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Purpose: Patient-Reported Outcomes are essential to properly assess treatment effectiveness in randomized clinical trial (RCT) for Major Depressive Disorder (MDD). MDD self-assessment may vary over time depending on change in the meaning of patients' self-evaluation of depression, i.e. Response Shift (RS). Our aim was to investigate RS and its impact on different depression domains in a clinical trial comparing rTMS versus Venlafaxine., Methods: The occurrence and type of RS was determined using Structural Equation Modeling applied to change over time in 3 domains (Sad Mood, Performance Impairment, Negative Self-Reference) of the short-form Beck Depression Inventory (BDI-13) in a secondary analysis of a RCT on 170 patients with MDD treated by rTMS, venlafaxine or both., Results: RS was evidenced in the venlafaxine group in the Negative Self-Reference and Sad Mood domains., Conclusion: RS effects differed between treatment arms in self-reported depression domains in patients with MDD. Ignoring RS would have led to a slight underestimation of depression improvement, depending on treatment group. Further investigations of RS and advancing new methods are needed to better inform decision making based on Patient-Reported Outcomes., Competing Interests: Declaration of competing interest The authors declare that they have no conflict of interest., (Copyright © 2023. Published by Elsevier Ltd.)

Growing evidence has suggested that mindfulness-based interventions (MBIs) could have beneficial effects on the acute phase of depression and on the prevention of depressive relapse or recurrence. Despite growing clinical interest, the effects of MBIs on brain functioning in patients with MDD remain unclear. The aim of this systematic review was to assess the changes in brain functioning associated with MBIs in patients with MDD. A systematic search was conducted, and of the 56 articles found, 8 were eligible. MBIs have modulatory effects on several brain regions implicated in the pathophysiology of MDD, such as the prefrontal cortex, the basal ganglia, the anterior and posterior cingulate cortices, and the parietal cortex. These regions have been implicated in self-awareness, attention and emotion regulation. Some of these findings were consistent with the effects of MBIs observed in healthy subjects and patients with other psychiatric disorders, especially enhanced activity in the frontal and subcortical regions related to the improved somatosensory awareness. Further studies are needed to elucidate the mechanisms of MBIs in MDD., (Copyright © 2018 Elsevier Ltd. All rights reserved.)

Repetitive transcranial magnetic stimulation (rTMS) and transcranial direct current stimulation (tDCS) are noninvasive brain stimulation techniques currently used as therapeutic tools in various psychiatric conditions. Applied over the dorsolateral prefrontal cortex (DLPFC), they showed their efficacy in reducing drug-resistant symptoms in patients with major depression and in patients with schizophrenia with predominantly negative symptoms. The DLPFC is a brain structure involved in the expression of these symptoms as well as in other dysfunctional functions observed in theses conditions such as emotional processes. The goal of this review is to establish whether or not a link exists between clinical improvements and modulation of emotional processes following the stimulation of the DLPFC in both conditions. The data collected show that improved emotional processes is not linked to a clinical improvement neither in patients with depression nor in patients with negative schizophrenia. Our results suggests that although sharing common brain structures, the brain networks involved in both symptoms and in emotional processes would be separate.

Objectives: Depression is a frequent but potentially treatable clinical dimension in patients with schizophrenia spectrum disorders (PWS). However, there is a lack of consensual recommendations regarding the optimal strategy to manage depression in PWS. In this study, we aimed to compare the various proposed strategies to define a core set of valid care recommendations for depression management in PWS. Methods: After a systematic search of the literature, the methodological quality of 10 international guidelines from four continents was compared using a validated guideline appraisal instrument (AGREE II). Key recommendations for the management of depression in PWS were subsequently reviewed and discussed. Results: The methodological quality of the guidelines was heterogeneous. Although all guidelines proposed pharmacotherapy, psychosocial interventions were a minor concern. Waiting for antipsychotic effects mostly was recommended during the acute phase of schizophrenia. During the postpsychotic phase of the illness, a switch to a second‐generation antipsychotic and/or the adjunction of an antidepressant were the primary recommendations. Cognitive behavioural therapy and other medications were considered with strong variations. Conclusions: Further studies are needed to strengthen the level of evidence for antidepressive approaches in PWS. The inclusion of PWS as stakeholders is also considered to be a major issue for future guideline development. [ABSTRACT FROM AUTHOR]

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In a double blind controlled study, rTMS results in a similar antidepressant effect to sham in combination with paroxetine. Both groups had the same delay in scale''s scores improvement. rTMS seems not to be efficient as an add-on treatment to pharmacological medication in non-resistant major depression. [Copyright &y& Elsevier]

Background Despite growing evidence supporting the clinical interest of repetitive transcranial magnetic stimulation (rTMS) in treatment-resistant depression (TRD), little is known regarding the effects of clinical and sociodemographic factors on the clinical outcome in patients. Methods We retrospectively investigated the effects of clinical (using the 3-factor model of the Montgomery-Åsberg depression rating scale [MADRS] encompassing dysphoria, retardation and vegetative symptoms) and sociodemographic characteristics of participants on clinical outcome in a sample of 54 TRD patients receiving low frequency rTMS (1 Hz, 360 pulses) applied over the right dorsolateral prefrontal cortex combined with sham venlafaxine. Results Responders ( n = 29) displayed lower retardation baseline scores (13.6 ± 2.9) than non-responders (15.6 ± 2.9; n = 25; P = 0.02). We also observed a significant difference between the numbers of ex-smokers in responders and non-responders groups; all ex-smokers ( n = 8) were responders to rTMS ( P = 0.005). Conclusion Low MADRS retardation factor and ex-smoker status is highly prevalent in responders to low frequency rTMS. Further studies are needed to investigate the predictive value of these factors. [ABSTRACT FROM AUTHOR]