RESUMO
Depressive illnesses in non-Western societies are often masked by somatic attributes that are sometimes impervious to pharmacological agents. This study explores the effectiveness of repetitive transcranial magnetic stimulation (rTMS) for people experiencing treatment-resistant depression (TRD) accompanied by physical symptoms. Data were obtained from a prospective study conducted among patients with TRD and some somatic manifestations who underwent 20 sessions of rTMS intervention from January to June 2020. The Hamilton Rating Scale for Depression (HAMD) was used for clinical evaluation. Data were analysed using descriptive and inferential techniques (multiple logistic regression) in SPSS. Among the 49 participants (mean age: 42.5 ± 13.3), there was a significant reduction in posttreatment HAMD scores compared to baseline (t = 10.819, p < 0.0001, and 95% CI = 8.574-12.488), indicating a clinical response. Approximately 37% of the patients responded to treatment, with higher response rates among men and those who remained in urban areas, had a history of alcohol use, and were subjected to the standard 10 HZ protocol. After adjusting for all extraneous variables, the rTMS protocol emerged as the only significant predictor of response to the rTMS intervention. To our knowledge, this is the first study to examine the effectiveness of rTMS in the treatment of somatic depression.
RESUMO
Objectives: We sought to identify subgroups of psychiatric patients in a sample of patients admitted at a tertiary care hospital in Oman who received electroconvulsive therapy (ECT) based on their demographic and clinical outcomes. Methods: We retrospectively collected data from patients who received ECT at Al Massarah Hospital, Muscat, Oman, between January 2015 and December 2019. Sociodemographic characteristics, clinical profiles, and psychiatric comorbidities were examined. Results: A total of 179 psychiatric patients received ECT; 96 (53.6%) were females. The average age at diagnosis was 42.5 years. Two-step cluster analysis showed 70 (39.1%) patients in cluster one and 109 (60.9%) patients in cluster two. Patients in cluster one included more (61.4%) females, were older (mean = 55.2 years), married (95.7%), and unemployed (88.6%). They reported they had comorbidities (55.7%) and less frequent ECT use (mean = 8.7) than patients in cluster two. Clusters differences were found on gender (p = 0.001), age (p < 0.001), marital status (p < 0.001), and occupation (p = 0.001). Significant differences were found for diagnosis (p < 0.001), comorbid medical conditions (p < 0.001), and use of ECT sessions (p = 0.006). Conclusions: Psychiatric patients receiving ECT are heterogeneous, with different demographic and clinical outcomes. Our study has shown that patients in cluster one are older females, unemployed, with more comorbidities, and depressive disorders, but received fewer ECT sessions. This study provides important information for clinicians to identify strategies to promote the use of ECT on its effectiveness and safety issues for each group.