doiSerbia

Attitudes towards repetitive transcranial magnetic stimulation among depressive patients and medical students

Engelke Christina (Heinrich Heine University, Department of Psychiatry and Psychotherapy, Medical Faculty, Duesseldorf, Germany)
Jänner Michaela (Heinrich Heine University, Department of Psychiatry and Psychotherapy, Medical Faculty, Duesseldorf, Germany)
Cordes Joachim (Kaiserswerther Diakonie, Duesseldorf, Germany)
Ehringfeld Isabell (Heinrich Heine University, Department of Psychiatry and Psychotherapy, Medical Faculty, Duesseldorf, Germany)
Klieser Leonhard (Heinrich Heine University, Department of Psychiatry and Psychotherapy, Medical Faculty, Duesseldorf, Germany)
Kujović Milenko (Heinrich Heine University, Department of Psychiatry and Psychotherapy, Medical Faculty, Duesseldorf, Germany)

Introduction/Objective. Repetitive transcranial magnetic stimulation (rTMS) is a non-invasive and safe brain stimulation method for the treatment of therapy resistant depression in adulthood. The German S3 guideline for unipolar depression recommends the use of high frequency rTMS of the left dorsolateral prefrontal cortex for depressive patients who did not respond primarily to antidepressant pharmacotherapy. Although a number of meta-analyses demonstrated its antidepressant efficacy on a high evidence level, rTMS is rarely offered to patients with mental disorders in German psychiatric hospitals. Methods. We introduced a questionnaire-based survey examining patients’ (n = 122) and medical students’ (n = 53) attitude towards rTMS. The questionnaire consisted of 10 questions with a 5-point Likert-scale. When testing for group differences, we conducted χ2 tests. Results. The majority of students and patients are not aware of rTMS as a psychiatric treatment of depression, with more patients than students not being aware (χ2(1) = 9.462, p = 0.002; 39.3% vs. 17%). However, participants wish to be informed in more detail about rTMS. In general, positive attitudes cover the assumption of safety, while negative attitudes show concerns regarding the efficacy and a lack of trust in the method, mainly due to the fear of irreversible brain damage. Most participants would rather take psychiatric medication than rTMS. rTMS was assumed to be a helpful [χ2(2) = 16.710, p < 0.001 (patients: 32.8% vs. students: 5.7%)] and well-tolerated treatment [χ2(1) = 9.110, p = 0.003 (36.1% vs. 15.1%)] significantly more often by patients than by students. Conclusion. Our results show a clear need for more information on rTMS as a psychiatric treatment for patients and medical students to fight present prejudices and negative assumptions so that this treatment method with fewer side effects than medication may be used more often.

Keywords: repetitive transcranial magnetic stimulation, attitudes, depression