Depressive Tendency and Counseling Outcomes in Thymoma-Associated MG

Association of Baseline Depressive Tendency With Post-Counseling Clinical Status in Patients With Thymoma-Associated Myasthenia Gravis

This study aimed to examine whether baseline depressive tendency independently predicts post-counseling clinical outcomes in patients with thymoma-associated MG. This single-group pre-post exploratory pilot study enrolled patients with thymoma-associated MG who received eight sessions of Gestalt-oriented psychological counseling. Depressive tendency was defined as a baseline Patient Health Question-naire-9 (PHQ-9) score ≥10. Clinical outcomes, including the Myasthenia Gravis Activities of Daily Living scale (MG-ADL), Myasthenia Gravis Quality of Life 15-item scale (MG-QoL15), and mental BMI (mBMI), were assessed before and after the intervention. Multivariable regression analyses were performed to evaluate whether baseline clinical severity independently predicted post-intervention outcomes after sequential adjustment for baseline scores, age, and sex.

Inclusion Criteria:

1. A confirmed diagnosis of MG associated with thymoma and prior completion of surgical treatment
2. Age ≥ 20 years
3. Ability to communicate clearly and provide reliable responses
4. Absence of cognitive impairment or severe psychiatric illness that could interfere with participation
5. Willingness to participate in the study with provision of written informed consent

Exclusion Criteria:

1. The absence of a confirmed diagnosis of myasthenia gravis
2. Failure to confirm thymoma on postoperative pathological examination
3. Inability to communicate adequately in Mandarin, Taiwanese, English, or written form
4. The presence of conditions that could compromise verbal communication or regular participation in counseling sessions, such as significant traumatic brain injury, severe psychiatric disorders, or cognitive impairment