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Sierra P, Cañada Y, Benavent P, Sabater A, Ribes J, Livianos L, Garcia-Blanco A. Opinion, Use and Knowledge About Transcranial Magnetic Stimulation in Spain: A National Survey of Mental Health Professionals. Psychiatr Q 2024; 95:271-285. [PMID: 38880831 DOI: 10.1007/s11126-024-10073-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/14/2024] [Indexed: 06/18/2024]
Abstract
Transcranial magnetic stimulation (TMS) is a non-invasive method of neuromodulation with heterogeneous usage between countries, which may be potentially influenced by healthcare professionals' opinions. This study aimed to assess the knowledge, acceptability, and attitudes of mental health professionals in Spain towards TMS. A cross-sectional multicentric study was conducted using an online survey, with 219 participants including psychiatrists, psychologists, and residents. Nearly 100% of participants correctly answered theoretical aspects related to the rationale and indications of TMS. Although only 55% considered TMS effective, 80% would refer patients if TMS were available at their workplace, and 74% would undergo TMS if experiencing depression. 85% believed neuromodulation training should be increased in residency, and 73% demanded TMS inclusion in public hospitals. Teaching staff and psychologists defined TMS as a last resort (p = 0.03 and 0.045). Both disagreed on its ease of use (p < 0.001) and patient referral (p = 0.01), considering an impact on the therapeutic bond (p = 0.029). Previous TMS training, clinical experience, or availability of TMS at the workplace, were associated with better knowledge, a higher perception of efficacy and utility in treating resistant patients (all p < 0.05). In conclusion, surveyed mental health professionals in Spain demonstrated good knowledge of the technique and positive opinions regarding its utility. Findings emphasized limited clinical experience of the sample, a call for training programs, and the demand for the inclusion of TMS in the portfolio of Spanish public hospitals.
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Affiliation(s)
- Pilar Sierra
- Department of Psychiatry and Psychology, La Fe University and Polytechnic Hospital, Building D. 106th Av Fernando Abril Martorell, Valencia, 46026, Spain
- Mental Health Research Unit, La Fe Health Research Institute, Valencia, Spain
- Department of Medicine, University of Valencia, Valencia, Spain
| | - Yolanda Cañada
- Department of Psychiatry and Psychology, La Fe University and Polytechnic Hospital, Building D. 106th Av Fernando Abril Martorell, Valencia, 46026, Spain.
- Mental Health Research Unit, La Fe Health Research Institute, Valencia, Spain.
| | - Pilar Benavent
- Department of Psychiatry and Psychology, La Fe University and Polytechnic Hospital, Building D. 106th Av Fernando Abril Martorell, Valencia, 46026, Spain
- Mental Health Research Unit, La Fe Health Research Institute, Valencia, Spain
| | - Ana Sabater
- Department of Psychiatry and Psychology, La Fe University and Polytechnic Hospital, Building D. 106th Av Fernando Abril Martorell, Valencia, 46026, Spain
- Mental Health Research Unit, La Fe Health Research Institute, Valencia, Spain
| | - Josep Ribes
- Department of Psychiatry and Psychology, La Fe University and Polytechnic Hospital, Building D. 106th Av Fernando Abril Martorell, Valencia, 46026, Spain
| | - Lorenzo Livianos
- Department of Psychiatry and Psychology, La Fe University and Polytechnic Hospital, Building D. 106th Av Fernando Abril Martorell, Valencia, 46026, Spain
- Mental Health Research Unit, La Fe Health Research Institute, Valencia, Spain
