{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T18:48:28Z","timestamp":1787770108859,"version":"build-2784847793"},"reference-count":51,"publisher":"SAGE Publications","issue":"6","license":[{"start":{"date-parts":[[2022,8,22]],"date-time":"2022-08-22T00:00:00Z","timestamp":1661126400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Can J Psychiatry"],"published-print":{"date-parts":[[2023,6]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To systematically evaluate the efficacy of repetitive transcranial magnetic stimulation (rTMS) in reducing comorbid anxiety and depressive symptoms in patients with obsessive-compulsive disorder (OCD).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Three electronic databases were searched for randomized, sham-controlled clinical trials evaluating rTMS for the treatment of OCD. Hedge's g was calculated as the effect size for anxiety\/depression symptom severity (primary outcome) and OCD severity (secondary outcome). Subgroup analyses and meta-regression analyses were carried out to evaluate the most promising target and whether a reduction in OCD severity moderates the change in anxiety or depression scores.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Twenty studies ( n\u2009=\u2009688) were included in the meta-analysis. rTMS had small-medium effect size on OCD (Hedge's g\u2009=\u20090.43; 95% confidence interval [CI]: [0.20, 0.65]; P\u2009&lt;\u20090.001), anxiety (Hedge's g\u2009=\u20090.3; 95% CI: [0.11, 0.48]; P\u2009=\u20090.001) and depression (Hedge's g\u2009=\u20090.24; 95% CI: [0.07, 0.40]; P\u2009=\u20090.003) symptoms. Subgroup analysis showed that protocols targeting dorsolateral prefrontal cortex (DLPFC) were effective for 3 outcome measures. The change in anxiety, but not depression severity, was moderated by a change in OCD symptom scores. However, the findings are uncertain as a majority of the studies had some concerns or a high risk of bias.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Active rTMS protocol targeting DLPFC is effective in reducing the comorbid anxiety\/depression symptoms along with OCD severity. The antidepressant effect is not moderated by the anti-obsessive effect of rTMS.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/07067437221121112","type":"journal-article","created":{"date-parts":[[2022,8,22]],"date-time":"2022-08-22T03:41:33Z","timestamp":1661139693000},"page":"407-417","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":15,"title":["Efficacy of Repetitive Transcranial Magnetic Stimulation on Comorbid Anxiety and Depression Symptoms in Obsessive-Compulsive Disorder: A Meta-Analysis of Randomized Sham-Controlled Trials"],"prefix":"10.1177","volume":"68","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2282-904X","authenticated-orcid":false,"given":"Navya Spurthi","family":"Thatikonda","sequence":"first","affiliation":[{"name":"Obsessive-Compulsive Disorder Clinic, Department of Psychiatry, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bengaluru, Karnataka, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7907-523X","authenticated-orcid":false,"given":"Pratibha","family":"Vinod","sequence":"additional","affiliation":[{"name":"Obsessive-Compulsive Disorder Clinic, Department of Psychiatry, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bengaluru, Karnataka, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6729-6414","authenticated-orcid":false,"given":"Srinivas","family":"Balachander","sequence":"additional","affiliation":[{"name":"Obsessive-Compulsive Disorder Clinic, Department of Psychiatry, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bengaluru, Karnataka, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Binukumar","family":"Bhaskarpillai","sequence":"additional","affiliation":[{"name":"Department of Biostatistics, NIMHANS, Bengaluru, Karnataka, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shyam Sundar","family":"Arumugham","sequence":"additional","affiliation":[{"name":"Obsessive-Compulsive Disorder Clinic, Department of Psychiatry, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bengaluru, Karnataka, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9925-9631","authenticated-orcid":false,"given":"Y.C. 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