Transcranial Direct Current Stimulation (tDCS) and online wellbeing training used at home for perinatal and maternal loss patients with adiagnosis of depression: depression, real world-functioning, and quality of life outcomes

Abstract

Background: There is a high prevalence of depression in the perinatal period and for women who experience maternal loss, which is linked to worse real-world functioning and quality of life. Research evidence indicates that transcranial direct current stimulation (tDCS) can reduce symptoms of depression. Flow FL-100 is a tDCS device self-administered by a patient at home in combination with a software application-delivered wellbeing behaviour therapy training. Training modules include: “Behaviour activation”, “Mindfulness”, “Exercise for your brain”, “An anti-depression diet”, and “Therapeutic sleep”. Purpose/Aim: This study is the first to introduce Flow FL-100 tDCS in combination with a software application-delivered wellbeing behaviour therapy training into a Specialist Perinatal Mental Health Service and Maternal Mental Health Service. In addition to the support and interventions provided by these services, this study investigated the impact on depression, real-world functioning, and health-related quality of life for patients diagnosed with depression. Methods: An open-label patient cohort design with no control group. Baseline and 6-week follow-up assessments were completed using the participant self-report measures: Patient Health Questionnaire (PHQ-9), Work and Social Adjustment Scale (WSAS), and EuroQol five-dimension (EQ-5D-5L). Results: Twenty-five female patients completed six weeks of tDCS treatment. Their average age was 36 years, and their ages ranged from 27 to 42 years. Reliable improvement and remission rates for PHQ-9 were 64% and 52%, respectively. PHQ-9 and WSAS scores significantly improved, with large effect sizes. EQ-5D-5L results showed significant improvements in the EQ health index score and EQ-VAS score, with medium effect sizes. Conclusion: tDCS and online wellbeing behaviour therapy training can be successfully integrated into Perinatal Mental Health Service and Maternal Mental Health Service depression treatment offer. This study’s findings provide evidence that tDCS and online wellbeing behaviour therapy training delivered in conjunction with the interventions provided by Specialist Perinatal Mental Health and Maternal Loss Psychology Services for patients with depression diagnosis can provide improvements in depression symptoms, functioning and quality of life. It is important to be able to offer an evidence-based addition and/or alternative to existing depression treatments (antidepressant medication and psychotherapies).