全部 标题 作者
关键词 摘要

OALib Journal期刊
ISSN: 2333-9721
费用：99美元
投递稿件

查看量下载量

相关文章

更多...

“Flow” Transcranial Direct Current Stimulation (tDCS) for Depression Treatment in a Community Mental Health Team (CMHT) Service: Depression, Functioning, and Health-Related Quality of Life Outcomes

DOI: 10.4236/ojd.2024.134006, PP. 79-96

Keywords: Depression, Quality of Life, Functioning, Transcranial Direct Current Stimulation (tDCS), Schizophrenia

Full-Text   Cite this paper   Add to My Lib

Abstract:

Background: People who experience severe mental illness (SMI) have a high prevalence of depression symptoms, which is linked to worse functioning and quality of life. Research evidence indicates that transcranial direct current stimulation (tDCS) can reduce symptoms of depression. Flow FL-100 is a transcranial direct current stimulation (tDCS) device self-administered by a patient at home in combination with a software application that delivered wellbeing behaviour therapy training. Purpose/Aim: This study investigates if Flow can be introduced to a Community Mental Health Team (CMHT) service and the impact of Flow in treating depression. The study addresses the questions: “what are the depression reliable improvement and remission rates?” and “can Flow significantly reduce depressive symptoms and improve real world functioning (everyday, social and occupational functioning) and health-related quality of life?”. Methods: An open-label patient cohort design with no control group. Pre-intervention and 6-week follow-up intervention assessments using the participant self-report measures: Patient Health Questionnaire (PHQ-9), Work and Social Adjustment Scale (WSAS), and EuroQol five-dimension (EQ-5D-5L). Participants were 31 CMHT patients, 15 males and 16 females, with an age range of 21 to 64 years, and average age of 42 years. Results: PHQ-9 reliable improvement and remission rates were 51.61% and 12.9%, respectively. PHQ-9 scores significantly improved, from 20.9 (SD 5.55) to 14.6 (SD 7.33) at 6 weeks, with large effect size. WSAS scores improved from 31.3 (SD 6.02) to 22.5 (SD 11.43) at 6 weeks, with large effect size. EQ-5D-5L results showed significant improvements in the health index score, and three EQ-5D-5L dimensions (“mobility”, “self-care”, and “pain”). Conclusion: Flow tDCS treatment was integrated into a CMHT service and was found to be beneficial in terms of improving functioning and quality of life and reducing depression symptoms. Flow FL100 tDCS and wellbeing behaviour therapy training could be offered through all CMHT services to people with SMI to treat depression, enable better functioning, and improve quality of life.