- Department of Medicine, University of Valencia, Valencia, Spain
- CIBERESP-17, Valencia, Spain
| | - Ana Garcia-Blanco
- Department of Psychiatry and Psychology, La Fe University and Polytechnic Hospital, Building D. 106th Av Fernando Abril Martorell, Valencia, 46026, Spain
- Mental Health Research Unit, La Fe Health Research Institute, Valencia, Spain
- Department of Personality, Evaluation, and Psychological Treatments, University of Valencia, Valencia, Spain
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Samalin L, Yrondi A, Charpeaud T, Genty JB, Blanc O, Sauvaget A, Stéphan F, Walter M, Bennabi D, Bulteau S, Haesebaert F, D'Amato T, Poulet E, Holtzmann J, Richieri RM, Attal J, Nieto I, El-Hage W, Bellivier F, Schmitt L, Lançon C, Bougerol T, Leboyer M, Aouizerate B, Haffen E, Courtet P, Llorca PM. Adherence to treatment guidelines in clinical practice for using electroconvulsive therapy in major depressive episode. J Affect Disord 2020; 264:318-323. [PMID: 32056767 DOI: 10.1016/j.jad.2020.01.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2019] [Revised: 12/20/2019] [Accepted: 01/03/2020] [Indexed: 12/24/2022]
Abstract
BACKGROUND ECT is the most effective treatment of major depressive episode (MDE) but remains a neglected treatment. The French Society for Biological Psychiatry and Neuropsychopharmacology aimed to determine whether prescribing practice of ECT followed guidelines recommendations. METHODS This multicenter, retrospective study included adult patients with major depressive disorder (MDD) or bipolar disorder (BD), who have been treated with ECT for MDE. Duration of MDE and number of lines of treatment received before ECT were collected. The reasons for using ECT, specifically first-line indications (suicidality, urgency, presence of catatonic and psychotic features, previous ECT response, patient preference) were recorded. Statistical comparisons between groups used standard statistical tests. RESULTS Seven hundred and forty-five individuals were included. The mean duration of MDE before ECT was 10.1 months and the mean number of lines of treatment before ECT was 3.4. It was significantly longer for MDD single episode than recurrent MDD and BD. The presence of first-line indications for using ECT was significantly associated to shorter duration of MDE (9.1 vs 13.1 months, p<0.001) and lower number of lines of treatment before ECT (3.3 vs 4.1, p<0.001). LIMITATIONS This is a retrospective study and not all facilities practicing ECT participated that could limit the extrapolation of the results. CONCLUSION Compared to guidelines, ECT was not used as first-line strategy in clinical practice. The presence of first-line indications seemed to reduce the delay before ECT initiation. The improvements of knowledge and access of ECT are needed to decrease the gap between guidelines and clinical practice.
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Affiliation(s)
- L Samalin
- French Society for Biological Psychiatry and Neuropsychopharmacology, Saint Germain en Laye, France; Fondation Fondamental, Créteil, France; Department of Psychiatry, CHU Clermont-Ferrand, University of Clermont Auvergne, Clermont-Ferrand EA 7280, France.
| | - A Yrondi
- French Society for Biological Psychiatry and Neuropsychopharmacology, Saint Germain en Laye, France; Fondation Fondamental, Créteil, France; Service de Psychiatrie et de Psychologie Médicale de l'adulte, CHU de Toulouse, Hôpital Purpan, ToNIC Toulouse NeuroImaging Center, University of Toulouse, Inserm, UPS, Toulouse, France
| | - T Charpeaud
- French Society for Biological Psychiatry and Neuropsychopharmacology, Saint Germain en Laye, France; Department of Psychiatry, CHU Clermont-Ferrand, University of Clermont Auvergne, Clermont-Ferrand EA 7280, France
