 It has been empirically demonstrated that these widely recognized instruments have significant reliability and internal consistency. Inter - rater reliability will be insured through observation and comparison. One psychiatrist will be the rater for the TMS plus medication group and another psychiatrist will be the rater for the medication group. Both researchers are experienced clinicians and both will subscribe to generally accepted and clearly defined scoring criteria and scoring rules. Additional efforts to maximize inter - rater consistency by providing these raters with the opportunity to discuss previous practical experience as raters utilizing these particular instruments as well as practice rating exercises. Statistically, the degree of consistency between the two psychiatrists will be determined by calculating of a coefficient of correlation or coefficient of inter - scorer reliability. 