Overview
his real-world observational study examines whether sensation-seeking personality traits influence the clinical response to transcranial magnetic stimulation (TMS) in patients with treatment-resistant depression (TRD). Participants will complete a validated sensation seeking scale prior to TMS treatment, and depressive symptoms will be assessed using standardized clinical scales during and after the TMS course.
Description
his study aims to explore the relationship between sensation seeking traits and clinical outcomes following TMS therapy in adults with treatment-resistant depression (TRD). Using a naturalistic, real-world treatment setting, patients undergoing standard TMS therapy will complete a validated sensation seeking questionnaire (e.g., Zuckerman Sensation Seeking Scale or similar) prior to treatment initiation. Depression severity will be measured at baseline, mid-treatment, and post-treatment using established scales (e.g., HAM-D, MADRS, or PHQ-9). The study will analyze whether sensation seeking predicts treatment response or remission rates, contributing to a better understanding of psychological moderators of TMS effectiveness.
Eligibility
Inclusion Criteria:
- Adults (≥18 years).
- Diagnosis according to ICD-10: recurrent depressive disorder, severe depressive disorder, schizoaffective disorder (depressive episode) or bipolar affective disorder (depressive episode).
- Treatment-Resistant Depression (TRD): inadequate response to ≥2 adequate antidepressant trials in the current episode (per clinician judgment or ATHF if available).
- Baseline assessments available: MADRS within ≤7 days before first TMS session and baseline Sensation Seeking Scale (SSS) prior to or at treatment initiation.
- Capacity to provide informed consent and ability to complete study questionnaires in the site language.
Exclusion Criteria:
- Contraindications to TMS (per device labeling/clinical standards): any ferromagnetic or electronic intracranial/cranial implants, cochlear implant, deep brain stimulator, medication pump near coil, skull defect, or other conditions deemed unsafe by the treating clinician.
- History of seizure/epilepsy (except single, clearly provoked event), current epileptiform disorder, or significant neurological disease lowering seizure threshold (e.g., recent stroke, brain tumor, active TBI with persistent sequelae, active CNS infection).
- Moderate-to-severe substance use disorder within the past 3 months (excluding nicotine/caffeine), per clinician assessment.
- Imminent suicide risk requiring a higher level of care (e.g., active plan/intent) at screening.
- Concurrent acute ECT or investigational device/drug during the TMS acute course (participation allowed if such treatments are not initiated during the observation window).
- Any condition that, in the judgment of the treating clinician or PI, would preclude safe TMS delivery or reliable outcome measurement (e.g., severe cognitive impairment preventing valid MADRS/SSS completion).
