Neurofeedback Training as Adjuvant Therapy for Improving Depressive Symptoms Based on Patient Health Questionnaire – 9 (Phq-9) Scores in Post schizophrenia Depression: A Case Report

Post-schizophrenic depression, a depressive episode that occurs in patients with schizophrenia, often presents with more prominent depressive symptoms than schizophrenic symptoms. Despite pharmacotherapy, additional therapies are essential to improve symptoms and overall functioning. This study explores the use of neurofeedback as an adjuvant therapy in a 50-year-old female patient with a history of paranoid schizophrenia. The patient presented with symptoms of sadness, withdrawal, auditory and visual hallucinations, and a PHQ-9 score of 22. Along with pharmacotherapy (escitalopram, risperidone, and trihexyphenidyl), the patient underwent five sessions of neurofeedback with an alpha/theta/beta2 protocol aimed at enhancing alpha waves, which are often deficient in depressed individuals. Results showed that the patient's alpha wave amplitude increased from 9.2% in the first session to 9.9% in the fifth session, and the PHQ-9 score decreased, indicating improvement in depressive symptoms. These findings suggest that neurofeedback is an effective non-invasive therapy for post-schizophrenic depression, enhancing treatment outcomes when used alongside pharmacological interventions, ultimately improving the patient's quality of life and mental health.