The present study investigated possible therapeutic effects and safety of sequentially combined low-frequency repetitive transcranial magnetic stimulation (rTMS) to the right dorsolateral prefrontal cortex and supplementary motor area in patients with treatment-resistant obsessive-compulsive disorder. Between February 2007 and January 2008, we carried out a study with a rater-blinded, sham-controlled design in which 20 patients with treatment-resistant obsessive-compulsive disorder, confirmed by a psychiatrist after use of the Structured Clinical Interview for DSM-IV Axis I Disorders-Clinician Version, were randomly assigned to either active rTMS (n = 10) or sham treatment (n = 10). Over 10 days, rTMS of 1 Hz was given at 110% of the motor threshold for 20 minutes over the right dorsolateral prefrontal cortex and sequentially at 1 Hz at 100% of the motor threshold for 20 minutes over the supplementary motor area. The primary outcome measure was the Yale-Brown Obsessive Compulsive Scale (YBOCS) score. For the between-group analyses, there were no significant differences over 4 weeks between the active and sham groups on the YBOCS (F = 0.01, P = .92) and the Montgomery-Asberg Depression Rating Scale (MADRS; F = 0.39, P = .54). In repeated-measures analyses on all subjects, there was a significant effect of time on the YBOCS (F = 5.48, P = .009) and the MADRS (F = 6.55, P = .004). There were no significant group-by-time interactions for the YBOCS (F = 0.03, P = .94) or the MADRS (F = 0.09, P = .67). These findings suggest that 10 sessions of sequential rTMS of the right dorsolateral prefrontal cortex and the supplementary motor area at low frequency had no therapeutic effect on obsessive-compulsive symptoms. However, rTMS was a safe method of treatment, and there was no significant change in cognitive function after rTMS. Further controlled studies using a more sophisticated sham system in larger samples are required to confirm the effect of rTMS in obsessive-compulsive disorder. clinicaltrials.gov Identifier: NCT00932204.

Objective: Decline in psychosocial functioning seems to be a core feature in schizophrenia across various phases of the disorder. Little is known about the relationship between psychosocial functioning and protective factors or psychopathologies in individuals in the prodrome phase of psychosis. We aimed to investigate whether psychosocial functioning is impaired in individuals in the putative prodromal phase of schizophrenia, and, if so, to identify factors associated with compromised psychosocial functioning. Method: Sixty participants at ultra-high risk (UHR) for psychosis and 47 healthy controls were recruited. All subjects were assessed in terms of psychosocial functioning using the Quality of Life Scale. A clinical assessment of psychopathology and protective factors, including resilience and coping style, was also conducted. Results: Psychosocial functioning in UHR participants was found to be compromised; this dysfunction was associated with negative symptoms, adaptive coping, and resilience. In addition, baseline resilience was lower among those in the UHR group who converted to frank psychosis than among those who did not. Conclusions: These findings imply that treatment strategies for individuals at UHR for psychosis should be comprehensive, promoting resilience as well as targeting the reduction of positive and negative symptoms to foster social reintegration and recovery.