 References

[1]  Alessandrini, M., Lançon, C., Fond, G., Faget-Agius, C., Richieri, R., Faugere, M. et al. (2016). A Structural Equation Modelling Approach to Explore the Determinants of Quality of Life in Schizophrenia. Schizophrenia Research, 171, 27-34.
https://doi.org/10.1016/j.schres.2016.01.012
[2]  Berlim, M. T., & Turecki, G. (2007). What Is the Meaning of Treatment Resistant/Refractory Major Depression (TRD)? A Systematic Review of Current Randomized Trials. European Neuropsychopharmacology, 17, 696-707.
https://doi.org/10.1016/j.euroneuro.2007.03.009
[3]  Bosanac, P., & Castle, D. J. (2012). Schizophrenia and Depression. The Medical Journal of Australia, 1, 36-39.
https://doi.org/10.5694/mjao12.10516
[4]  Brooks, R. (1996). Euroqol: The Current State of Play. Health Policy, 37, 53-72.
https://doi.org/10.1016/0168-8510(96)00822-6
[5]  Chang, M., Womer, F. Y., Edmiston, E. K., Bai, C., Zhou, Q., Jiang, X. et al. (2018). Neurobiological Commonalities and Distinctions among Three Major Psychiatric Diagnostic Categories: A Structural MRI Study. Schizophrenia Bulletin, 44, 65-74.
https://doi.org/10.1093/schbul/sbx028
[6]  Chhabra, H., Bose, A., Shivakumar, V., Agarwal, S. M., Sreeraj, V. S., Shenoy, S. et al. (2020). Tolerance of Transcranial Direct Current Stimulation in Psychiatric Disorders: An Analysis of 2000+ Sessions. Psychiatry Research, 284, Article 112744.
https://doi.org/10.1016/j.psychres.2020.112744
[7]  D’Urso, G., Toscano, E., Barone, A., Palermo, M., Dell’Osso, B., Di Lorenzo, G. et al. (2023). Transcranial Direct Current Stimulation for Bipolar Depression: Systematic Reviews of Clinical Evidence and Biological Underpinnings. Progress in Neuro-Psychopharmacology and Biological Psychiatry, 121, Article 110672.
https://doi.org/10.1016/j.pnpbp.2022.110672
[8]  Etchecopar-Etchart, D., Korchia, T., Loundou, A., Llorca, P., Auquier, P., Lançon, C. et al. (2021). Comorbid Major Depressive Disorder in Schizophrenia: A Systematic Review and Meta-Analysis. Schizophrenia Bulletin, 47, 298-308.
https://doi.org/10.1093/schbul/sbaa153
[9]  EuroQol Group (1990). EuroQol—A New Facility for the Measurement of Health-Related Quality of Life. Health Policy, 16, 199-208.
[10]  Fregni, F., El-Hagrassy, M. M., Pacheco-Barrios, K., Carvalho, S., Leite, J., Simis, M. et al. (2021). Evidence-Based Guidelines and Secondary Meta-Analysis for the Use of Transcranial Direct Current Stimulation in Neurological and Psychiatric Disorders. International Journal of Neuropsychopharmacology, 24, 256-313.
https://doi.org/10.1093/ijnp/pyaa051
[11]  Gardsjord, E. S., Romm, K. L., Friis, S., Barder, H. E., Evensen, J., Haahr, U. et al. (2016). Subjective Quality of Life in First-Episode Psychosis. A Ten-Year Follow-Up Study. Schizophrenia Research, 172, 23-28.
https://doi.org/10.1016/j.schres.2016.02.034
[12]  Ghazi-Noori, A. R., Woodham, R. D., Rezaei, H., Sharif, M. S., Bramon, E., Ritter, P., & Fu, C. H. (2024). Home-Based Transcranial Direct Current Stimulation in Bipolar Depression: An Open-Label Treatment Study of Clinical Outcomes, Acceptability and Adverse events. International Journal of Bipolar Disorders, 12, Article No. 30.
[13]  Goodkind, M., Eickhoff, S. B., Oathes, D. J., Jiang, Y., Chang, A., Jones-Hagata, L. B. et al. (2015). Identification of a Common Neurobiological Substrate for Mental Illness. Journal of the American Medical Association Psychiatry, 72, Article 305.
https://doi.org/10.1001/jamapsychiatry.2014.2206
[14]  Gordon, M. S., Dux, P. E., & Filmer, H. L. (2021). Not Quite All in Our Head: Intervention is a Better Predictor of tDCS Mind-Wandering Effects than Subjective Beliefs about Experimental Results.
