Hostname: page-component-8448b6f56d-dnltx Total loading time: 0 Render date: 2024-04-23T06:19:05.826Z Has data issue: false hasContentIssue false
  • English
  • Français

A 2-year follow-up study of patients participating in our transcranial pulsating electromagnetic fields augmentation in treatment-resistant depression

Published online by Cambridge University Press:  13 January 2015

Per Bech ,
Lone Lindberg ,
Birgit Straasø  and
Erik Roj Larsen
Per Bech*
Affiliation:
Psychiatric Research Unit, Psychiatric Centre North Zealand, Copenhagen University Hospital, Hillerød, Denmark
Lone Lindberg
Affiliation:
Psychiatric Research Unit, Psychiatric Centre North Zealand, Copenhagen University Hospital, Hillerød, Denmark
Birgit Straasø
Affiliation:
Psychiatric Research Unit, Psychiatric Centre North Zealand, Copenhagen University Hospital, Hillerød, Denmark
Erik Roj Larsen
Affiliation:
Department of Affective Disorders, Mood Disorders Research Unit, Aarhus University Hospital, Denmark
*
Per Bech, Psychiatric Research Unit, Psychiatric Centre North Zealand, University of Copenhagen, Dyrehavevej 48, DK-3400 Hillerød, Denmark. Tel: +453 864 3095; Fax: +454 826 3877; E-mail: Per.bech@regionh.dk
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective

We have made a 2-year follow-up study to evaluate the effect of repeated transcranial pulsating electromagnetic fields (T-PEMF) augmentation in patients who had achieved remission but later on relapsed, as well as to identify factors contributing to treatment-resistant depression in patients who did not respond to T-PEMF.

Methods

Using the Longitudinal Expert Assessment of All Data approach the patients were classified in four groups: A: patients who achieved remission; B: patients with doubtful effect; C: patients with no effect; and D: patients who were hard-to-assess.

Results

In group A, comprising 27 patients, 13 had relapsed; they obtained a clear remission after a repeated course of T-PEMF augmentation. In group D, comprising 16 patients, we identified misdiagnostic factors both concerning the event of remission after the previous T-PEMF augmentation and concerning the aetiology (psychosocial stressors and co-morbid conditions). Compared with the other groups, the group D patients had a smaller number of previous episodes (p=0.09) and a longer duration of the current episode (p=0.01).

Conclusion

T-PEMF has an effect among patients who relapsed after remission with the first series of T-PEMF. Treatment-resistant depression is a condition that has a high degree of multivariate problems. Misuse of alcohol or drugs, severe somatic disorders and other psychosocial problems may need other kinds of treatment before T-PEMF augmentation.

Keywords

depressive disordertranscranial pulsating electromagnetic fieldstreatment of relapsetreatment-resistant depression
Type
Original Articles
Information
Acta Neuropsychiatrica , Volume 27 , Issue 2 , April 2015 , pp. 119 - 125
Check for updates
Copyright
© Scandinavian College of Neuropsychopharmacology 2015 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1. Lehmann, HE. Therapy-resistant depressions – a clinical classification. Pharmakopsychiatr Neuropsychopharmakol 1974;7:156–163.Google Scholar
2. Greden, JF, Riba, MB, McInnis, MG. eds. Treatment Resistant Depression: A Roadmap for Effective Care. Washington, DC: American Psychiatric Publishing, 2011.Google Scholar
3. Kasper, S, Montgomery, S. eds. Treatment-Resistant Depression. Chichester: Wiley-Blackwell, 2013.CrossRefGoogle Scholar
4. Carvalho, AF, Berk, M, Hyphantis, TN, Mcintyre, RS. The integrative management of treatment-resistant depression: a comprehensive review and perspectives. Psychother Psychosom 2014;83:70–88.Google Scholar
5. Straasø, B, Lauritzen, L, Lunde, M et al. Dose-remission of pulsating electromagnetic fields as augmentation in therapy-resistant depression: a randomized, double-blind controlled study. Acta Neuropsychiatr 2014;26:272–279.CrossRefGoogle ScholarPubMed
6. European Agency for the Evaluation of Medicinal Products. Note for Guidance on Good Clinical Practice CPMP/ICH/135/95. London: European Agency for the Evaluation of Medicinal Products, 1997.Google Scholar
7. Spitzer, RL. Psychiatric diagnosis: are clinicians still necessary? Compr Psychiatry 1983;24:399–411.Google Scholar
8. Bech, P. Clinical Psychometrics. Oxford: Wiley Blackwell, 2012.Google Scholar
9. Bech, P, Bille, J, Moller, SB, Hellstrom, LC, Ostergaard, SD. Psychometric validation of the Hopkins Symptom Checklist (SCL-90) subscales for depression, anxiety, and interpersonal sensitivity. J Affect Disord 2014;160:98–103.Google Scholar
10. Siegel, S. Nonparametric statistics for the behavioural sciences. New York: McGraw Hill, 1956.Google Scholar
11. Karlsson, H, Hirvonen, J, Salminen, J, Hietala, J. Increased serotonin receptor 1A binding in major depressive disorder after psychotherapy, but not after SSRI pharmacotherapy, is related to improved social functioning capacity. Psychother Psychosom 2013;82:260–261.CrossRefGoogle Scholar
12. Sartorius, N. Description and classification of depressive disorders. Contributions for the definition of the therapy-resistance and of therapy resistant depressions. Pharmakopsychiatr Neuropsychopharmakol 1974;7:76–79.Google Scholar
13. World Health Organization. International Classification of Diseases: Ninth Revision (ICD-9). Geneva: World Health Organization, 1978.Google Scholar
14. World Health Organization. International Statistical Classification of Diseases and Related Health Problems, 10th Revision (ICD-10). Diagnostic Criteria for Research. Geneva: World Health Organization, 1993.Google Scholar
15. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), 5th edn. Washington, DC: American Psychiatric Association, 2013.Google Scholar
16. Murphy, E. The prognosis of depression in old age. Br J Psychiatr 1983;142:111–119.Google Scholar
17. Shea, MT, Glass, DR, Pilkonis, PA, Watkins, J, Docherty, JP. Frequency and implications of personality disorders in a sample of depressed outpatients. J Personal Disord 1987;1:27–42.CrossRefGoogle Scholar
18. Worthington, J, Fava, M, Agustin, C et al. Consumption of alcohol, nicotine, and caffeine among depressed outpatients. Relationship with response to treatment. Psychosomatics 1996;37:518–522.CrossRefGoogle ScholarPubMed
19. O’Reardon, JP, Amsterdam, JD. Medical disorders and treatment-resistant depression. In: Amsterdam JD, Hornig M, Nierenberg AA, editors. Treatment-Resistant Mood Disorder. Cambridge: Cambridge University Press, 2001. p. 405–429.Google Scholar
20. Lauritzen, L, Odgaard, K, Clemmesen, L et al. Relapse prevention by means of paroxetine in ECT-treated patients with major depression: a comparison with imipramine and placebo in medium-term continuation therapy. Acta Psychiatrica Scandinavica 1996;94:241–251.CrossRefGoogle ScholarPubMed