343. LONGITUDINAL FOLLOW-UP STUDY OF MOOD SYMPTOM RATING, SUICIDALITY, PSYCHOLOGICAL AND PHYSICAL HEALTH AND QUALITY OF LIFE POST-RTMS IN THE REFRACTORY DEPRESSED PATIENTS IN TAIWAN

Abstract Background In the past 5 years, 479 depressed patients received transcranial magnetic stimulation therapy (TMS) at our department. Among them, 53 subjects have more than twice TMS treatment. The questions we would like to ask is that how often the depressed subjects should have a follow-up TMS? To answer that, our aim is first to measure their current mood symptoms and their quality of life periodically post-TMS. Aims & Objectives The aim is first to measure their current mood symptoms and their quality of life periodically post-TMS to answer the question that we would like to ask is how often the depressed subjects should have a follow-up TMS after the previous one? Method One procedure is to perform a prospective follow-up study at one and three months post-TMS. The other one is to follow-up retrospectively for six months and for one year pre-TMS. The procedures included clinic medical record, cellphone interview by a skillful nurse for SF12 (quality of life, including mental health and physical health), PHQ-9, Brief Symptom Rating Scale (BSRS-6, including suicide assessment), Taiwan depression questionnaire (TDQ). Results Physical component summary (PCS) and mental component summary (MCS) from SF12 showed one-month (mn) FU are 44.8 (+9.3) %, and 36.6 (7.7) %, 6-mn: 48.9 (+5.4) %, and 37.3 (+7.5) % and 12-mn: 49.7 (+5,7) % and 42.8 (+ 6.9) %, respectively. PHQ-9 score: 7.6 (+6.7), 5.7 (+5.0) and 2.1 (+2.4) at 1-, 6- and 12- mn respectively. BSRS-6 showed 4.9 (+5.1), 0.75 (+1.4) and 0.75 (+1.4) at 1-,6-, 12- mn respectively. TDQ score revealed 12 (+12.4), 8.8 (+ 8.2) and 2.9 (+4.3) at 1-,6- and 12- mn respectively. Suicidality severity with much more in mild to moderate degree has remianed around 40 to 45% at all 1-, 6-, 12-mn FU, Only 7.9% has severe degree at 1-mn FU. Compared to non-responder to TMS, responder showed better MCS, lower PHQ-9 and BSRS score with less suicidal ideation and decreased TDQ score, seen at 1-mn and 6 mn but not at 12-mn FU time. Discussion & Conclusions The treatment refractory depressed patients demonstrated more psychological distress with lower MCS% when in comparison with general population in Hong-Kong (36.6% vs. 53.8%) and also worse physical distress with lower PCS (44.8% vs. 67.9%), indicating that quality of life in refractory depressed patients has declined in both physical and mental distress. Despite that, 6- and 12-mn FU data showed better outcome in mood and suicidality after 6 and 12 months. Additionallyr, by this data, physicians should pay attention to suicidal tendency in these difficult-to-treat depressed patients, even after TMS treatment, indicating that depressed patients might need periodical rTMS therapy, particularly in the initial 3 months post-TMS period.