Personality Trait Predictive Utility and Stability in Transcranial Magnetic Stimulation (rTMS) for Major Depression: Dissociation of Neuroticism and Self-Criticism: Utilité prédictive et stabilité des traits de personnalité dans la stimulation magnétique transcrânienne répétitive (SMTr) pour la dépression majeure : dissociation du neuroticisme et de l’autocritique
| Autor: | Shiv Bhanot, Daniel C. Kopala-Sibley, Marcelo T. Berlim, Alexander McGirr, Gabrielle B. Chartier, Jaeden Cole, Peter Y. Chan |
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| Rok vydání: | 2019 |
| Předmět: |
Dissociation (neuropsychology)
Self-criticism medicine.medical_treatment media_common.quotation_subject behavioral disciplines and activities Neuroticism 030227 psychiatry Transcranial magnetic stimulation 03 medical and health sciences Psychiatry and Mental health 0302 clinical medicine nervous system mental disorders medicine Trait Antidepressant Personality Psychology psychological phenomena and processes 030217 neurology & neurosurgery Original Research media_common Clinical psychology |
| Zdroj: | Can J Psychiatry |
| ISSN: | 1497-0015 0706-7437 |
| Popis: | Background: Cost-efficient and non-invasive predictors of antidepressant response to repetitive transcranial magnetic stimulation (rTMS) are required. The personality vulnerabilities—neuroticism and self-criticism—are associated with antidepressant outcomes in other modalities; however, self-criticism has not been examined in response to rTMS, and the literature on neuroticism and rTMS is inconsistent. Methods: This naturalistic, 4-week study involved daily dorsolateral prefrontal cortex (DLFPC) rTMS for major depression (15 unipolar, 2 bipolar). Participants completed the Big Five Inventory (neuroticism) and the Depressive Experiences Questionnaire (self-criticism) at baseline and at the end of treatment. Changes in depressive symptoms, as rated by the clinician, were quantified using the 21-item Hamilton Depression Rating Scale. Given the inconsistencies in data regarding the stability of neuroticism in patients receiving rTMS, we performed a systematic review and quantitative meta-analysis of trials examining rTMS and neuroticism. Results: rTMS significantly improved depressive symptoms, and this was predicted by higher levels of self-criticism but not neuroticism. Self-criticism was stable over the 4 weeks of rTMS; however, neuroticism decreased, and this was not related to decreases in depressive symptoms. Our quantitative meta-analysis of 4 rTMS trials in major depression ( n = 52 patients) revealed decreases in neuroticism, with a moderate effect size. Limitations: Our results are limited by a small sample size, and the absence of a sham-rTMS group. Our meta-analysis included only 4 trials. Conclusion: Highly self-critical patients appear to benefit more from rTMS than less self-critical patients. Neuroticism, a conceptually similar but distinct personality domain, does not appear to predict antidepressant response, yet this vulnerability factor for depression decreases after rTMS. |
| Databáze: | OpenAIRE |
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