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| Author(s): |
Bruna Bariani Teixeira
Total Authors: 1
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| Document type: | Doctoral Thesis |
| Press: | São Paulo. |
| Institution: | Universidade de São Paulo (USP). Faculdade de Medicina (FM/SBD) |
| Defense date: | 2025-06-30 |
| Examining board members: |
Leandro da Costa Lane Valiengo;
André Brooking Negrão;
Rafael Augusto Teixeira de Sousa
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| Advisor: | Leandro da Costa Lane Valiengo |
| Abstract | |
Major depressive disorder (MDD) is a leading cause of disability, especially among older adults. Repetitive transcranial magnetic stimulation (rTMS) is an effective non-pharmacological treatment, and theta burst stimulation (TBS) offers shorter sessions. Acceptance and Commitment Therapy (ACT) is an intervention that has been shown to be effective in treating MDD. However, to date, no studies have evaluated the combination of TTMS and ACT in geriatric depression. This study consisted of a randomized, double-blind, controlled clinical trial. The objective was to evaluate the efficacy of TBS combined with a brief focal psychotherapy protocol of four ACT sessions in the treatment of 29 individuals, aged 60 years or older, with MDD and a Hamilton Depression Rating Scale (HDRS) score >16. All 29 volunteers received TBS for the first 20 days, with supplemental sessions at weeks 6, 8, and 12. The ACT group (n = 16) participated in four weekly 60-minute ACT sessions, while the control group (CG) (n = 13) had supportive sessions. The results showed that the ACT group showed a faster response in MDD symptoms: they obtained significantly lower HDRS at week 6 compared to the CG (p = 0.007). However, the difference was not sustained at weeks 8 (p=0.111) and 12 (p = 0.307). As a secondary step, we also observed that at week 6, a percentage of remissions in the ACT group (56.3%) was significantly higher compared to the control group (15.4%; p = 0.024). These findings suggest that the combination of TBS and ACT may accelerate the reduction of depressive symptoms in elderly individuals with MDD, favoring a faster clinical response. However, the differential effects between the groups did not remain significant throughout the follow-up. Studies with larger samples are needed. (AU) | |
| FAPESP's process: | 22/02539-3 - Effect of a brief and focal protocol of Acceptance and Commitment Therapy (ACT) in patients with depression undergoing repetitive transcranial magnetic stimulation by the Theta-burst method: clinical trial, randomized, evaluator blinded, controlled |
| Grantee: | Bruna Bariani Teixeira |
| Support Opportunities: | Scholarships in Brazil - Doctorate |