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This study aims to explore the efficacy, safety and long-term effects of common and available non-invasive neuromodulation techniques in the treatment of depression, and to provide a data basis for the establishment of individualized treatment and efficacy prediction models. 450 patients will be enrolled and randomly assigned to five different treatments. Psychopathological assessment will be performed in both acute and maintenance phases of treatment with the Hamilton Depression Rating Scale, the Hamilton Anxiety Rating Scale, and the Patient Health Questionaire-9, the Sheehan Disability Scale, the Vascular Quality of Life-6 Questionnaire respectively.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| drug therapy group | Experimental | Drug: drug therapy There is no restriction on the choice of therapeutic drugs. |
|
| drug therapy combined with repetitive transcranial magnetic stimulation (rTMS) group | Experimental | Device: rTMS Stimulation will be performed for 20 working days once a day (4 weeks). Extend course to 30 sessions (6 weeks) in responders who have not achieved symptom remission. Frequency: 10Hz; Intensity: 110% RMT; Coil-type: F8; Sessions-pulse: 3000; Site: the left dorsolateral prefrontal cortex. Drug: drug therapy There is no restriction on the choice of therapeutic drugs. |
|
| drug therapy combined with light therapy group | Experimental | Device: light therapy Active 10,000-lux fluorescent white light box for 30 min/d in the early morning for 6 weeks. Drug: drug therapy There is no restriction on the choice of therapeutic drugs. |
|
| drug therapy combined with electroconvulsive therapy (ECT) group | Experimental | Device: ECT The electrode placements are bifrontal (BF); the electrical intensity is 1.5 to 2.0 times the seizure threshold (ST); 3 times per week. Drug: drug therapy There is no restriction on the choice of therapeutic drugs. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| rTMS | Device | Stimulation will be performed for 20 working days once a day (4 weeks). Extend course to 30 sessions (6 weeks) in responders who have not achieved symptom remission. Frequency: 10Hz; Intensity: 110% RMT; Coil-type: F8; Sessions-pulse: 3000; Site: the left dorsolateral prefrontal cortex. |
| Measure | Description | Time Frame |
|---|---|---|
| the change of the HAMD-17 score | the change of HAMD-17 score between baseline and after treatment. | baseline, and 1, 2, 4, 8, 12, 24, 36, 48 weeks. |
| Measure | Description | Time Frame |
|---|---|---|
| remission rate | HAMD-17 total score ≤ 7 after treatment. | 12, 24, 36, 48 weeks. |
| response rate | a reduction rate of HAMD-17 score ≥ 50% from baseline after treatment. |
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Inclusion Criteria:
Exclusion Criteria:
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Shanghai Mental Health Center | Shanghai | Shanghai Municipality | 200030 | China |
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| ID | Term |
|---|---|
| D003865 | Depressive Disorder, Major |
| ID | Term |
|---|---|
| D003866 | Depressive Disorder |
| D019964 | Mood Disorders |
| D001523 | Mental Disorders |
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| ID | Term |
|---|---|
| D010789 | Phototherapy |
| D004358 | Drug Therapy |
| ID | Term |
|---|---|
| D013812 | Therapeutics |
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| drug therapy combined with magnetic seizure therapy (MST) group | Experimental | Device: MST A coil placement at the vertex (i.e., Cz in 10-20 electroencephalogram [EEG] system) with a frequency of stimulation of 100 Hz, pulse width of 0.2 to 0.4 ms, and stimulation duration of 10 seconds; 2 times per week. Drug: drug therapy There is no restriction on the choice of therapeutic drugs. |
|
|
| light therapy | Device | Active 10,000-lux fluorescent white light box for 30 min/d in the early morning for 6 weeks. |
|
| ECT | Device | The electrode placements are bifrontal (BF); the electrical intensity is 1.5 to 2.0 times the seizure threshold (ST); 3 times per week. |
|
| MST | Device | A coil placement at the vertex (i.e., Cz in 10-20 electroencephalogram [EEG] system) with a frequency of stimulation of 100 Hz, pulse width of 0.2 to 0.4 ms, and stimulation duration of 10 seconds; 2 times per week. |
|
| drug therapy | Drug | There is no restriction on the choice of therapeutic drugs. |
|
| 12, 24, 36, 48 weeks. |