Abstract
Background & Objectives: Today, one of the most common mental disorders in the world is depression. Across the world, depressive disorder is increasing at an alarming rate, and more than 350 million people suffer from it. There is an association between depressive disorder and obsessive–compulsive symptoms, because of its emotionally based disorder. Their main similarity is an internal anxiety and tension that manifests itself in the form of avoidance, experiences of unwanted intrusive thoughts, intense worries, and an inability to control and contain worrying topics. Although many studies have been conducted to investigate the effects of Repetitive Magnetic Stimulation Therapy (rTMS) on depressive disorder, no study has been conducted in the world on the role of this treatment on obsessive–compulsive symptoms in patients with depression, considering the significant prevalence of depressive disorder in the country, as well as its close relationship with obsessive–compulsive symptoms. Therefore, this study was conducted to investigate the effectiveness of rTMS on the symptoms of obsessive–compulsive in adults with depressive disorder.
Methods: This quasi–experimental research employed a pretest–posttest design with a control group. The statistical population of the study consisted of all adult patients diagnosed with depressive disorder who visited psychology and psychiatry clinics in Yazd City, Iran during the year 2024. Among adults with depressive disorder referred to the psychology clinics of Yazd, 30 qualified volunteers were included in the study with the available sampling method: 15 of them were randomly assigned to the intervention group and 15 to the control group. The inclusion criteria for participants were as follows: having depressive disorder with obsessive symptoms confirmed by a psychiatrist, age range over twenty years, completion of the informed consent form for study participation, and non–concurrent use of psychotherapy and pharmacotherapy. The exclusion criteria for participants were as follows: absence from one therapy session, non–completion of the questionnaire, and unwillingness to continue cooperation throughout the research. In the first session, ethical considerations were addressed, including stating the research objectives, adherence to the principle of confidentiality, maintaining individuals’ privacy, recording information in writing with the permission of the sample individuals, voluntary participation, and informed consent of the samples. Subsequently, the patients’ condition was assessed, and a pretest was conducted in two groups, with the results recorded. The obsessive–compulsive symptoms variable scores were compared using the Maudsley Obsessive–Compulsive Inventory (MOCI) (Hodgson & Rachman, 1977) at two time points before and after rTMS. For data analysis, means and standard deviations were calculated in the descriptive statistics section. In the inferential statistics section, analysis of covariance was used. The data were analyzed using SPSS version 23. The significance level of the tests was set at 0.05.
Results: The results of the covariance analysis indicated that the mean score of obsessive symptoms in adults with depressive disorder in the intervention group, after receiving rTMS, was significantly reduced compared to the control group (p<0.001). Furthermore, based on the results related to effect size, 73% of the difference between the intervention and control groups in obsessive symptoms was due to rTMS.
Conclusion: According to the finding, 10 sessions of 20 minutes of rTMS on the right dorsolateral prefrontal cortex has a significant effect on the reducing obsessive–compulsive symptoms in adults with depressive disorder and lead to the improvement of obsessive–compulsive symptoms in these patients.