title: Self-directedness: an indicator for clinical response to the HF-rTMS treatment in refractory melancholic depression.
abstract: Although well-defined predictors of response are still unclear, clinicians refer a variety of depressed patients for a repetitive Transcranial Magnetic Stimulation (rTMS) treatment. It has been suggested that personality features such as Harm Avoidance (HA) and self-directedness (SD) might provide some guidance for a classical antidepressant treatment outcome. However, to date no such research has been performed in rTMS treatment paradigms. In this open study, we wanted to examine whether these temperament and character scores in particular would predict clinical outcome in refractory unipolar depressed patients when a typical high-frequency (HF)-rTMS treatment protocol is applied. Thirty six unipolar right-handed antidepressant-free treatment resistant depressed (TRD) patients, all of the melancholic subtype, received 10 HF-rTMS sessions applied to the left dorsolateral prefrontal cortex (DLPFC). All patients were classified as at least stage III TRD and were assessed with the Temperament and Character Inventory (TCI) before a HF-rTMS treatment. Only the individual scores on SD predicted clinical outcome. No other personality scales were found to be a predictor of this kind of application. Our results suggest that refractory MDD patients who score higher on the character scale SD may be more responsive to the HF-rTMS treatment.
authors.affiliation: Department of Psychiatry and Medical Psychology, Ghent University Hospital, Ghent University, Ghent, Belgium; Department of Psychiatry University Hospital (UZBrussel), Brussels, Belgium; Ghent Experimental Psychiatry (GHEP) Lab, Ghent, Belgium. Electronic address: chris.baeken@ugent.be.
authors.forename: Chris
authors.initials: C
authors.lastname: Baeken
authors.affiliation: Department of Psychiatry and Medical Psychology, Ghent University Hospital, Ghent University, Ghent, Belgium; Ghent Experimental Psychiatry (GHEP) Lab, Ghent, Belgium.
authors.forename: Stefanie
authors.initials: S
authors.lastname: Desmyter
authors.affiliation: Department of Psychiatry and Medical Psychology, Ghent University Hospital, Ghent University, Ghent, Belgium; Ghent Experimental Psychiatry (GHEP) Lab, Ghent, Belgium.
authors.forename: Romain
authors.initials: R
authors.lastname: Duprat
authors.affiliation: Department of Experimental Clinical and Health Psychology, Ghent University, Ghent, Belgium.
authors.forename: Rudi
authors.initials: R
authors.lastname: De Raedt
authors.affiliation: Department of Psychiatry and Medical Psychology, Ghent University Hospital, Ghent University, Ghent, Belgium.
authors.forename: Dirk
authors.initials: D
authors.lastname: Van Denabbeele
authors.affiliation: Department of Psychiatry and Medical Psychology, Ghent University Hospital, Ghent University, Ghent, Belgium.
authors.forename: Hannelore
authors.initials: H
authors.lastname: Tandt
authors.affiliation: Department of Psychiatry and Medical Psychology, Ghent University Hospital, Ghent University, Ghent, Belgium.
authors.forename: Gilbert M D
authors.initials: GM
authors.lastname: Lemmens
authors.affiliation: Department of Psychiatry and Medical Psychology, Ghent University Hospital, Ghent University, Ghent, Belgium.
authors.forename: Myriam
authors.initials: M
authors.lastname: Vervaet
authors.affiliation: Department of Psychiatry and Medical Psychology, Ghent University Hospital, Ghent University, Ghent, Belgium.
authors.forename: Kees
authors.initials: K
authors.lastname: van Heeringen
mesh_terms: D000328:Adult; D000928:Antidepressive Agents / Q000627:therapeutic use; D003866:Depressive Disorder / Q000175:diagnosis / Q000188:drug therapy / Q000523:psychology; D061218:Depressive Disorder, Treatment-Resistant / Q000175:diagnosis* / Q000523:psychology / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010555:Personality Inventory; D012647:Self-Assessment; D050781:Transcranial Magnetic Stimulation / Q000379:methods / Q000639:trends*; D016896:Treatment Outcome
chemical_list: D000928:Antidepressive Agents
keywords: HF-rTMS; Melancholia; Self-directedness; Treatment resistance; Unipolar depression