Efficacy of repetitive transcranial magnetic stimulation combined with health education in the treatment of refractory depression and its effects on cognitive function and sleep quality / 中国基层医药

ABSTRACT

Objective:To investigate the efficacy of repetitive transcranial magnetic stimulation (rTMS) combined with health education in the treatment of refractory depression and its effects on cognitive function and sleep quality.Methods:Ninety patients with refractory depression who received treatment in Hangzhou Seventh People's Hospital from January 2018 to January 2021 were included in this study. They were randomly assigned to receive either rTMS (control group, n = 45) or rTMS combined with health education (observation group, n = 45). All patients received 4 weeks of treatment. Clinical efficacy, the scores of the Clinical Global Impressions (CGI) Scale and the Hamilton Rating Scale for Depression (HAMD), cognitive function, sleep quality, and quality of life pre- and post-intervention were compared between the two groups. Results:Total response rate was significantly higher in the observation group than in the control group [91.11% (41/45) vs. 71.11% (32/45), χ2 = 5.87, P < 0.05]. CGI scores post-intervention were significantly higher in the observation group than in the control group [(45.23 ± 7.89) points vs. (27.64 ± 4.53) points, t = 12.97, P < 0.05]. HAMD scores were significantly lower in the observation group than in the control group [(16.32 ± 2.76) points vs. (21.86 ± 3.98) points, t = 7.67, P < 0.05]. The number of categories achieved and the number of correct responses post-intervention in the observation group were (3.83 ± 0.61) and (85.45 ± 7.87), respectively, which were significantly higher than those in the control group [(2.98 ± 0.37), (73.25 ± 6.12), t = 7.99, 8.20, both P < 0.05]. The number of perseverative errors post-intervention in the observation group was significantly lower than that in the control group [(32.02 ± 1.89) vs. (35.12 ± 2.09), t = 7.38, P < 0.05]. The Pittsburgh Sleep Quality Index post-intervention was significantly lower in the observation group than in the control group [(9.84 ± 1.56) points vs. (12.32 ± 1.62) points, t = 7.39, P < 0.05). The scores of social function, material well-being, physical function, and psychological function post-intervention in the observation group were (59.98 ± 5.31) points, (34.23 ± 4.12) points, (56.87 ± 5.32) points, and (47.28 ± 5.65) points, which were significantly higher than those in the control group [(45.23 ± 6.57) points, (27.98 ± 2.65) points, (43.24 ± 4.53) points, (36.21 ± 4.12) points, t = 11.71, 8.55, 13.08, 10.62, all P < 0.05]. Conclusion:rTMS combined with health education is highly effective on refractory depression. The combined therapy can improve cognitive function and sleep quality and is of great innovation and science.