# TMS in major depression: A retrospective naturalistic study including two subjective tools

## TL;DR

This study examines the effectiveness of TMS for treating major depression and evaluates two new tools for measuring mood changes.

## Contribution

The study introduces and validates two new subjective mood scales for use in TMS treatment of depression.

## Key findings

- 56.7% of patients achieved remission based on HAM-D6 criteria after TMS treatment.
- Improvement in the SDS6 and DES at session 10 predicted remission.
- Subjective and objective mood assessments correlated well, especially at the end of therapy.

## Abstract

To report the outcomes of transcranial magnetic stimulation (TMS) treatment of patients with acute major depressive disorder (MDD), with particular attention to the performance of the individual assessment tools, including two new subjective mood scales.

Patients with MDD were treated with up to 35 daily TMS sessions. Objective quantification of mood utilised the Hamilton Depression Rating Scale (HAM-D6) and the Clinical Global Impression-Severity scale (CGI-S). Subjective quantification was made using the Subjective Depression Scale (SDS6) and a new Daily Emotion Score (DES) – a single question which is asked daily.

Ninety consecutive patients (58 females; 64.4%) with a mean age of 46.9 years were included. Using HAM-D6 criteria, 51 patients (56.7%) achieved remission. Scores obtained using the different tools correlated well at the same time point, especially at the conclusion of TMS therapy. The only statistically significant independent predictors of remission were the percentage improvement at session 10 (relative to baseline) in the SDS6 (p = .0026) and in the DES (p = .043).

The SDS6 was confirmed as a valuable companion for the HAM-D6. The DES correlated with the other subjective tool (SDS6); the latter, in particular, may also have utility in predicting treatment outcome.