Does Nurse Semi Structured Interview Added to a rTMS Improve Patients With Major Depressive Disorder?
Condition: Depressive Disorder, Major
MeSH terms: Depressive Disorder; Depression; Depressive Disorder, Major
Study type: Interventional

Summary: 
      Repeated Transcranial Magnetic Stimulation - R.TMS - is currently part of the treatment for
      depressive illness. This non-invasive technique is designed to stimulate certain areas of the
      cerebral cortex involved in this pathology. FDA approved this treatment in routine for
      depressive illness. R.TMS still remains in assessment. Due to the heterogeneity of methods
      and the weakness of the cohorts therapeutic superiority can not concluded .

      Stimulation parameters remain numerous even if a consensus is beginning to emerge. The
      therapeutic target is the left dorso - lateral prefrontal cortex. The lack of efficacy is
      probably due of the inaccuracy. The empirically location of the target does not take into
      account the inter-individual anatomical differences. The neuronavigation is becoming
      widespread in routine clinical practice.

      The referent nurse stays with the patient all along the rTMS sessions. His role is to set up
      treatment, to ensure the safety and the well-being of the patient. An rTMS session is an
      average of 30 minutes and is a very special moment to create a specific therapeutic
      relationship.

      No study was conducted to evaluate the therapeutic relationship. The assumption is made that
      rTMS with a semi - structured interview provides a qualitative and quantitative clinical
      response greater than a semi - structured rTMS without this nursing care. The investigators
      therefore propose to patients not receiving a semi-structured interview to listen to music
      with eyes closed.
    

Detailed description: 
      Repeated Transcranial Magnetic Stimulation - R.TMS - is currently part of the treatment for
      depressive illness. This non-invasive technique is designed to stimulate certain areas of the
      cerebral cortex involved in this pathology. The Food & Drug Administration - FDA - approved
      this treatment in routine for depressive illness. R.TMS still remains in assessment. Due to
      the heterogeneity of methods and the weakness of the cohorts therapeutic superiority can not
      concluded . Stimulation parameters remain numerous even if a consensus is beginning to
      emerge. The therapeutic target is the left dorso - lateral prefrontal cortex. The lack of
      efficacy is probably due of the inaccuracy. The empirically location of the target does not
      take into account the inter-individual anatomical differences. The neuronavigation is
      becoming widespread in routine clinical practice.

      The referent nurse stays with the patient all along the rTMS sessions. His role is to set up
      treatment, to ensure the safety and the well-being of the patient. An rTMS session is an
      average of 30 minutes and is a very special moment to create a specific therapeutic
      relationship. To our knowledge, no study was conducted to evaluate the therapeutic
      relationship. The assumption is made that rTMS with a semi - structured interview provides a
      qualitative and quantitative clinical response greater than a semi - structured rTMS without
      this nursing care. The investigators, therefore propose to patients not receiving a
      semi-structured interview to listen to music with eyes closed.
    

Intervention name(s): nurse semi-structured interview; Music & Relaxation with eyes closed
Intervention type(s): Other; Other
Intervention description(s): The first session of rTMS is D1. From the first meeting to D14 semi -structured interviews are set up; The first session of rTMS is D1. From the first meeting to D14 music & relaxation with eyes closed sessions are set up
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Outcomes Assessor)
Primary purpose: Treatment