Kfir Feffer

Objectives: To assess 24-month clinical outcomes of vagus nerve stimulation (VNS) in individuals with higher-grade treatment-resistant depression (HG-TRD) treated within a national open-label program, focusing on depressive severity, suicidality, safety, tolerability, and rates of response and remission. Methods: A prospective, open-label, multicenter cohort study was conducted on 19 patients who underwent VNS implantation between 2020 and 2023. Clinical assessments were performed at baseline and at 6, 12, 18, and 24 months. Depressive symptoms were evaluated using the Montgomery-Åsberg Depression Rating Scale (MADRS), including item 10 for suicidality. Outcomes included mean percentage change in MADRS scores, rates of response, remission, partial response, adverse events, and adherence. Sixteen participants completed the 24-month follow-up. All analyses were exploratory. Results: MADRS scores decreased significantly by 6 months ( P P <0.001) and this improvement persisted throughout follow-up. No serious safety concerns were identified. Tolerability and long-term adherence were high, with most patients continuing active device use throughout the study period. Conclusions: In this open-label, multicenter cohort of individuals with HG-TRD, VNS was associated with substantial and durable reductions in depressive severity and suicidality over 24 months. Despite limitations related to sample size and lack of a control group, the magnitude and persistence of clinical benefit support VNS as a viable long-term treatment for carefully selected patients with severe, highly resistant depression.

Caregivers of persons with mental illness experience stressors and anxiety during the psychiatric hospitalization of a family member. The implementation of a family-centered model could reduce these feelings, and therefore, such a model was developed in Israel. To examine whether the model's implementation makes a difference in the stress and anxiety experienced by caregivers, a comparative study was conducted in two psychiatric hospitals. Questionnaires were delivered twice to caregivers in an intervention group ( n = 93) and a control group ( n = 75). The anxiety level was lower in the intervention group than in the control group in the second delivery of the questionnaire. In addition, a lower level of anxiety was found in the intervention group in the second delivery of the questionnaire in comparison to the first. The findings, which can be attributed to the model's application, highlight the need for a paradigm shift to a family-centered model in psychiatric hospitals.