Transcranial Magnetic Stimulation and Treatment of Major Depressive Disorder with Comorbid Anxiety

Abstract

Major Depressive Disorder (MDD) often includes symptoms of anxiety, leading to comorbidity of MDD and an anxiety disorder, such as Generalized Anxiety Disorder (GAD), or Social Anxiety Disorder (SAD). Transcranial Magnetic Stimulation (TMS) is used to treat MDD and has shown promise in the treatment of anxiety disorders. Few studies have investigated the effectiveness of TMS on patients with comorbid MDD and anxiety. Methods: Patients were recruited from a local psychiatry clinic. Six patients were diagnosed with MDD, six patients with MDD and GAD, and five patients with MDD, GAD, and SAD. All patients received 36 treatments over a nine-week period. The Beck Depression Inventory 2 (BDI2) and Generalized Anxiety Disorder 7 (GAD7) were completed by patients at the beginning of the treatment period and at a two-week checkup. Results: Scores from the BDI and GAD were entered into an ANOVA with time (beginning, two-week follow up) and patients (MDD, MDD and GAD, MDD, GAD, and SAD) as the factors. For the BDI, all patients significantly improved from the beginning of treatment, but there was no significant difference between patient groups. For the GAD, there was a significant difference in time, indicating that all patients improved on anxiety symptoms by the two-week follow-up. Additionally, there was a marginal effect of time by diagnoses. Follow up tests indicated that all patients improved on GAD, but patients with MDD and GAD showed significant improvement over individuals with MDD, GAD, and SAD. Conclusions: Current results suggest that TMS may be effective in relieving depression symptoms in patients with comorbid disorders. Additionally, patients with MDD and GAD also showed significant improvement over patients with MDD, GAD, and SAD. The current results are similar to previous studies that suggest patients with SAD and comorbid mood disorder vs more persistent symptoms and longer treatment durations.