Major depressive disorder (MDD) significantly impacts mood, cognitive function, and psychological defense structures. While repetitive Transcranial Magnetic Stimulation (rTMS) is an established non-invasive neuromodulation therapy for depression, its influence on psychodynamic constructs such as defense mechanisms remains insufficiently explored.
This single-center prospective study will enroll 50 adult participants (aged 18-65) diagnosed with non-psychotic MDD according to DSM-5 criteria (confirmed via SCID-5). Participants will receive rTMS treatment as part of their standard clinical care. Clinical assessments will be conducted by a blinded researcher at three time points: baseline (pre-treatment), 1 month, and 3 months post-baseline.
Primary outcomes will measure shifts in defense mechanism styles (mature, neurotic, immature) using the Defense Style Questionnaire (DSQ). Secondary outcomes will assess depressive symptom severity (Hamilton Depression Rating Scale - HAM-D), anxiety levels (Hamilton Anxiety Rating Scale - HAM-A), clinical severity and improvement (Clinical Global Impression Scale - CGI), and functional impairment (World Health Organization Disability Assessment Schedule 2.0 - WHODAS 2.0).
