iTBS-Neurosplasticity for Female Youth With Depression

TBs

Inclusion criteria

• are assigned female sex at birth;
• are 16yo to 24yo;
• outpatients;
• are competent to assent (those age 16-18) or consent to participate (those age 19-24);
• have a Diagnostic and Statistical Manual of Mental Disorders Fifth edition (DSM 5) diagnosis of Major Depressive Episode by Mini-International Neuropsychiatric Interview (MINI) version 7.0.0 for participants aged 18-24 and Adolescents (MINI-KID) for participants aged 16-17;
• have a score ≥ 18 on the Hamilton Depression Rating Scale (HDRS-17 item) or Depressive symptom severity as shown by a total Children's Depression Rating Scale Revised (CDRS-R) score 40;
• have not changed dose or initiated a new regular antidepressant or antidepressant augmentation treatment(s) for 4 weeks prior to starting TMS treatment;
• are able to adhere to the treatment schedule;
• pass both the TMS and MRI adult safety screening questionnaires.

Exclusion criteria

• have Moderate or Severe Substance Use Disorder (except tobacco) within the last three (3) months;
• have a concomitant major unstable medical illness;
• have active suicidal intent;
• have not responded to 2 or more adequate trials of antidepressant medication in the current episode as meassured by the ATHF form
• are pregnant or planning to become pregnant during the study period;
• have a lifetime (MINI) diagnosis of any psychotic disorder;
• have a MINI anxiety disorder or personality disorder assessed by a study investigator to be primary and causing greater impairment than MDE;
• have previously had ECT or rTMS;
• have any significant neurological disorder or any significant head trauma with clear radiological evidence of cerebrovascular injury on imaging.
• have any intracranial implant (e.g., aneurysm clips) or any other metal object within or near the head, excluding the mouth, that cannot be safely removed;
• have history of epilepsy
• are participating in standardized regular psychotherapy provided by a psychiatrist or a registered psychologist for less than 3 months prior to study entry or planning to start during the course of rTMS treatments;
• have a clinically significant laboratory abnormality, in the opinion of the one of the principal investigators;
• have a non-correctable clinically significant sensory impairment (i.e., cannot hear well enough to cooperate with interview);