{
    "abstract": "Antidepressive treatment outcomes can be assessed using sum scores from measurement scales, but symptom clusters may better capture the multidimensional structure of depression. Little is known about the comparative effectiveness of different treatment modalities on these clusters. We sought to evaluate the effects of rTMS and antidepressant medication on four symptom clusters and the extent to which these differ between treatments. In addition, we assessed whether baseline cluster scores predicted (non)response.\nData were obtained from two clinical trials (DETECT: rTMS vs. medication; PITA: tricyclic antidepressants). Primary outcomes were symptom cluster scores: 'General Depression', 'Anxiety', 'Somatic Symptoms' and 'Insomnia'. In the primary analysis based on DETECT, a MANCOVA comparing rTMS with medication was performed. For validation, a MANCOVA was performed replacing medication data from DETECT with data from PITA. Baseline symptom cluster scores were compared between responders and non-responders, as well as treatment groups.\nIn both the primary and validation analyses, no difference was seen between rTMS and medication on the symptom clusters. Similar patterns of response were observed in all groups, with 'Insomnia' showing the greatest effect of treatment. Baseline cluster scores did not predict treatment response.\nWe did not find a differential effect of rTMS or antidepressant medication on depressive symptom clusters. Both treatments demonstrated comparable response patterns for all clusters, and baseline cluster scores did not differ between responders and non-responders. Future studies with larger samples or more homogeneous treatments may elucidate the role of symptom clusters as a tool for more individualized treatment.\nPITA NCT03548675 DETECT The Netherlands Trial Register NL7628.",
    "authors": [
        {
            "affiliation": "Department of Psychiatry, Radboud University Medical Center, Nijmegen, The Netherlands. iris.dalhuisen@radboudumc.nl.",
            "firstname": "Iris",
            "initials": "I",
            "lastname": "Dalhuisen"
        },
        {
            "affiliation": "Department of Psychiatry, Radboud University Medical Center, Nijmegen, The Netherlands.\nDonders Institute for Brain Cognition and Behavior, Centre for Medical Neuroscience, Nijmegen, The Netherlands.",
            "firstname": "Tom",
            "initials": "T",
            "lastname": "Biemans"
        },
        {
            "affiliation": "Department of Psychiatry, Radboud University Medical Center, Nijmegen, The Netherlands.\nAntes, Parnassia Group, Rotterdam, The Netherlands.",
            "firstname": "Cornelis F",
            "initials": "CF",
            "lastname": "Vos"
        },
        {
            "affiliation": "Department of Psychiatry, Radboud University Medical Center, Nijmegen, The Netherlands.\nDonders Institute for Brain Cognition and Behavior, Centre for Medical Neuroscience, Nijmegen, The Netherlands.",
            "firstname": "Sophie Ter",
            "initials": "ST",
            "lastname": "Hark"
        },
        {
            "affiliation": "Neurocare Clinics, Nijmegen, The Netherlands.",
            "firstname": "Iris",
            "initials": "I",
            "lastname": "van Oostrom"
        },
        {
            "affiliation": "Depression Expertise Centre, Pro Persona Mental Health Care, Nijmegen, The Netherlands.\nBehavioral Science Institute, Radboud University, Nijmegen, The Netherlands.",
            "firstname": "Jan",
            "initials": "J",
            "lastname": "Spijker"
        },
        {
            "affiliation": "Center for Economic Evaluations, Trimbos Institute - Netherlands Institute of Mental Health and Addiction, Utrecht, The Netherlands.",
            "firstname": "Ben",
            "initials": "B",
            "lastname": "Wijnen"
        },
        {
