title: The Diagnostic Apathia Scale predicts a dose-remission relationship of T-PEMF in treatment-resistant depression.
abstract: OBJECTIVE
  The aim of this study was to evaluate the predictive validity of the apathy subsyndrome in patients with therapy-resistant depression in the dose-remission study with transcranial pulsating electromagnetic fields (T-PEMF).
  
  
  METHODS
  The apathy subsyndrome consists of the symptoms of fatigue, concentration and memory problems, lack of interests, difficulties in making decisions, and sleep problems. We evaluated 65 patients with therapy-resistant depression. In total, 34 of these patients received placebo T-PEMF in the afternoon and active T-PEMF in the morning, that is, one daily dose. The remaining 31 patients received active T-PEMF twice daily. Duration of treatment was 8 weeks in both groups. The Hamilton Depression Scale (HAM-D17) and the Bech-Rafaelsen Melancholia Scale (MES) were used to measure remission. We also focused on the Diagnostic Apathia Scale, which is based on a mixture of items from the MINI and the HAM-D17/MES.
  
  
  RESULTS
  In patients without apathy, the remission rate after T-PEMF was 83.9% versus 58.8% in patients with apathy (p≤0.05). In patients without apathy receiving one active dose daily 94.4% remitted versus 50% for patients with apathy (p≤0.05). In patients without apathy who received two active doses 69.9% remitted versus 66.7% for patients with apathy (p≤0.05).
  
  
  CONCLUSIONS
  Taking the baseline diagnosis of the apathy syndrome into consideration, we found that in patients without apathy one daily dose of T-PEMF is sufficient, but in patients with apathy two daily doses are necessary. Including the apathy syndrome as predictor in future studies would seem to be clinically relevant.
authors.affiliation: 1Psychiatric Research Unit,Psychiatric Centre North Zealand,Copenhagen University Hospital,Hillerød,Denmark.
authors.forename: Per
authors.initials: P
authors.lastname: Bech
authors.affiliation: 1Psychiatric Research Unit,Psychiatric Centre North Zealand,Copenhagen University Hospital,Hillerød,Denmark.
authors.forename: Marianne
authors.initials: M
authors.lastname: Lunde
authors.affiliation: 1Psychiatric Research Unit,Psychiatric Centre North Zealand,Copenhagen University Hospital,Hillerød,Denmark.
authors.forename: Lise
authors.initials: L
authors.lastname: Lauritzen
authors.affiliation: 1Psychiatric Research Unit,Psychiatric Centre North Zealand,Copenhagen University Hospital,Hillerød,Denmark.
authors.forename: Birgit
authors.initials: B
authors.lastname: Straasø
authors.affiliation: 1Psychiatric Research Unit,Psychiatric Centre North Zealand,Copenhagen University Hospital,Hillerød,Denmark.
authors.forename: Lone
authors.initials: L
authors.lastname: Lindberg
authors.affiliation: 2Department of Psychiatry,Psychiatric Centre Copenhagen,Copenhagen University Hospital,Copenhagen,Denmark.
authors.forename: Maj
authors.initials: M
authors.lastname: Vinberg
authors.affiliation: 1Psychiatric Research Unit,Psychiatric Centre North Zealand,Copenhagen University Hospital,Hillerød,Denmark.
authors.forename: Mogens
authors.initials: M
authors.lastname: Undén
authors.affiliation: 3Psychiatric Research Unit,Psychiatric Centre Copenhagen,Copenhagen University Hospital,Copenhagen NV,Denmark.
authors.forename: Lone Christina
authors.initials: LC
authors.lastname: Hellström
authors.affiliation: 4Department of Cellular and Molecular Medicine,Panum institute,University of Copenhagen,Copenhagen,Denmark.
authors.forename: Steen
authors.initials: S
authors.lastname: Dissing
authors.affiliation: 5Department of Affective Disorders,Mood Disorders Research Unit,Aarhus University Hospital,Aarhus,Denmark.
authors.forename: Erik Roj
authors.initials: ER
authors.lastname: Larsen
mesh_terms: D057565:Apathy; D061218:Depressive Disorder, Treatment-Resistant / Q000523:psychology* / Q000628:therapy*; D006801:Humans; D011237:Predictive Value of Tests; D011569:Psychiatric Status Rating Scales; D012074:Remission Induction / Q000379:methods; D015203:Reproducibility of Results; D013577:Syndrome; D050781:Transcranial Magnetic Stimulation
keywords: treatment-resistant depression