https://www.biorxiv.org/content/10.1101/2021.11.14.468553v1.full
[15]  Gregory, A., Mallikarjun, P., & Upthegrove, R. (2017). Treatment of Depression in Schizophrenia: Systematic Review and Meta-Analysis. British Journal of Psychiatry, 211, 198-204.
https://doi.org/10.1192/bjp.bp.116.190520
[16]  Griffiths, C. A. (2009). Sense of Coherence and Mental Health Rehabilitation. Clinical Rehabilitation, 23, 72-78.
https://doi.org/10.1177/0269215508095360
[17]  Griffiths, C., da Silva, K. M., Jiang, H., Smart, D., & Zafar, A. (2024a). “Flow” Transcranial Direct Current Stimulation (tDCS) for Depression Treatment in a Primary Healthcare General Practice—Depression, Functioning, and Health-Related Quality of Life Outcomes. Open Journal of Depression, 13, 25-39.
[18]  Griffiths, C., Jiang, H., Smart, D., & Zafar, A. (2024b). “Flow” Transcranial Direct Current Stimulation (tDCS) for Depression Treatment in a Primary Healthcare General Practice—An Open-Label Cohort Study Measuring Montgomery-Åsberg Depression Rating Scale (MADRS-S) Outcomes. Open Journal of Psychiatry, 14, 386-399.
https://doi.org/10.4236/ojpsych.2024.144024
[19]  Griffiths, C., Walker, K., & Willis, A. (2024c). A Qualitative Study Exploring the Experience and Value of Flow Transcranial Direct Current Stimulation (tDCS) and Behaviour Therapy Training Software Used at Home for Community Mental Health Team (CMHT) Patients with Symptoms of Depression. Open Journal of Depression, 13, 6-23.
https://doi.org/10.4236/ojd.2024.131002
[20]  Griffiths, C., Walker, K., Jiang, H., & Noel-Johnson, A. (2023). A Qualitative Study Exploring the Experience and Value of “Flow” Transcranial Direct Current Stimulation (tDCS) Device and Behaviour Therapy Training Software Application at Home for Symptoms of Depression. Open Journal of Depression, 12, 65-86.
https://doi.org/10.4236/ojd.2023.124007
[21]  Grycuk, L., Moruzzi, F., Bardjesteh, E., Gaughran, F., Campbell, I. C., & Schmidt, U. (2021). Participant Experiences of Transcranial Direct Current Stimulation (tDCS) as a Treatment for Antipsychotic Medication Induced Weight Gain. Frontiers in Psychology, 12, Article 694203.
https://doi.org/10.3389/fpsyg.2021.694203
[22]  Hammond, G. C., Croudace, T. J., Radhakrishnan, M., Lafortune, L., Watson, A., McMillan-Shields, F. et al. (2012). Comparative Effectiveness of Cognitive Therapies Delivered Face-to-Face or over the Telephone: An Observational Study Using Propensity Methods. PLOS ONE, 7, e42916.
https://doi.org/10.1371/journal.pone.0042916
[23]  Han, W., Sorg, C., Zheng, C., Yang, Q., Zhang, X., Ternblom, A. et al. (2019). Low-Rank Network Signatures in the Triple Network Separate Schizophrenia and Major Depressive Disorder. Neuro Image: Clinical, 22, Article 101725.
https://doi.org/10.1016/j.nicl.2019.101725
[24]  Harris, E. C., & Barraclough, B. (1997). Suicide as an Outcome for Mental Disorders. British Journal of Psychiatry, 170, 205-228.
https://doi.org/10.1192/bjp.170.3.205
[25]  Helfer, B., Samara, M. T., Huhn, M., Klupp, E., Leucht, C., Zhu, Y. et al. (2016). Efficacy and Safety of Antidepressants Added to Antipsychotics for Schizophrenia: A Systematic Review and Meta-Analysis. American Journal of Psychiatry, 173, 876-886.
https://doi.org/10.1176/appi.ajp.2016.15081035
[26]  Herdman, M., Gudex, C., Lloyd, A., Janssen, M., Kind, P., Parkin, D. et al. (2011). Development and Preliminary Testing of the New Five-Level Version of EQ-5D (EQ-5D-5L). Quality of Life Research, 20, 1727-1736.
https://doi.org/10.1007/s11136-011-9903-x
