Repetitive transcranial magnetic stimulation (rTMS) was developed as a noninvasive neuromodulation therapy for treatment-resistant depression, but it has not been applied in the clinical setting in Japan. The ECT and rTMS Review Committee of the Japanese Society of Psychiatry and Neurology (JSPN) conducted a questionnaire survey focused on psychiatric specialists to assess their interest and opinions regarding the introduction of rTMS therapy for depression to the clinical setting in Japan.
 The subjects of this questionnaire survey were representatives of 1,318 nationwide training facilities for psychiatric specialists certified by the JSPN, and the response rate was 53.9%. Of the responding facilities, 64.0% had obtained information about rTMS from medical journals and 9.6% had never obtained information on rTMS. Concerning the application of rTMS therapy for depression in the clinical setting in Japan, 60.3% of the responding facilities answered that it would be better, and 4.8% answered that there was "no need" for its introduction. Concerning potential problems with the future approval of rTMS therapy in the clinical setting in Japan, 62.7% of the responding facilities answered that there was insufficient evidence for the therapeutic benefits; 56.0% indicated that the differences in indications between rTMS therapy and other existing therapies was unclear;and 50.2, 57.9, and 51.2% stated that there was insufficient information on rTMS equipment manipulation and techniques, equipment and personnel costs involved in the introduction of rTMS, and its economic profitability, respectively. In addition, 90.0% of the responding facilities indicated that treatment guidelines for rTMS by academic societies were necessary, and 63.2% desired a training seminar to regulate rTMS operations.
 This questionnaire survey suggested that psychiatric specialists are interested in rTMS and the majority of them desired the introduction of rTMS therapy for depression to the clinical setting in Japan. On the other hand, they also recognized several problems with its introduction and the necessity of treatment guidelines and training seminars for rTMS therapy. Based on the results of this study, it is necessary to work for the appropriate, safe, and effective clinical application of rTMS therapy for depression in Japan.
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