although cognitive behaviour therapy (CBT) is the treatment of choice for post-traumatic stress disorder (PTSD), there is no evidence of its success with PTSD patients still under direct threat of terrorist attacks. This study reports the first randomized controlled trial of CBT for PTSD terrorist-affected people. Twe...
journal_title:World psychiatry : official journal of the World Psychiatric Association (WPA)
pub_type: 杂志文章
doi:10.1002/j.2051-5545.2011.tb00058.x
更新日期:2011-10-01 00:00:00
abstract::There is wide agreement that the Internet can serve as a tool that enhances well-being. It is more difficult, however, to find consensus around the issue of problematic Internet use. That may be in part because scientific investigation has lagged far behind technological advances and media attention. The diagnostic sc...
journal_title:World psychiatry : official journal of the World Psychiatric Association (WPA)
pub_type: 杂志文章
doi:10.1002/j.2051-5545.2010.tb00278.x
更新日期:2010-06-01 00:00:00
abstract::Substance use is a major cause of disability globally. This has been recognized in the recent United Nations Sustainable Development Goals (SDGs), in which treatment coverage for substance use disorders is identified as one of the indicators. There have been no estimates of this treatment coverage cross-nationally, ma...
journal_title:World psychiatry : official journal of the World Psychiatric Association (WPA)
pub_type: 杂志文章
doi:10.1002/wps.20457
更新日期:2017-10-01 00:00:00
abstract::The United Nations (UN) Convention on the Rights of Persons with Disabilities (CRPD) is the most up-to-date international legal instrument concerning the rights of persons with disabilities. Such persons are taken to include those with serious mental disorders. According to an authoritative interpretation of a crucial...
journal_title:World psychiatry : official journal of the World Psychiatric Association (WPA)
pub_type: 杂志文章
doi:10.1002/wps.20584
更新日期:2019-02-01 00:00:00
abstract::Antipsychotic drugs such as clozapine and olanzapine are associated with an increased risk for type 2 diabetes, but relatively little is known about the relationship between risk factors for type 2 diabetes established in the general population and type 2 diabetes in people with psychosis. We estimated the prevalence ...
journal_title:World psychiatry : official journal of the World Psychiatric Association (WPA)
pub_type: 杂志文章
doi:10.1002/wps.20130
更新日期:2014-06-01 00:00:00
abstract::This paper summarizes the findings for the Latin American and Caribbean countries of the WPA Task Force on Steps, Obstacles and Mistakes to Avoid in the Implementation of Community Mental Health Care. It presents an overview of the provision of mental health services in the region; describes key experiences in Argenti...
journal_title:World psychiatry : official journal of the World Psychiatric Association (WPA)
pub_type: 杂志文章
doi:10.1002/j.2051-5545.2012.tb00130.x
更新日期:2012-10-01 00:00:00
abstract::This study examined the transcultural robustness of a screening instrument for hypomania, the Hypomania Checklist-32, first revised version (HCL-32 R1). It was carried out in 2606 patients from twelve countries in five geographic regions (Northern, Southern and Eastern Europe, South America and East Asia). In addition...
journal_title:World psychiatry : official journal of the World Psychiatric Association (WPA)
pub_type: 杂志文章
doi:10.1002/j.2051-5545.2010.tb00268.x
更新日期:2010-02-01 00:00:00
abstract::A timely determination of the risk of post-traumatic stress disorder (PTSD) is a prerequisite for efficient service delivery and prevention. We provide a risk estimate tool allowing a calculation of individuals' PTSD likelihood from early predictors. Members of the International Consortium to Predict PTSD (ICPP) share...
journal_title:World psychiatry : official journal of the World Psychiatric Association (WPA)
pub_type: 杂志文章
doi:10.1002/wps.20608
更新日期:2019-02-01 00:00:00
abstract::In this paper we report the clinical utility of the diagnostic guidelines for ICD-11 mental, behavioural and neurodevelopmental disorders as assessed by 339 clinicians in 1,806 patients in 28 mental health settings in 13 countries. Clinician raters applied the guidelines for schizophrenia and other primary psychotic d...
journal_title:World psychiatry : official journal of the World Psychiatric Association (WPA)
pub_type: 杂志文章
doi:10.1002/wps.20581
更新日期:2018-10-01 00:00:00
abstract::Data concerning the effectiveness of naturalistic treatments (treatment-as-usual) in child and adolescent psychiatric (CAP) services are scarce. The purpose of this prospective observational study was to examine the effectiveness of CAP treatments in a naturalistic outpatient setting. Three hundred six patients (atten...
journal_title:World psychiatry : official journal of the World Psychiatric Association (WPA)
pub_type: 杂志文章
doi:10.1002/j.2051-5545.2010.tb00288.x
更新日期:2010-06-01 00:00:00
abstract::Psychiatrists would undoubtedly support the notion of promoting such qualities as empathy, sensitivity and caring in the pursuit of good clinical practice. However, cultivating what we may call the "art of psychiatry" is not straightforward, since the qualities that constitute it are elusive. I propose that the means ...
journal_title:World psychiatry : official journal of the World Psychiatric Association (WPA)
pub_type: 杂志文章
doi:
更新日期:2005-10-01 00:00:00
abstract::Studies from North America have concluded that supported employment using the Individual Placement and Support (IPS) model is effective in helping individuals with severe and persistent mental illness gain competitive employment. The aim of this study was to investigate the effectiveness and cost-effectiveness of IPS ...
journal_title:World psychiatry : official journal of the World Psychiatric Association (WPA)
pub_type: 杂志文章
doi:10.1002/j.2051-5545.2011.tb00035.x
更新日期:2011-06-01 00:00:00
abstract::Schizophrenia is characterized by positive symptoms, negative symptoms and cognitive impairment. Positive symptoms may be related to excessive dopamine (DA) function, as suggested by the common antidopaminergic properties of antipsychotic medications, which are most effective at treating positive symptoms. Negative sy...
journal_title:World psychiatry : official journal of the World Psychiatric Association (WPA)
pub_type: 杂志文章
doi:
更新日期:2003-10-01 00:00:00
abstract::Most psychotherapies for depression have been developed in high-income Western countries of North America, Europe and Australia. A growing number of randomized trials have examined the effects of these treatments in non-Western countries. We conducted a meta-analysis of these studies to examine whether these psychothe...
journal_title:World psychiatry : official journal of the World Psychiatric Association (WPA)
pub_type: 杂志文章
doi:10.1002/wps.20493
更新日期:2018-02-01 00:00:00
abstract::The need for psychological therapies for psychosis is increasingly recognised. In recent years, two psychological approaches, cognitive behavioural therapy (CBT) and family interventions (FI), have emerged from among a range of psychological approaches as effective therapies with the strongest evidence base. The theor...
journal_title:World psychiatry : official journal of the World Psychiatric Association (WPA)
pub_type: 杂志文章
doi:
更新日期:2003-10-01 00:00:00
abstract::Genome-wide association studies (GWAS) have revealed hundreds of genetic loci associated with the vulnerability to major psychiatric disorders, and post-GWAS analyses have shown substantial genetic correlations among these disorders. This evidence supports the existence of a higher-order structure of psychopathology a...
journal_title:World psychiatry : official journal of the World Psychiatric Association (WPA)
pub_type: 杂志文章
doi:10.1002/wps.20772
更新日期:2020-10-01 00:00:00