[27]  Hsu, C., Chou, P., Brunoni, A. R., Hung, K., Tseng, P., Liang, C. et al. (2024). Comparing Different Non-Invasive Brain Stimulation Interventions for Bipolar Depression Treatment: A Network Meta-Analysis of Randomized Controlled Trials. Neuroscience & Biobehavioral Reviews, 156, Article 105483.
https://doi.org/10.1016/j.neubiorev.2023.105483
[28]  Jakubovski, E., Johnson, J. A., Nasir, M., Müller-Vahl, K., & Bloch, M. H. (2019). Systematic Review and Meta-Analysis: Dose-Response Curve of SSRIs and SNRIs in Anxiety Disorders. Depression and Anxiety, 36, 198-212.
https://doi.org/10.1002/da.22854
[29]  Jeon, D., Jung, D., Kim, S., Shim, J., Moon, J., Seo, Y. et al. (2018). Adjunct Transcranial Direct Current Stimulation Improves Cognitive Function in Patients with Schizophrenia: A Double-Blind 12-Week Study. Schizophrenia Research, 197, 378-385.
https://doi.org/10.1016/j.schres.2017.12.009
[30]  Jog, M. A., Anderson, C., Kubicki, A., Boucher, M., Leaver, A., Hellemann, G. et al. (2023). Transcranial Direct Current Stimulation (tDCS) in Depression Induces Structural Plasticity. Scientific Reports, 13, Article No. 2841.
https://doi.org/10.1038/s41598-023-29792-6
[31]  Kroenke, K., Spitzer, R. L., & Williams, J. B. W. (2001). The PHQ-9. Journal of General Internal Medicine, 16, 606-613.
https://doi.org/10.1046/j.1525-1497.2001.016009606.x
[32]  Kroenke, K., Spitzer, R. L., Williams, J. B. W., Monahan, P. O., & Löwe, B. (2007). Anxiety Disorders in Primary Care: Prevalence, Impairment, Comorbidity, and Detection. Annals of Internal Medicine, 146, 317-325.
https://doi.org/10.7326/0003-4819-146-5-200703060-00004
[33]  Lehoux, C., Gobeil, M., Lefèbvre, A., Maziade, M., & Roy, M. (2009). The Five-Factor Structure of the PANSS: A Critical Review of Its Consistency across Studies. Clinical Schizophrenia & Related Psychoses, 3, 103-110.
https://doi.org/10.3371/csrp.3.2.5
[34]  Lépine, J. P., & Briley, M. (2011). The Increasing Burden of Depression. Neuropsychiatric Disease and Treatment, 7, 3-7.
[35]  Li, J., Kung, S., Croarkin, P., & Lapid, M. (2024). Transcranial Direct Current Stimulation (tDCS) for Treatment Resistant Depression (TRD): A Systematic Review. The American Journal of Geriatric Psychiatry, 32, S99.
https://doi.org/10.1016/j.jagp.2024.01.181
[36]  Lisoni, J., Nibbio, G., Baldacci, G., Zucchetti, A., Cicale, A., Zardini, D. et al. (2024). Improving Depressive Symptoms in Patients with Schizophrenia Using Bilateral Bipolar-Nonbalanced Prefrontal tDCS: Results from a Double-Blind Sham-Controlled Trial. Journal of Affective Disorders, 349, 165-175.
https://doi.org/10.1016/j.jad.2024.01.050
[37]  Ma, Q., Tang, Y., Wang, F., Liao, X., Jiang, X., Wei, S. et al. (2020). Transdiagnostic Dysfunctions in Brain Modules across Patients with Schizophrenia, Bipolar Disorder, and Major Depressive Disorder: A Connectome-Based Study. Schizophrenia Bulletin, 46, 699-712.
https://doi.org/10.1093/schbul/sbz111
[38]  Marks, I. (1986). Behavioural Psychotherapy: Maudsley Pocket Book of Clinical Management. John Wright.
[39]  McIntyre, R. S., Alsuwaidan, M., Baune, B. T., Berk, M., Demyttenaere, K., Goldberg, J. F. et al. (2023). Treatment-Resistant Depression: Definition, Prevalence, Detection, Management, and Investigational Interventions. World Psychiatry, 22, 394-412.
https://doi.org/10.1002/wps.21120
[40]  Moffa, A. H., Martin, D., Alonzo, A., Bennabi, D., Blumberger, D. M., Benseñor, I. M. et al. (2020). Efficacy and Acceptability of Transcranial Direct Current Stimulation (tDCS) for Major Depressive Disorder: An Individual Patient Data Meta-Analysis. Progress in Neuro-Psychopharmacology and Biological Psychiatry, 99, Article 109836.
https://doi.org/10.1016/j.pnpbp.2019.109836
