{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,23]],"date-time":"2026-08-23T04:53:01Z","timestamp":1787460781236,"version":"build-2736575974"},"reference-count":84,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2024,11,11]],"date-time":"2024-11-11T00:00:00Z","timestamp":1731283200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Psychiatry"],"abstract":"<jats:sec><jats:title>Introduction<\/jats:title><jats:p>Despite the high hopes for the use of transcranial magnetic stimulation (TMS) in the treatment of depression, between 30% and 60.5% of patients do not respond to stimulation. The factors contributing to non-response, especially those related to personality, remain insufficiently investigated. The main aim of our study was to compare the efficacy of active TMS and sham\u2013placebo protocols in combined therapy of treatment-resistant depression with evaluation of possible personality disorders comorbidity.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The study was conducted between December 2019 and December 2022, as a randomized, double-blind, active comparator-controlled and sham-controlled parallel trial. Patients (n = 41) were randomized into one of two experimental conditions (active TMS vs. placebo) and screened before and after stimulation as well as at a 3-month follow-up. Personality disorders were assessed with The Structured Clinical Interview for DSM-5 Personality Disorders.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>There were no significant differences between the TMS active and sham groups in terms of general characteristics, coexisting personality disorders, and Montgomery\u2013\u00c5sberg Depression Rating Scale scores before stimulation, at the end of stimulation, and after 3 months of stimulation. However, linear regression analysis revealed significant negative associations between the coexistence of personality disorders and the reduction of depressive symptoms from baseline to the end of stimulation. The post-hoc exploratory analysis on the first phase of the RCT confirmed the presence of personality disorders to be a consistent negative influence on the reduction of depressive symptoms post-stimulation, regardless of protocol and experimental condition and demonstrated a smaller percentage reduction in depressive symptoms after stimulation in patients with personality disorders.<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion<\/jats:title><jats:p>A central conclusion, based on our study, is that transcranial magnetic stimulation for treatment-resistant depression cannot be considered as a method independent of co-occurring personality disorders.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fpsyt.2024.1363984","type":"journal-article","created":{"date-parts":[[2024,11,11]],"date-time":"2024-11-11T06:11:10Z","timestamp":1731305470000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":4,"title":["Preliminary findings of a randomized controlled trial investigating the efficacy of transcranial magnetic stimulation in treatment-resistant depression: a post-hoc analysis on the role of co-occurring personality disorders"],"prefix":"10.3389","volume":"15","author":[{"given":"Julian","family":"Maciaszek","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joanna","family":"Rymaszewska","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomasz","family":"Wieczorek","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patryk","family":"Piotrowski","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dorota","family":"Szcze\u015bniak","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan A.","family":"Besz\u0142ej","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Monika","family":"Ma\u0142ecka","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bogna","family":"Bogudzi\u0144ska","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adrianna","family":"Senczyszyn","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Damian","family":"Siwicki","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marta","family":"Biercewicz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Krzysztof","family":"Kowalski","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Zimny","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Przemys\u0142aw","family":"Podg\u00f3rski","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karolina","family":"Fila-Paw\u0142owska","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2024,11,11]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1177\/00048674211068788","article-title":"Revisiting the effectiveness of repetitive Transcranial magnetic stimulation treatment in depression, again","volume":"56","author":"Fitzgerald","year":"2022","journal-title":"Aust N Z J Psychiatry"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1038\/nrn2169","article-title":"Is there a future for therapeutic use of transcranial magnetic stimulation","volume":"8","author":"Ridding","year":"2007","journal-title":"Nat Rev Neurosci"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1001\/jamapsychiatry.2016.3644","article-title":"Repetitive transcranial magnetic stimulation for the acute treatment of major depressive episodes: A systematic review with network metaanalysis","volume":"74","author":"Brunoni","year":"2017","journal-title":"JAMA Psychiatry"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.1016\/j.clinph.2014.05.021","article-title":"Evidence-based guidelines on the therapeutic use of repetitive transcranial magnetic stimulation (rTMS)","volume":"125","author":"Lefaucheur","year":"2014","journal-title":"Clin Neurophysiol"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1177\/0706743716660033","article-title":"Canadian network for mood and anxiety treatments (CANMAT) 2016 clinical guidelines for the management of adults with major depressive disorder: section 4. 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