28th National Clinical Education Symposium Presentation Abstracts

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OP-02 Treatment Conditions for Patients with Dementia in Forensic Psychiatry: Population-Specific Features and Critical Perspectives on Current Practice - Page 56
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OP-04 Comparison of the Heart-Brain Coupling Paradigm Between the Dorsomedial and Dorsolateral Prefrontal Cortices and Evaluation of Its Association with Response to Accelerated iTBS Treatment Targeting the Dorsomedial Prefrontal Cortex - Page 60
Ali Tarık Altunç, , Melike Nur Altunç, , Yusuf Çiçek, , Ahmet Torun, , Sarp Yoldas, , Burç Çağrı Poyraz

OP-05 Associations Between Suicide Attempt Severity and Routine Inflammatory and Hematological Markers - Page 62
Hale Rodriguez Camacho, Fatih Ekici

OP-06 Post-Traumatic Stress Disorder and Complex Post-Traumatic Stress Disorder in Fibromyalgia: A Pilot Study - Page 63
Cansu Ünsal Mavi, , Öznur Dilara Tüzün, , Rabia Bahar Demircan Endeş, , Asude Ak, , Meltem Karaatlı Erdoğan

OP-07 Association Between Smartphone Addiction and Attention Performance - Page 65
Taylan Tanışan, , Süheyla Ünal

20 APRIL 2026, MONDAY
08:45 - 10:00 OP-01 Repetitive Transcranial Magnetic Stimulation (rTMS) Treatment Response in Major Depression: Associations with Anger Expression Styles and Somatic Symptoms

OP-01 Repetitive Transcranial Magnetic Stimulation (rTMS) Treatment Response in Major Depression: Associations with Anger Expression Styles and Somatic Symptoms

Elif Poyraz1, Onur Durmaz1

1. Psychiatry Department, Erenkoy Mental and Nervous Diseases Training and Research Hospital, Istanbul, Turkiye

DOI: 10.5080/61upk.ozt420 Page 54

BACKGROUND AND AIM:Major depressive disorder (MDD) is frequently accompanied by anger regulation difficulties and prominent somatic symptoms, increasing overall clinical burden. Although repetitive transcranial magnetic stimulation (rTMS) is an established treatment for depression, its relationship with anger expression styles and somatic symptom severity remains unclear. This study aimed to evaluate clinical changes following rTMS in patients with MDD and to examine the associations between anger expression styles, particularly suppressed anger (anger-in), somatic symptoms, and treatment response.
METHODS (Ethics Committee Approval must be obtained and the number should be specified.):This prospective observational study included 30 patients diagnosed with unipolar MDD according to DSM-5 criteria. All patients received 20 sessions of rTMS targeting the left dorsolateral prefrontal cortex (20 Hz, 100% motor threshold, 2000 pulses per session). Depression (HAMD), anxiety (HAMA), somatic symptoms (PHQ-15), pain severity (VAS), quality of life (SF-12), and anger dimensions (STAXI-2) were assessed before and after treatment. Ethical approval was obtained from the institutional ethics committee. (30.05.2024/26).
RESULTS:The mean age of the participants was 42.9 ± 12.9 years, and 70% were female. rTMS was associated with significant reductions in depressive symptoms (HAMD: 16.63 ± 4.56 to 10.13 ± 6.28, p < 0.001), with remission observed in 33.3% and clinical response in 40% of patients. Anxiety, somatic symptoms, and pain severity also improved significantly (all p ? 0.001). State anger did not change following treatment. Baseline anger-in levels were not associated with changes in somatic symptoms, and baseline PHQ-15 scores were not related to antidepressant response (p > 0.05). Higher trait anger and lower anger control were associated with greater reductions in pain severity.
CONCLUSIONS:rTMS was associated with significant improvements across affective, somatic, and pain-related domains in MDD. Anger expression styles did not predict overall treatment response but showed a symptom-specific association with pain outcomes, suggesting that anger-related traits may represent relatively stable Keywords: depression, pain, rTMS, quality of life, anger, somatic symptoms