Predictors of rTMS and Group Therapy Efficacy in Adolescent Depression

Hebei Medical University

Status: Completed

Conditions: Major Depressive Disorder (MDD); Adolescent Depression

Treatments: Behavioral: Group Cognitive Behavioral Therapy (CBT); Device: Repetitive Transcranial Magnetic Stimulation (rTMS)

Study type: Observational

Funder types: Other

Identifiers

NCT07283419

2023S00133

Details and patient eligibility

About

This study aims to identify baseline predictors of treatment efficacy in adolescents with Major Depressive Disorder (MDD) undergoing a combined intervention of repetitive transcranial magnetic stimulation (rTMS) and group therapy. Specifically, the study investigates the predictive value of family environment characteristics (cohesion, conflict, expressiveness) and cognitive functions (executive function, attention/inhibition).

Full description

Adolescent depression is a significant health concern, and while combined therapies involving neuromodulation and psychotherapy show promise, individual treatment responses vary heterogeneity. This prospective cohort study enrolled 163 adolescents aged 12-18 with MDD. All participants received a standardized 4-week intervention consisting of 20 sessions of high-frequency (10 Hz) rTMS over the left dorsolateral prefrontal cortex (DLPFC) and 8 sessions of group Cognitive Behavioral Therapy (CBT).

Baseline assessments included the Family Environment Scale (FES) and a neuropsychological battery including the Stroop Color-Word Test and Wisconsin Card Sorting Test (WCST). The primary outcome was the percentage reduction in depressive symptoms measured by the HAMD-24 scale. The study employs multiple linear regression to determine which baseline factors independently predict superior treatment outcomes.

Enrollment: 163 patients

Sex: All

Ages: 12 to 18 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Primary diagnosis of Major Depressive Disorder (MDD) according to ICD-10 criteria.
• Score of ≥ 20 on the 24-item Hamilton Depression Rating Scale (HAMD-24).
• Sufficient intellectual and linguistic ability to complete assessments and participate in therapy.
• Provided written informed consent (participants and guardians).

Exclusion criteria

• Lifetime diagnosis of a psychotic or bipolar disorder.
• Current substance use disorder.
• Significant neurological illness (e.g., epilepsy) or metallic implants contraindicated for rTMS.
• Receiving concurrent formal psychotherapy outside the study protocol.

Trial design

163 participants in 1 patient group

rTMS + Group Therapy Cohort

Description:

Adolescents diagnosed with MDD who received the standardized combined intervention.

Treatment:

Device: Repetitive Transcranial Magnetic Stimulation (rTMS)

Behavioral: Group Cognitive Behavioral Therapy (CBT)