Objectives: Up to 40% of adolescents with Major Depressive Disorder (MDD) do not respond to treatment. Repetitive Transcranial Magnetic Stimulation (rTMS) is an effective treatment in adults for MDD which shows promising efficacy in adolescents, however additional controlled investigations are needed. This pilot study compared rTMS applied to the left-side of the head and right-side in a randomized controlled trial. We hypothesized rTMS treatment would lead to an improvement in Children’s Depression Rating Scale Revised (CDRS-R) depression scores of adolescents with MDD at 1-month follow-up compared to baseline. No difference in response between left- and right-sided rTMS was expected.Methods: Fourteen adolescents who had been previously treated for MDD but had continued to suffer with MDD for an average of 2 years were randomly allocated to right (low frequency) or left (high frequency) rTMS. rTMS was applied to the scalp over the dorsolateral prefrontal cortex over 20 treatments given over four weeks. The primary outcome measure was the CDRS-R. Outcome assessments occurred at 10 sessions and 20 sessions, with follow-up at one month and six months.Results: CDRS-R scores improved significantly across the 20 rTMS treatments, with peak response at 1-month follow-up. Two (14%) adolescents had ≥ 50% score improvement and a further four (29%) demonstrated partial response (between 25 and 50% reduction) by 1-month follow-up. Treatment gains were sustained at 6-month follow-up. There was no significant difference in efficacy between left- and right-sided treatment.Conclusion: This small study found preliminary evidence that adolescents with MDD benefited from rTMS.
Suicide is a substantial contributor to global mortality, with suicidal ideation (SI) a significant predictor of suicide. Research has demonstrated relationships between dispositional coping styles and SI. This study aimed to advance this research by moving from the disposition coping level to examining the specific coping strategies people use when experiencing SI. Further, it aimed to examine whether prediction of the coping strategies individuals would use if they experienced SI differs from the actual coping strategies employed by people that have experienced SI. Seventy-seven help-seeking adults (Mage = 31.6, SD = 10.4) with (n = 49) or without (n = 28) history of SI completed measures of SI-related coping (modified Brief COPE) and current emotional distress (DASS-21) via online survey. ANCOVA revealed a significant association between SI history status and endorsement of Problem-Focused coping strategies, while controlling for current emotional distress levels. Participants without SI history reported greater predicted Problem-Focused coping use than actual use reported by participants with SI history. Subsequent facet-level ANCOVAs demonstrated that participants without SI history predicted they would use Active Coping, Use of Informational Support, and Planning strategies to a greater extent than was reported by people who did experience SI. The findings suggest individuals without SI history may overestimate their ability to use such adaptive coping strategies, and may represent an overestimation of overall ability to cope with potential SI. Future research may build on these preliminary findings and examine the factors explaining these differences to help inform programs related to SI and coping.
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