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Type of Resource (primo): dissertations
Name: Personal
Name: Personal
Name: Corporate
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Note: thesis: Thesis (Sc. M.)--Brown University, 2023
Genre (aat): theses
Abstract: Background: Health practitioners have a growing understanding of the impact of social determinants on patients' mental health outcomes. However, little research exists on how a depressed patient’s social wealth affects their access to and clinical benefit from Transcranial Magnetic Stimulation (TMS) therapy. TMS represents an effective treatment for potentially vulnerable patients with Major Depressive Disorder (MDD). An analysis of a TMS patient cohort’s social needs could offer valuable insights to inform holistic mental health care and aid in the identification of barriers to TMS. In this pursuit of comprehensive psychiatric care, it is important to understand the effect of social needs on patient response to TMS treatment; we anticipated that TMS treatment non-responders have greater social needs than responders. Methods: We performed a retrospective analysis of data obtained from patients who underwent an acute series of TMS therapy at Butler Hospital between 2019 and 2021 for MDD. Inventory of Depressive Symptomatology-Self Report (IDS-SR) scores were utilized to measure depressive symptom severity and to define response and remission. To assess patients' levels of social assets, we implemented a modified version of The Accountable Health Communities Health-Related Social Needs (AHC-HRSN) Screening Tool as a self-report measure, with questions added to explore community engagement. Results: Data was collected for n=74 patients. We found that patients who had accessed TMS were generally characterized by minimal deficits regarding basic needs and substance use. A majority reported social isolation and disabling symptom burden. Our regression models identified thirteen possible predictors of response to TMS. Patients in our cohort showed areas of significant improvement in self-reported social needs after a series of TMS treatments. Conclusion: This cohort had elevated levels of social assets, though depressive symptoms may contribute to disengagement with others and the community. Depressed patients show some areas of significant improvement in self-reported social needs after a series of TMS treatments. These results highlight the potential to provide additional patient support and for creating opportunities to connect patients with higher social burdens to TMS. Further exploration is needed to fully elucidate the relationship between determinants and TMS patient outcomes.
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Subject (fast) (authorityURI="http://id.worldcat.org/fast", valueURI="http://id.worldcat.org/fast/01005663")
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