High-frequency repetitive TMS for suicidal ideation in adolescents with depression

Paul E. Croarkin, Paul A. Nakonezny, Zhi De Deng, Magdalena Romanowicz, Jennifer L.Vande Voort, Deniz Doruk Camsari, Kathryn M. Schak, John D. Port, Charles P. Lewis

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Background: This exploratory study sought to examine the effect of an acute course of high-frequency repetitive TMS on suicidal ideation in adolescents. Methods: Data were pooled from 3 prior protocols providing a 30-session course of open-label TMS treatment for adolescents with treatment-resistant depression. All participants (n = 19) were outpatients taking antidepressant medication, with TMS provided as adjunctive treatment. Suicidality was assessed at baseline, after 10 treatments, after 20 treatments, and after 30 treatments. Outcome measures of suicidal ideation included the Columbia Suicide Severity Rating Scale (C-SSRS) “Intensity of Ideation” subscale and Item 13 “Suicidality” on the Children's Depression Rating Scale, Revised (CDRS-R). Results: The predicted odds of suicidal ideation (CDRS-R Item 13 and C-SSRS Intensity of Ideation subscale) significantly decreased over 6 weeks of acute TMS treatment without adjustments for illness (depression) severity. However, the magnitude of the decrease in the predicted odds of suicidal ideation across 6 weeks of treatment was attenuated and rendered non-significant in subsequent analyses that adjusted for illness (depression) severity. Limitations: This was an exploratory study with a small sample size and no sham control. Regulatory and ethical barriers constrained enrollment of adolescents with severe suicidality. Conclusions: The present findings suggest that open-label TMS mitigated suicidal ideation in adolescents through the treatment and improvement of depressive symptom severity. Although caution is warranted in the interpretation of these results, the findings can inform the design and execution of future interventional trials targeting suicidal ideation in adolescents.

Original languageEnglish (US)
Pages (from-to)282-290
Number of pages9
JournalJournal of Affective Disorders
Volume239
DOIs
StatePublished - Oct 15 2018

Fingerprint

Suicidal Ideation
Depression
Therapeutics
Suicide
Treatment-Resistant Depressive Disorder
Sample Size
Antidepressive Agents
Outpatients
Outcome Assessment (Health Care)

Keywords

  • Adolescent
  • Brain stimulation
  • Depression
  • Suicidal ideation
  • Suicidality
  • Transcranial magnetic stimulation

ASJC Scopus subject areas

  • Clinical Psychology
  • Psychiatry and Mental health

Cite this

Croarkin, P. E., Nakonezny, P. A., Deng, Z. D., Romanowicz, M., Voort, J. L. V., Camsari, D. D., ... Lewis, C. P. (2018). High-frequency repetitive TMS for suicidal ideation in adolescents with depression. Journal of Affective Disorders, 239, 282-290. https://doi.org/10.1016/j.jad.2018.06.048

High-frequency repetitive TMS for suicidal ideation in adolescents with depression. / Croarkin, Paul E.; Nakonezny, Paul A.; Deng, Zhi De; Romanowicz, Magdalena; Voort, Jennifer L.Vande; Camsari, Deniz Doruk; Schak, Kathryn M.; Port, John D.; Lewis, Charles P.

In: Journal of Affective Disorders, Vol. 239, 15.10.2018, p. 282-290.

Research output: Contribution to journalArticle

Croarkin, PE, Nakonezny, PA, Deng, ZD, Romanowicz, M, Voort, JLV, Camsari, DD, Schak, KM, Port, JD & Lewis, CP 2018, 'High-frequency repetitive TMS for suicidal ideation in adolescents with depression', Journal of Affective Disorders, vol. 239, pp. 282-290. https://doi.org/10.1016/j.jad.2018.06.048
Croarkin, Paul E. ; Nakonezny, Paul A. ; Deng, Zhi De ; Romanowicz, Magdalena ; Voort, Jennifer L.Vande ; Camsari, Deniz Doruk ; Schak, Kathryn M. ; Port, John D. ; Lewis, Charles P. / High-frequency repetitive TMS for suicidal ideation in adolescents with depression. In: Journal of Affective Disorders. 2018 ; Vol. 239. pp. 282-290.
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