Adolescent Depression, Major Depressive Disorder (MDD)
Conditions
Brief summary
This study aims to identify baseline predictors of treatment efficacy in adolescents with Major Depressive Disorder (MDD) undergoing a combined intervention of repetitive transcranial magnetic stimulation (rTMS) and group therapy. Specifically, the study investigates the predictive value of family environment characteristics (cohesion, conflict, expressiveness) and cognitive functions (executive function, attention/inhibition).
Detailed description
Adolescent depression is a significant health concern, and while combined therapies involving neuromodulation and psychotherapy show promise, individual treatment responses vary heterogeneity. This prospective cohort study enrolled 163 adolescents aged 12-18 with MDD. All participants received a standardized 4-week intervention consisting of 20 sessions of high-frequency (10 Hz) rTMS over the left dorsolateral prefrontal cortex (DLPFC) and 8 sessions of group Cognitive Behavioral Therapy (CBT). Baseline assessments included the Family Environment Scale (FES) and a neuropsychological battery including the Stroop Color-Word Test and Wisconsin Card Sorting Test (WCST). The primary outcome was the percentage reduction in depressive symptoms measured by the HAMD-24 scale. The study employs multiple linear regression to determine which baseline factors independently predict superior treatment outcomes.
Interventions
DEVICERepetitive Transcranial Magnetic Stimulation (rTMS)
High-frequency (10 Hz) rTMS applied over the left dorsolateral prefrontal cortex (DLPFC), administered 5 days per week for 4 weeks (20 sessions total).
BEHAVIORALGroup Cognitive Behavioral Therapy (CBT)
Manualized group therapy sessions focused on psychoeducation, cognitive restructuring, emotion regulation, and interpersonal skills, held twice weekly for 4 weeks (8 sessions total).
Sponsors
The First Hospital of Hebei Medical University
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
12 Years to 18 Years
Healthy volunteers
No
Inclusion criteria
* Primary diagnosis of Major Depressive Disorder (MDD) according to ICD-10 criteria. * Score of ≥ 20 on the 24-item Hamilton Depression Rating Scale (HAMD-24). * Sufficient intellectual and linguistic ability to complete assessments and participate in therapy. * Provided written informed consent (participants and guardians).
Exclusion criteria
* Lifetime diagnosis of a psychotic or bipolar disorder. * Current substance use disorder. * Significant neurological illness (e.g., epilepsy) or metallic implants contraindicated for rTMS. * Receiving concurrent formal psychotherapy outside the study protocol.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Percentage Reduction in HAMD-24 Score | Baseline and Week 4 | Treatment efficacy is defined as the percentage reduction in the 24-item Hamilton Depression Rating Scale (HAMD-24) score from baseline to the end of treatment. The formula used is: \[(HAMD-24 at Baseline - HAMD-24 at Week 4) / HAMD-24 at Baseline\] × 100%. The HAMD-24 assesses the severity of depressive symptoms, with higher scores indicating more severe depression. |
Countries
China
Outcome results
None listed