| | - J B Genty
- French Society for Biological Psychiatry and Neuropsychopharmacology, Saint Germain en Laye, France; Fondation Fondamental, Créteil, France; University of Paris-Est, UMR_S955, UPEC, Créteil, France Inserm, U955, Equipe 15 Psychiatrie génétique, Créteil, France; AP-HP, Hôpital H. Mondor-A. Chenevier, Pôle de psychiatrie, Créteil, France
| | - O Blanc
- French Society for Biological Psychiatry and Neuropsychopharmacology, Saint Germain en Laye, France; Fondation Fondamental, Créteil, France; Department of Psychiatry, CHU Clermont-Ferrand, University of Clermont Auvergne, Clermont-Ferrand EA 7280, France
| | - A Sauvaget
- French Society for Biological Psychiatry and Neuropsychopharmacology, Saint Germain en Laye, France; CHU Nantes, Movement - Interactions - Performance, MIP, EA 4334, INSERM-U1246 SPHERE University of Nantes and University of Tours, Nantes, France
| | - F Stéphan
- French Society for Biological Psychiatry and Neuropsychopharmacology, Saint Germain en Laye, France; Fondation Fondamental, Créteil, France; Service Hospitalo-Universitaire de Psychiatrie Générale et de Réhabilitation Psycho Sociale, EA 7479, CHRU de Brest, Hôpital de Bohars, Brest, France
| | - M Walter
- French Society for Biological Psychiatry and Neuropsychopharmacology, Saint Germain en Laye, France; Fondation Fondamental, Créteil, France; Service Hospitalo-Universitaire de Psychiatrie Générale et de Réhabilitation Psycho Sociale, EA 7479, CHRU de Brest, Hôpital de Bohars, Brest, France
| | - D Bennabi
- French Society for Biological Psychiatry and Neuropsychopharmacology, Saint Germain en Laye, France; Fondation Fondamental, Créteil, France; Department of Clinical Psychiatry, CIC-1431 INSERM, CHU de Besançon, EA481 Neurosciences, University Bourgogne Franche-Comté, Besançon, France
| | - S Bulteau
- French Society for Biological Psychiatry and Neuropsychopharmacology, Saint Germain en Laye, France; CHU Nantes, Movement - Interactions - Performance, MIP, EA 4334, INSERM-U1246 SPHERE University of Nantes and University of Tours, Nantes, France
| | - F Haesebaert
- French Society for Biological Psychiatry and Neuropsychopharmacology, Saint Germain en Laye, France; Fondation Fondamental, Créteil, France; Centre Hospitalier Le Vinatier, Inserm U1028, CNRS UMR5292, Lyon Neuroscience Research Center, PSY-R2 Team, University Lyon 1, Lyon, France
| | - T D'Amato
- French Society for Biological Psychiatry and Neuropsychopharmacology, Saint Germain en Laye, France; Fondation Fondamental, Créteil, France; Centre Hospitalier Le Vinatier, Inserm U1028, CNRS UMR5292, Lyon Neuroscience Research Center, PSY-R2 Team, University Lyon 1, Lyon, France
| | - E Poulet
- French Society for Biological Psychiatry and Neuropsychopharmacology, Saint Germain en Laye, France; Fondation Fondamental, Créteil, France; Department of Emergency Psychiatry, hospices civils de Lyon, Edouard-Herriot Hospital, Neuroscience Research Center, CNRS UMR5292, PSY-R2 Team, University Lyon, Lyon, France
| | - J Holtzmann
- French Society for Biological Psychiatry and Neuropsychopharmacology, Saint Germain en Laye, France; Fondation Fondamental, Créteil, France; CHU Grenoble Alpes, Grenoble Institut Neurosciences, Inserm, U1216, University of Grenoble Alpes, Grenoble, France
| | - R M Richieri
- French Society for Biological Psychiatry and Neuropsychopharmacology, Saint Germain en Laye, France; Fondation Fondamental, Créteil, France; Pôle Psychiatrie, CHU La Conception, Marseille, France
| | - J Attal
