This open naturalistic study aims to evaluate the efficacy of rTMS in routine practice on auditory resistant hallucinations (AHR) of patients with schizophrenia. To this end, two stimulation methods will be offered to patients: the rTMS stimulation method and the cTBS stimulation method.We principally use the AHRS scale to evaluate the effectiveness of rTMS on RAH in patients with schizophrenia. Our main hypothesis is that rTMS used under naturalistic conditions, in addition to antipsychotics, would allow a relative improvement of resistant auditory hallucinations assessed by the AHRS scale between baseline and end of treatment in patients with schizophrenia.
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
TREATMENT
Masking
TRIPLE
Enrollment
30
The patient receives treatment under naturalistic conditions in routine practice.
The patient receives the treatment under naturalistic conditions in routine practice.
Etablissement Public de Santé de Ville-Evrard
Neuilly-sur-Marne, France
RECRUITINGThe evolution will be evaluated mainly with the AHRS (Auditory Hallucinations Rating Scale)
Refer to the definition of AHRS above (in Primary Outcome Measure)
Time frame: Baseline and at the end of the treatment, also at 1 month and 3 months after the end of the treatment
Response rate: a response is defined as a decrease greater than or equal to 30% of total AHRS score from baseline to end of treatment.
Refer to the definition of AHRS above
Time frame: Baseline and at the end of the treatment
Rate of patients with an end-of-treatment score < 3 on the Positive And Negative Syndrome Scale (PANSS) "Hallucinatory Behavior" item
The PANSS is a 30 items scale rated from 1 (absent) to 7 (extreme), that assesses psychopathological symptoms observed in patients with psychotic states, particularly schizophrenia.
Time frame: Baseline and at the end of the treatment
Cognitive symptoms: Montreal Cognitive Assessment (MOCA), Stroop
The MoCA scale is the most sensitive rapid assessment test and provides the broadest evaluation of cognitive functions (attention, concentration, executive functions, memory, language, visualconstructive abilities, abstraction, calculation, orientation). It tends to replace the MMSE in clinical practice. A score \< 26 (25 if cultural level \< 3 = primary diploma = CEP) is considered abnormal. The Stroop scale evaluates the capacity for attention and inhibition; thus, it allows to measure the level of interference generated by the automatisms in the accomplishment of a task. The result of the test allows us to see if the person is correctly inhibiting the response (values greater than 0, positive) or if there are significant interference problems (if it is a negative value).
Time frame: Baseline and 1 month after the end of treatment
Addictive attitudes: number of cigarettes/d (tobacco), The Cannabis Abuse Screening Test (CAST), Marijuana Craving Questionnaire (MCQ)
The CAST is a 6-item scale for identifying problematic cannabis use. Each of these items describes use behaviors or problems encountered with cannabis use. The CAST score determines the patient's level of dependence. A score of 1 or less means low risk. A score of 2 means moderate risk. A score of 3 or higher means high risk. The MCQ self-report scale is a questionnaire on marijuana craving. It consists of four constructs or factors that characterize cannabis craving: compulsivity, emotionality, expectancy and determination. A separate score is calculated for each factor. The MCQ can be used to measure cue-induced craving in a research setting or natural craving in cannabis-dependent individuals presenting for treatment.
Time frame: Baseline and at the end of the treatment
Mood: Calgary Depression Scale for Schizophrenia (CDSS)
The CDSS, is designed to assess depression in people with schizophrenia. It takes into account negative symptomatology and possible extrapyramidal effects of neuroleptics. The questionnaire consists of 9 items covering the last 2 weeks. Each item is evaluated on a 4 points Likert scale ranging from : "Absent" (0) to "Severe" (3). The total score is obtained by adding the items and gives a score out of 27.
Time frame: Baseline and the end of the treatment
Quality of life: The Subjective Quality of Life Scale (S-QoL)
The SQoL questionnaire is a self-administered quality of life scale that assesses quality of life in people with schizophrenia from the patient's perspective. The questionnaire has 18 items, each item is rated on a 4 points Likert scale ranging from: "Much less" to "More than desired". Scores range from 0 to 100; higher scores represent better quality of life.
Time frame: Baseline and end of treatment, also at 1 month and 3 months after the end of the treatment
Clinical Global Impressions (CGI) Scale
Clinical Global Impression (CGI) scales are measures of symptom severity, response to treatment, and treatment effectiveness in treatment studies of patients with mental disorders.
Time frame: Baseline and end of treatment, also at 1 month and 3 months after the end of the treatment
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