Repetitive transcranial magnetic stimulation for major depression: A naturalistic observational study in an Australian private hospital.

Repetitive transcranial magnetic stimulation (rTMS) is an effective and evidence-based treatment for major depression, which is now as a mainstream treatment in clinical practice. However, there is limited data concerning its use in Australian private psychiatric hospital settings. This retrospective study examined routinely collected data of 153 inpatients, who received 20 rTMS treatments over four weeks. Primary outcomes measures were the 17-item Hamilton Depression Rating Scale (HAMD-17) and the 21-item Depression, Anxiety and Stress Scale (DASS-21). At post-treatment, response and remission rates were 54% and 28%, respectively, for the HAMD-17; and 53% response and 16% remission rates, for the DASS-21 Depression subscale, respectively. Although no gender differences were observed, younger patients demonstrated more improvements during acute rTMS but the effect was not significant after accounting for pre-treatment symptom severity. The findings of this naturalistic study suggest that an acute course of rTMS provided in private clinical settings resulted in similar response and remission rates to longer rTMS courses. Shorter rTMS courses appear to have satisfactory efficacy in treating major depression, in clinically diverse and real-world practice.

Electroconvulsive therapy for treatment of late-onset obsessive compulsive disorder.

An 81-year-old female with no previous psychiatric history presented with late-onset obsessive compulsive disorder following an acute right macular hemorrhage and loss of vision. Following a thorough organic screen to exclude a physical cause, various high doses of selective serotonin reuptake inhibitors were tried with no therapeutic benefit. The patient had significant remission of her symptoms following a course of electroconvulsive therapy.