            "affiliation": "Department of Psychiatry, GGZ inGeest Specialized Mental Health Care, Amsterdam, Netherlands.",
            "firstname": "Eric",
            "initials": "E",
            "lastname": "van Exel"
        },
        {
            "affiliation": "Department of Psychiatry & Psychology, St. Antonius Hospital, Utrecht, Nieuwegein, The Netherlands.",
            "firstname": "Hans",
            "initials": "H",
            "lastname": "van Mierlo"
        },
        {
            "affiliation": "Department of Psychiatry, ETZ Hospital (Elisabeth-TweeSteden Ziekenhuis), Tilburg, The Netherlands.",
            "firstname": "Dieuwertje",
            "initials": "D",
            "lastname": "de Waardt"
        },
        {
            "affiliation": "Research Institute Brainclinics, Brainclinics Foundation, Nijmegen, The Netherlands.\nStanford Brain Stimulation Lab, Stanford University, Palo Alto, USA.",
            "firstname": "Martijn",
            "initials": "M",
            "lastname": "Arns"
        },
        {
            "affiliation": "Department of Psychiatry, Radboud University Medical Center, Nijmegen, The Netherlands.\nDonders Institute for Brain Cognition and Behavior, Centre for Medical Neuroscience, Nijmegen, The Netherlands.",
            "firstname": "Indira",
            "initials": "I",
            "lastname": "Tendolkar"
        },
        {
            "affiliation": "Department of Psychiatry, Radboud University Medical Center, Nijmegen, The Netherlands.",
            "firstname": "Joost",
            "initials": "J",
            "lastname": "Janzing"
        },
        {
            "affiliation": "Department of Psychiatry, Radboud University Medical Center, Nijmegen, The Netherlands.\nDonders Institute for Brain Cognition and Behavior, Centre for Medical Neuroscience, Nijmegen, The Netherlands.",
            "firstname": "Philip",
            "initials": "P",
            "lastname": "van Eijndhoven"
        }
    ],
    "conclusions": null,
    "copyrights": "\u00a9 2025. The Author(s).",
    "doi": "10.1007/s00406-025-02012-0\n10.1016/S0140-6736(12)61729-2\n10.1016/S0924-977X(98)00004-2\n10.3928/02793695-20210816-01\n10.1176/ajp.2006.163.11.1905\n10.1038/nn1944\n10.1001/jamapsychiatry.2016.3644\n10.4088/JCP.9078tx1c\n10.1007/s11920-010-0160-4\n10.1176/appi.ajp.161.12.2163\n10.1186/s12916-015-0325-4\n10.1016/j.jad.2014.10.010\n10.1007/s00213-002-1147-6\n10.1016/j.jad.2014.10.047\n10.1002/jclp.20213\n10.1136/jnnp.23.1.56\n10.1111/j.2044-8260.1967.tb00530.x\n10.1097/YCT.0000000000000623\n10.1016/j.eclinm.2022.101765\n10.1176/appi.ajp.20230556\n10.1001/jamanetworkopen.2023.12443\n10.1186/s12888-022-03732-6\n10.1016/j.brs.2008.09.006\n10.1176/appi.ajp.2019.19090915\n10.5935/1984-0063.20220032\n10.1016/j.psc.2009.05.004\n10.1002/wps.20375\n10.1017/S0033291711001905\n10.1177/0013164413495237",
    "journal": "European archives of psychiatry and clinical neuroscience",
    "keywords": [
        "Antidepressants",
        "Depression",
        "Symptom clusters",
        "Treatment resistance",
        "rTMS"
    ],
    "methods": null,
    "publication_date": "2025-04-23",
    "pubmed_id": "40266345\n23245607\n10082232\n34459676\n17074942\n17726478\n28030740\n20667285\n20963521\n15569884\n25879936\n25451401\n12185396\n25487682\n16287149\n14399272\n6080235\n31464814\n36483268\n39108161\n37155164\n35123427\n20539835\n32160765\n19716990\n28127906\n21929846\n25705052",
    "results": "In both the primary and validation analyses, no difference was seen between rTMS and medication on the symptom clusters. Similar patterns of response were observed in all groups, with 'Insomnia' showing the greatest effect of treatment. Baseline cluster scores did not predict treatment response.",
    "title": "A comparison between rTMS and antidepressant medication on depressive symptom clusters in treatment-resistant depression.",
    "xml": "<Element 'PubmedArticle' at 0x788506189a80>"
}