Abstract
Background and aims: Schizophrenia is one of the most complicated psychiatric disorders. Some afflicted patients show resistance to routine treatments. Repetitive transcranial magnetic stimulation (rTMS) is a noninvasive brain stimulation technique with the potential to reduce symptoms among patients with schizophrenia. The aim of this study was to evaluate the effects of high-frequency rTMS on auditory hallucinations and working memory among patients with schizophrenia. Methods: This experimental study was conducted using a pretest-posttest controlled design. The statistical population of the study consisted of all patients with schizophrenia and auditory hallucinations who referred to the outpatient psychiatric emergency department of Imam Hossein hospital, Tehran, Iran, in 2019. In total, twelve eligible patients were recruited through convenience sampling and randomly allocated to a control and an intervention group. Participants in the intervention group individually received rTMS in ten sessions, while their counterparts in the control group received no intervention during the study. Data were collected using the diagnostic interview, the screening questionnaire for rTMS, the Positive and Negative Syndrome Scale for schizophrenia, the Varieties of Inner Speech Questionnaire, and the Working Memory Measure. Data analysis was performed using univariate and multivariate analyses of covariance. Results: The posttest mean score of auditory hallucination in the intervention group was significantly less than the control group, while the posttest mean score of working memory in the intervention group was significantly greater than the control group (P<0.05). Conclusion: This study suggests the effectiveness of rTMS in significantly reducing auditory hallucinations and improving working memory among patients with schizophrenia.
Highlights
Schizophrenia is one of the most bizarre and most complicated psychiatric disorders
The statistical population of the study consisted of all patients with schizophrenia and auditory hallucinations who referred to the outpatient psychiatric emergency department of Imam Hossein hospital, Tehran, Iran, in 2019
Inclusion criteria were an age of 20–45 years, an intelligent quotient of more than 80, definite diagnosis of auditory verbal hallucinations according to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), medication resistance determined by treatment failure with at least two different psychiatric medications, normal intracranial pressure, no instability in health status, no history of drug abuse, no serious medical disorder, no risk of post-Repetitive transcranial magnetic stimulation (rTMS) convulsion due to medical or neurological disorders, no pregnancy, no history of neurosurgery or cerebral injuries or disorders, no comorbid psychiatric disorder, and consent for participation
Summary
Schizophrenia is one of the most bizarre and most complicated psychiatric disorders. It is characterized by severe alterations in perception, thinking, action, selfconcept, and interpersonal communications [1]. Patients with schizophrenia experience alterations in cognitive functions such as speech perception, memory, planning, and attention. They usually talk with themselves or hear sounds in the brain [8]. Repetitive transcranial magnetic stimulation (rTMS) is a noninvasive brain stimulation technique with the potential to reduce symptoms among patients with schizophrenia. The aim of this study was to evaluate the effects of high-frequency rTMS on auditory hallucinations and working memory among patients with schizophrenia. Conclusion: This study suggests the effectiveness of rTMS in significantly reducing auditory hallucinations and improving working memory among patients with schizophrenia.
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