A Study of Attitudes Towards Transcranial Magnetic Stimulation for Treating Depression

Background. Transcranial Magnetic Stimulation (TMS), a non-invasive brain stimulation method, is a first-line treatment for patients with treatment-resistant depression (TRD). However, its implementation in Georgia remains limited due to knowledge gaps, a lack of systemic support, and cultural barriers.

Objective. This study examined the perspectives of patients and therapists towards the newly established TMS service at Ilia State University, which was supported by the Competitive Innovations Fund (CIF). It focused on motivations for engaging in treatment, experiences with the service, and perceived barriers to service utilisation.

Methods. A qualitative design was employed, combining case studies and a focus group. Two patients with TRD who completed the full TMS course alongside psychopharmacological treatment were interviewed both clinically and in-depth, and their clinical documentation was analysed. Additionally, a focus group was conducted with five therapists involved in providing TMS care.

Results. Patients were motivated by renewed hope after long-term, ineffective treatment. Barriers included depressive symptoms, stigma, and anxiety about the unfamiliar method. Therapists initially expressed ambivalence, which shifted to professional satisfaction and trust in the method as they observed improved clinical outcomes in the patients and sustained patient well-being.

Conclusion. Despite existing challenges, accurate information, combined treatment approaches, and supportive care increase the acceptability and effectiveness of TMS. Key obstacles remain, including a lack of professional training, absence of clear and patient-friendly information about the method and adapted clinical protocols; yet, patient motivation and hope appear to be decisive factors in treatment engagement.