Predictors of response and remission after transcranial magnetic stimulation for major depressive disorder: An international comparative study between Taiwan and Japan

Asian J Psychiatr. 2025 Jul:109:104541. doi: 10.1016/j.ajp.2025.104541. Epub 2025 May 20.

Abstract

Background: This study aimed to identify demographic, clinical, and protocol-related predictors of effectiveness of transcranial magnetic stimulation (TMS) therapy in patients with major depressive disorder (MDD) across Taiwan and Japan.

Methods: This retrospective observational study analyzed clinical data collected between September 2023 and August 2024 from patients with MDD treated either repetitive TMS or theta-burst stimulation at two institutes in Taiwan and one in Japan. All patients were assessed using the Hamilton Depression Rating Scale (HAMD) before and after a course of TMS treatment. Variables were assessed for their association with response, remission, and change of HAMD scores from baseline using a multiple logistic and linear regression model.

Results: 205 patients (131 Taiwanese and 74 Japanese) were included. The Taiwanese population had a significantly higher percentage of females than the Japanese population (71.0 % vs. 42.5 %). Being married (adjusted odd ratios [aOR] = 2.339) and being employed (aOR = 2.048) were more likely to achieve a response, whereas current alcohol use (aOR = 0.332) was less likely to be associated with response. Additionally, patients who were employed (aOR = 2.183) were more likely to achieve remission, whereas those with a longer duration of illness (aOR = 0.938) and current alcohol use (aOR = 0.310) were less likely to reach remission. Furthermore, being female, being married, being employed, and higher baseline HAMD were more likely having greater reductions in HAMD scores.

Conclusions: This study suggests the specific predictors when predicting the treatment outcome of TMS for MDD patients in Taiwan and Japan.

Keywords: International comparative study; Major depressive disorder; Theta-burst stimulation; Transcranial magnetic stimulation.

Publication types

  • Observational Study
  • Comparative Study

MeSH terms

  • Adult
  • Depressive Disorder, Major* / therapy
  • Female
  • Humans
  • Japan
  • Male
  • Middle Aged
  • Outcome Assessment, Health Care* / statistics & numerical data
  • Remission Induction
  • Retrospective Studies
  • Taiwan
  • Transcranial Magnetic Stimulation* / methods