2.1. Participants
MDD, psychotic, psychiatric, DSM-5
DISEASE, DISORDERS, CORTEX, NEUROLOGICAL DISEASE
The study designed as a randomised controlled trial; included 30 patients, aged 18–50 years, who were diagnosed with MDD according to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) criteria as outpatients in the Psychiatry Department of Pamukkale University Faculty of Medicine between October 2019 and July 2020. All the patients had full mental capacity, were literate, had no physical or neurological disease, had not responded to at least two antidepressant medications, one of which was serotonin norepinephrine reuptake inhibitor (SNRI) administered for at least 8 weeks, had no psychotic findings, and were not at severe risk of suicide. A control group was formed of 15 healthy volunteers, matched to the patient group in respect of age, sex and smoking status, and with no familial history of psychiatric disease.The patients were separated into two equal groups in a double-blind, random manner. In one group, 20 sessions of high frequency (10Hz) rTMS were applied to the left dorsolateral prefrontal cortex, and in the other group, 20 sessions of sham TMS. Throughout the study, all the patients continued taking their pharmacological treatments at the same dose. The calculated power (1-beta) was 0.72; considering type 1 error (alfa) of 0.05, sample size of 15, and effect size of 0.44’.