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.
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