Transcranial Direct Current Stimulation for Treatment of Depression during Inpatient Psychotherapy: Results from a Psychosomatic Hospital
Ulrich Palm *
Medical Park Chiemseeblick, Bernau-Felden, Germany; Dept. of Psychiatry and Psychotherapy, Klinikum der Universität München, Munich, Germany.
Andreas Menke
Medical Park Chiemseeblick, Bernau-Felden, Germany; Dept. of Psychiatry and Psychotherapy, Klinikum der Universität München, Munich, Germany.
Anna-Katharine Brem
University Hospital of Old Age Psychiatry, University of Bern, Bern, Switzerland and Centre for Healthy Brain Ageing, Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom.
Frank Padberg
Department of Psychiatry and Psychotherapy, Klinikum der Universität München, Munich, Germany.
Ulrike Vogelmann
Department of Psychiatry and Psychotherapy, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany.
*Author to whom correspondence should be addressed.
Abstract
Recent studies focusing on the combination of psychotherapy and transcranial direct current stimulation (tDCS) showed debatable results for an additional effect of tDCS in depression. Here, we aim at evaluating the effects of tDCS adjunct to a multimodal psychosomatic treatment. In this case series, we provide data of patients treated for major depressive disorder in a multimodal inpatient psychotherapy setting, including an intensive group and individual psychotherapy and psychopharmacologic treatment, receiving tDCS as an individual treatment attempt. Seven patients underwent 11-19 tDCS treatments and 3-5 psychotherapy sessions per week during their inpatient stay. One patient achieved response and remission in the Beck Depression Inventory, another patient achieved response criteria. The other five patients had moderate to no improvement. Overall, tDCS was well tolerated but had very limited effect in patients undergoing a multimodal psychosomatic treatment and psychopharmacologic regimen. This case series is limited by the lack of a control group but is in line with previous results questioning the additional effect of tDCS to psychotherapeutic or psychopharmacologic treatment. Furthermore, the combination of multimodal therapies hampers distinction between unspecific effects of care and tDCS.
Keywords: non-invasive brain stimulation, depression, tDCS, psychotherapy