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

Published online by Cambridge University Press:  02 October 2014

Per Bech*
Affiliation:
Psychiatric Research Unit, Psychiatric Centre North Zealand, Copenhagen University Hospital, Hillerød, Denmark
Marianne Lunde
Affiliation:
Psychiatric Research Unit, Psychiatric Centre North Zealand, Copenhagen University Hospital, Hillerød, Denmark
Lise Lauritzen
Affiliation:
Psychiatric Research Unit, Psychiatric Centre North Zealand, Copenhagen University Hospital, Hillerød, Denmark
Birgit Straasø
Affiliation:
Psychiatric Research Unit, Psychiatric Centre North Zealand, Copenhagen University Hospital, Hillerød, Denmark
Lone Lindberg
Affiliation:
Psychiatric Research Unit, Psychiatric Centre North Zealand, Copenhagen University Hospital, Hillerød, Denmark
Maj Vinberg
Affiliation:
Department of Psychiatry, Psychiatric Centre Copenhagen, Copenhagen University Hospital, Copenhagen, Denmark
Mogens Undén
Affiliation:
Psychiatric Research Unit, Psychiatric Centre North Zealand, Copenhagen University Hospital, Hillerød, Denmark
Lone Christina Hellström
Affiliation:
Psychiatric Research Unit, Psychiatric Centre Copenhagen, Copenhagen University Hospital, Copenhagen NV, Denmark
Steen Dissing
Affiliation:
Department of Cellular and Molecular Medicine, Panum institute, University of Copenhagen, Copenhagen, Denmark
Erik Roj Larsen
Affiliation:
Department of Affective Disorders, Mood Disorders Research Unit, Aarhus University Hospital, Aarhus, Denmark
*
Per Bech, Psychiatric Research Unit, Psychiatric Centre North Zealand, University of Copenhagen, Dyrehavevej 48, DK-3400 Hillerød, Denmark. Tel: +45 38 64 30 95; Fax: +45 48 26 38 77; E-mail: Per.bech@regionh.dk

Abstract

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.

Type
Original Articles
Copyright
© Scandinavian College of Neuropsychopharmacology 2014 

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