The Diagnostic Apathia Scale predicts a dose–remission relationship of T-PEMF in treatment-resistant depression

Oct 3, 2014Acta neuropsychiatrica

Apathy Scale predicts how treatment dose relates to recovery in treatment-resistant depression using T-PEMF

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Abstract

The remission rate after T-PEMF was 83.9% in patients without apathy and 58.8% in patients with apathy (p≤0.05).

Patients without apathy showed a significantly higher remission rate compared to those with apathy after T-PEMF treatment.
In the group receiving one active dose daily, 94.4% of patients without apathy achieved remission, while only 50% of patients with apathy did.
For patients receiving two active doses daily, the remission rates were 69.9% for those without apathy and 66.7% for those with apathy.
The results suggest that the presence of apathy may be associated with lower remission rates in therapy-resistant depression.
Two daily doses of T-PEMF may be necessary for patients with apathy to achieve similar remission rates as those without apathy.

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OBJECTIVE: The aim of this study was to evaluate the predictive validity of the apathy subsyndrome in patients with therapy-resistant depression in the dose-remission study with transcranial pulsating electromagnetic fields (T-PEMF).

METHODS: The apathy subsyndrome consists of the symptoms of fatigue, concentration and memory problems, lack of interests, difficulties in making decisions, and sleep problems. We evaluated 65 patients with therapy-resistant depression. In total, 34 of these patients received placebo T-PEMF in the afternoon and active T-PEMF in the morning, that is, one daily dose. The remaining 31 patients received active T-PEMF twice daily. Duration of treatment was 8 weeks in both groups. The Hamilton Depression Scale (HAM-D17) and the Bech-Rafaelsen Melancholia Scale (MES) were used to measure remission. We also focused on the Diagnostic Apathia Scale, which is based on a mixture of items from the MINI and the HAM-D17/MES.

RESULTS: In patients without apathy, the remission rate after T-PEMF was 83.9% versus 58.8% in patients with apathy (p≤0.05). In patients without apathy receiving one active dose daily 94.4% remitted versus 50% for patients with apathy (p≤0.05). In patients without apathy who received two active doses 69.9% remitted versus 66.7% for patients with apathy (p≤0.05).

CONCLUSION: Taking the baseline diagnosis of the apathy syndrome into consideration, we found that in patients without apathy one daily dose of T-PEMF is sufficient, but in patients with apathy two daily doses are necessary. Including the apathy syndrome as predictor in future studies would seem to be clinically relevant.

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The Diagnostic Apathia Scale predicts a dose–remission relationship of T-PEMF in treatment-resistant depression

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