Acceptability of active and sham home-based transcranial direct current stimulation in major depression: mixed methods qualitative analysis in a randomised controlled trial

Sep 30, 2026

Transcranial direct current stimulation (tDCS) is positioned as a novel, non-invasive option for major depressive disorder (MDD), yet participant acceptability is often inferred indirectly through attrition, satisfaction ratings, and adverse events. This study examines acceptability through structured questionnaires and individual interviews within a remote, multisite, double-blind, placebo-controlled randomized superiority trial of a 10-week home-based tDCS course. Four themes—acceptability, ease of use, side effects, and trial participation—indicate generally high acceptability alongside concerns about device functionality and side effects.

LanguageEnglish

CategoryResearch & Report

FormatPDF

Pages12

Reading Time30 min

AccessFree to download

Abstract

Introduction

Acceptability as a multifaceted concept

Frameworks for assessing acceptability

Context: MDD treatments and tDCS background

Methods

Results

Conclusions

Lagerberg etal. Annals of General Psychiatry (2026) 25:1 [https://doi.org/10.1186/s12991-025-00607-4](https://doi.org/10.1186/s12991-025-00607-4) Annals of General Psychiatry RESEARCH Open Access Acceptability of active and sham home-based transcranial direct current stimulation in major depression: mixed methods qualitative analysis in a randomised controlled trial Peter J. Lagerberg 1*, Rachel D. Woodham 1, Sudhakar Selvaraj2,3, Nahed Lajmi 1, Harriet Hobday 1, Gabrielle Sheehan 1, Ali-Reza Ghazi-Noori 1, Maheen Rizvi2, Sarah S. Kwon2, Paulette Orhii2,4, Rodrigo Machado-Vieira2, Jair C. Soares2, Allan H. Young5,6,7, António R. Fidalgo 1, Hakimeh Rezaei 1,5,8 and Cynthia H. Y. Fu 1,5,6* Abstract Purpose Transcranial direct current stimulation (tDCS) is a novel non-invasive brain stimulation therapy that is a potential treatment for major depressive disorder (MDD) . Acceptability impacts patient preference, treatment adherence and outcomes, however, it has typically been assessed through measures of attrition, self-reported satisfaction levels, or adverse events. We sought to explore participant acceptability using structured questionnairesand individual interviews. Methods Acceptability was assessed in a fully remote, multisite, double-blind, placebo-controlled, randomized superiority trial of a 10-week course of home-based tDCS for MDD. Questionnaires were conducted at baseline and atthe 10-week end of treatment. Participants were 174 adults (120 women) with MDD in a current depressive episode of at least moderate severity. Active or sham tDCS was self-administered over 10 weeks with remote supervision at regular intervals. A thematic analysis was conducted. Results Four themes were revealed: acceptability, ease of use, side effects, and trial participation. The themes indicated generally high acceptability of tDCS as a treatment of MDD in both the active and sham treatment groups. Some participants noted concerns about the technical functionality of the device and the impact of side effects. Conclusions The first three themes are central to understanding participant perspectives oftDCS and its feasibility as a treatment option. In addition, the theme of trial participation highlights the value of participant support when introducing a new treatment, which may underscore treatment options in general. Furthermore, acceptability is a dynamic concept as participant views changed during treatment. Trial registration NCT05202119, registered on 9th January 2022. *Correspondence: Peter J. Lagerberg [u1909705@uel.ac.uk](u1909705@uel.ac.uk)[ ](u1909705@uel.ac.uk)Cynthia H. Y. Fu [c.fu@uel.ac.uk](c.fu@uel.ac.uk); [cynthia.fu@kcl.ac.uk](cynthia.fu@kcl.ac.uk) Full list of author information is available at the end of the article © The Author(s) 2025. Open Access This article is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License, which permits any non-commercial use, sharing, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if you modified the licensed material. You do not have permission under this licence to share adapted material derived from this article or parts of it. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit [http://creati](http://creati)[vecommons.org/l](vecommons.org/l)icenses/by-nc-nd/4.0/. Lagerberg et al. Annals of General Psychiatry (2026) 25:1 Page 2 of 12 Keywords Major depression, Transcranial dire

FAQs

How was acceptability evaluated in this trial?

Acceptability was assessed using structured questionnaires at baseline and at the 10-week end of treatment, along with individual interviews. A thematic analysis was then conducted.

What trial design and treatment delivery method were used?

The study was a fully remote, multisite, double-blind, placebo-controlled randomized superiority trial. Participants received a 10-week course of home-based active or sham tDCS with remote supervision at regular intervals.

What themes emerged regarding participant experiences?

Four themes were identified: acceptability, ease of use, side effects, and trial participation. Overall acceptability was generally high, though some participants reported concerns about technical functionality and side effects.

Sep 30, 2026

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