Non-invasive brain stimulation combined with psychosocial intervention for depression: A systematic review and meta-analysis

He, Jiali; Tang, Yiling; Lin, Jingxia; Faulkner, Guy; Tsang, Hector W. H.; Chan, Sunny H. W.

Abstract

Objectives: This review investigates the efficacy and safety of non-invasive brain stimulation (NIBS) combined with psychosocial intervention on depressive symptoms. Materials and methods: We systematically searched five electronic databases from their inception to June 2021: PubMed, Embase, PsycINFO, Web of Science, and Medline. Randomized or non-randomized clinical trials in which NIBS plus psychosocial intervention was compared to control conditions in people with depressive symptoms were included. Results: A total of 17 eligible studies with 660 participants were included. The meta-analysis results showed that NIBS combined with psychosocial therapy had a positive effect on moderate to severe depression ([SMD = − 0.46, 95%CI (− 0.90, − 0.02), I2 = 73%, p <.01]), but did not significantly improve minimal to mild depression ([SMD = − 0.12, 95%CI (− 0.42, 0.18), I2 = 0%, p =.63]). Compared with NIBS alone, the combination treatment had a significantly greater effect in alleviating depressive symptoms ([SMD = − 0.84, 95%CI (− 1.25, − 0.42), I2 = 0%, p =.93]). However, our results suggested that the pooled effect size of ameliorating depression of NIBS plus psychosocial intervention had no significant difference compared with the combination of sham NIBS [SMD = − 0.12, 95%CI (− 0.31, 0.07), I2 = 0%, p =.60] and psychosocial intervention alone [SMD = − 0.97, 95%CI (− 2.32, 0.38), I2 = 72%, p =.01]. Conclusion: NIBS when combined with psychosocial intervention has a significant positive effect in alleviating moderately to severely depressive symptoms. Further well-designed studies of NIBS combined with psychosocial intervention on depression should be carried out to consolidate the conclusions and explore the in-depth underlying mechanism.

• Journal Article Type: Article
• Acceptance Date: Mar 7, 2022
• Online Publication Date: Apr 19, 2022
• Publication Date: Dec 1, 2022
• Deposit Date: Oct 30, 2022
• Publicly Available Date: Oct 31, 2022
• Journal: BMC Psychiatry
• Electronic ISSN: 1471-244X
• Publisher: BioMed Central
• Peer Reviewed: Peer Reviewed
• Volume: 22
• Issue: 1
• DOI: https://doi.org/10.1186/s12888-022-03843-0
• Keywords: Psychiatry, Mental health, NIBS, Psychosocial intervention, Depression, Systematic review, Meta-analysis
• Public URL: https://uwe-repository.worktribe.com/output/10110459
• Publisher URL: https://bmcpsychiatry.biomedcentral.com/articles/10.1186/s12888-022-03843-0
• Additional Information: Received: 26 August 2021; Accepted: 7 March 2022; First Online: 19 April 2022; : ; : Not applicable. The manuscript does not contain clinical studies or patient data.; : Not applicable.; : The authors declare there is no conflict of interest.