[41]  Monsonet, M., Kwapil, T. R., & Barrantes-Vidal, N. (2022). Exploring the Psychometric Properties and the Factor Structure of the Calgary Depression Scale for Schizophrenia across the Schizotypy Continuum. Assessment, 29, 686-699.
https://doi.org/10.1177/1073191120986622
[42]  Montgomery, S. A., & Åsberg, M. (1979). A New Depression Scale Designed to Be Sensitive to Change. British Journal of Psychiatry, 134, 382-389.
https://doi.org/10.1192/bjp.134.4.382
[43]  Mundt, J. C., Marks, I. M., Shear, M. K., & Greist, J. M. (2002). The Work and Social Adjustment Scale: A Simple Measure of Impairment in Functioning. British Journal of Psychiatry, 180, 461-464.
https://doi.org/10.1192/bjp.180.5.461
[44]  Mutz, J., Edgcumbe, D. R., Brunoni, A. R., & Fu, C. H. Y. (2018). Efficacy and Acceptability of Non-Invasive Brain Stimulation for the Treatment of Adult Unipolar and Bipolar Depression: A Systematic Review and Meta-Analysis of Randomized Sham-Controlled Trials. Neuroscience & Biobehavioral Reviews, 92, 291-303.
https://doi.org/10.1016/j.neubiorev.2018.05.015
[45]  Mutz, J., Vipulananthan, V., Carter, B., Hurlemann, R., Fu, C. H. Y., & Young, A. H. (2019). Comparative Efficacy and Acceptability of Non-Surgical Brain Stimulation for the Acute Treatment of Major Depressive Episodes in Adults: Systematic Review and Network Meta-Analysis. British Medical Journal, 364, Article 11079.
https://doi.org/10.1136/bmj.l1079
[46]  Narita, Z., Inagawa, T., Sueyoshi, K., Lin, C., & Sumiyoshi, T. (2017). Possible Facilitative Effects of Repeated Anodal Transcranial Direct Current Stimulation on Functional Outcome 1 Month Later in Schizophrenia: An Open Trial. Frontiers in Psychiatry, 8, Article 184.
https://doi.org/10.3389/fpsyt.2017.00184
[47]  NICE (2019) Position Statement on Use of the EQ-5D-5L Value Set for England.
https://www.nice.org.uk/about/what-we-do/our-programmes/nice-guidance/technology-appraisal-guidance/eq-5d-5l
[48]  Nikolin, S., Moffa, A., Razza, L., Martin, D., Brunoni, A. R., Palm, U. et al. (2023). Time-course of the tDCS Antidepressant Effect: An Individual Participant Data Meta-Analysis. Progress in Neuro-Psychopharmacology and Biological Psychiatry, 125, Article 110752.
https://doi.org/10.1016/j.pnpbp.2023.110752
[49]  Office for National Statistics (2022). Cost of Living and Depression in Adults, Great Britain: 29 September to 23 October 2022.
https://www.ons.gov.uk/peoplepopulationandcommunity/healthandsocialcare/mentalhealth/articles/costoflivinganddepressioninadultsgreatbritain/29septemberto23october2022
[50]  Palm, U., Keeser, D., Hasan, A., Kupka, M. J., Blautzik, J., Sarubin, N. et al. (2016). Prefrontal Transcranial Direct Current Stimulation for Treatment of Schizophrenia with Predominant Negative Symptoms: A Double-Blind, Sham-Controlled Proof-of-Concept Study. Schizophrenia Bulletin, 42, 1253-1261.
https://doi.org/10.1093/schbul/sbw041
[51]  Peasgood, T., Brazier, J., & Papaioannou, D. (2012). A Systematic Review of the Validity and Responsiveness of EQ-5D and SF-6D for Depression and Anxiety.
https://eprints.whiterose.ac.uk/74659/1/12.15.pdf
[52]  Public Health England (2018). Severe Mental Illness (SMI) and Physical Health Inequalities: Briefing.
https://www.gov.uk/government/publications/severe-mental-illness-smi-physical-health-inequalities/severe-mental-illness-and-physical-health-inequalities-briefing
[53]  Razza, L. B., Palumbo, P., Moffa, A. H., Carvalho, A. F., Solmi, M., Loo, C. K. et al. (2020). A Systematic Review and Meta-Analysis on the Effects of Transcranial Direct Current Stimulation in Depressive Episodes. Depression and Anxiety, 37, 594-608.
https://doi.org/10.1002/da.23004