- French Society for Biological Psychiatry and Neuropsychopharmacology, Saint Germain en Laye, France; Fondation Fondamental, Créteil, France; University Department of Adult Psychiatry, La Colombiere Hospital, CHU Montpellier, University of Montpellier 1, Inserm, Montpellier 1061, France
| | - I Nieto
- French Society for Biological Psychiatry and Neuropsychopharmacology, Saint Germain en Laye, France; Fondation Fondamental, Créteil, France; AP-HP, GH Saint-Louis - Lariboisière - Fernand Widal, Pôle Neurosciences Tête et Cou, Inserm UMRS 1144, University Paris Diderot, Paris, France 16 UMR 1253, iBrain, University of Tours, Inserm, Tours, France
| | - W El-Hage
- French Society for Biological Psychiatry and Neuropsychopharmacology, Saint Germain en Laye, France; Fondation Fondamental, Créteil, France; Department of General and Academic Psychiatry, CH Charles Perrens, Bordeaux, Laboratory Nutrition and Integrative Neurobiology (UMR INRA 1286), University of Bordeaux, Bordeaux, France
| | - F Bellivier
- French Society for Biological Psychiatry and Neuropsychopharmacology, Saint Germain en Laye, France; Fondation Fondamental, Créteil, France; AP-HP, GH Saint-Louis - Lariboisière - Fernand Widal, Pôle Neurosciences Tête et Cou, Inserm UMRS 1144, University Paris Diderot, Paris, France 16 UMR 1253, iBrain, University of Tours, Inserm, Tours, France
| | - L Schmitt
- French Society for Biological Psychiatry and Neuropsychopharmacology, Saint Germain en Laye, France; Fondation Fondamental, Créteil, France; Service de Psychiatrie et de Psychologie Médicale de l'adulte, CHU de Toulouse, Hôpital Purpan, ToNIC Toulouse NeuroImaging Center, University of Toulouse, Inserm, UPS, Toulouse, France
| | - C Lançon
- French Society for Biological Psychiatry and Neuropsychopharmacology, Saint Germain en Laye, France; Fondation Fondamental, Créteil, France; Pôle Psychiatrie, CHU La Conception, Marseille, France
| | - T Bougerol
- French Society for Biological Psychiatry and Neuropsychopharmacology, Saint Germain en Laye, France; Fondation Fondamental, Créteil, France; CHU Grenoble Alpes, Grenoble Institut Neurosciences, Inserm, U1216, University of Grenoble Alpes, Grenoble, France
| | - M Leboyer
- French Society for Biological Psychiatry and Neuropsychopharmacology, Saint Germain en Laye, France; Fondation Fondamental, Créteil, France; University of Paris-Est, UMR_S955, UPEC, Créteil, France Inserm, U955, Equipe 15 Psychiatrie génétique, Créteil, France; AP-HP, Hôpital H. Mondor-A. Chenevier, Pôle de psychiatrie, Créteil, France
| | - B Aouizerate
- French Society for Biological Psychiatry and Neuropsychopharmacology, Saint Germain en Laye, France; Fondation Fondamental, Créteil, France; Department of General and Academic Psychiatry, CH Charles Perrens, Bordeaux, Laboratory Nutrition and Integrative Neurobiology (UMR INRA 1286), University of Bordeaux, Bordeaux, France
| | - E Haffen
- French Society for Biological Psychiatry and Neuropsychopharmacology, Saint Germain en Laye, France; Fondation Fondamental, Créteil, France; Department of Clinical Psychiatry, CIC-1431 INSERM, CHU de Besançon, EA481 Neurosciences, University Bourgogne Franche-Comté, Besançon, France
| | - P Courtet
- French Society for Biological Psychiatry and Neuropsychopharmacology, Saint Germain en Laye, France; Fondation Fondamental, Créteil, France; Department of Emergency Psychiatry and Acute Care, CHU Montpellier, Inserm U1061, Montpellier University, Montpellier, France
| | - P M Llorca
- French Society for Biological Psychiatry and Neuropsychopharmacology, Saint Germain en Laye, France; Fondation Fondamental, Créteil, France; Department of Psychiatry, CHU Clermont-Ferrand, University of Clermont Auvergne, Clermont-Ferrand EA 7280, France
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