[54]  Richards, D. A., & Borglin, G. (2011). Implementation of Psychological Therapies for Anxiety and Depression in Routine Practice: Two Year Prospective Cohort Study. Journal of Affective Disorders, 133, 51-60.
https://doi.org/10.1016/j.jad.2011.03.024
[55]  Rimmer, R. M., Woodham, R. D., Cahill, S., & Fu, C. H. (2022). Acceptability of Community-Based Transcranial Direct Current Stimulation (tDCS) in Major Depression: Mixed Methods Analysis of Individual Experiences.
https://osf.io/preprints/psyarxiv/xfvwq
[56]  Siris, S. G. (2000). Depression in Schizophrenia: Perspective in the Era of “Atypical” Antipsychotic Agents. American Journal of Psychiatry, 157, 1379-1389.
https://doi.org/10.1176/appi.ajp.157.9.1379
[57]  Siris, S. G., & Depression, B. C. (2003). Depression and Schizophrenia. In S. R. Hirsch, & D. R. Weinberger, Schizophrenia (pp. 142-167). Blackwell Publishing.
[58]  Tseng, P., Zeng, B., Hung, C., Liang, C., Stubbs, B., Carvalho, A. F. et al. (2022). Assessment of Noninvasive Brain Stimulation Interventions for Negative Symptoms of Schizophrenia. Journal of the American Medical Association Psychiatry, 79, 770-779.
https://doi.org/10.1001/jamapsychiatry.2022.1513
[59]  Upthegrove, R., Marwaha, S., & Birchwood, M. (2017). Depression and Schizophrenia: Cause, Consequence or Trans-Diagnostic Issue? Schizophrenia Bulletin, 43, sbw097.
https://doi.org/10.1093/schbul/sbw097
[60]  van der Gaag, M., Hoffman, T., Remijsen, M., Hijman, R., de Haan, L., van Meijel, B., & Wiersma, D. (2006). The Five-Factor Model of the Positive and Negative Syndrome Scale II: A Ten-Fold Cross-Validation of a Revised Model. Schizophrenia Research, 85, 280-287.
[61]  van Hout, B., Janssen, M. F., Feng, Y., Kohlmann, T., Busschbach, J., Golicki, D. et al. (2012). Interim Scoring for the EQ-5D-5L: Mapping the EQ-5D-5L to EQ-5D-3L Value Sets. Value in Health, 15, 708-715.
https://doi.org/10.1016/j.jval.2012.02.008
[62]  van Rooijen, G., Vermeulen, J. M., Ruhé, H. G., & de Haan, L. (2019). Treating Depressive Episodes or Symptoms in Patients with Schizophrenia. CNS Spectrums, 24, 239-248.
[63]  Vigo, D., Thornicroft, G., & Atun, R. (2016). Estimating the True Global Burden of Mental Illness. The Lancet Psychiatry, 3, 171-178.
https://doi.org/10.1016/s2215-0366(15)00505-2
[64]  Wang, J., Luo, H., Schülke, R., Geng, X., Sahakian, B. J., & Wang, S. (2021). Is Transcranial Direct Current Stimulation, Alone or in Combination with Antidepressant Medications or Psychotherapies, Effective in Treating Major Depressive Disorder? A Systematic Review and Meta-Analysis. BMC Medicine, 19, Article No. 319.
https://doi.org/10.1186/s12916-021-02181-4
[65]  Woodham, R. D., Selvaraj, S., Lajmi, N., Hobday, H., Sheehan, G., Ghazi-Noori, A. et al. (2024). Home-Based Transcranial Direct Current Stimulation Treatment for Major Depressive Disorder: A Fully Remote Phase 2 Randomized Sham-Controlled Trial.
https://doi.org/10.1038/s41591-024-03305-y
[66]  World Health Organization (2023). Depressive Disorder (Depression)—Fact Sheet.
https://www.who.int/news-room/fact-sheets/detail/depression
[67]  Wu, X., Zeng, L., Shen, H., Yuan, L., Qin, J., Zhang, P. et al. (2017). Functional Network Connectivity Alterations in Schizophrenia and Depression. Psychiatry Research: Neuroimaging, 263, 113-120.
https://doi.org/10.1016/j.pscychresns.2017.03.012
[68]  Zhuo, C., Fang, T., Chen, C., Chen, M., Sun, Y., Ma, X. et al. (2021). Brain Imaging Features in Schizophrenia with Co-Occurring Auditory Verbal Hallucinations and Depressive Symptoms—Implication for Novel Therapeutic Strategies to Alleviate the Reciprocal Deterioration. Brain and Behavior, 11, e01991.
https://doi.org/10.1002/brb3.1991

Full-Text

Contact Us

service@oalib.com

QQ:3279437679

WhatsApp +8615387084133