Abstract
Background:Deep brain stimulation (DBS) is under investigation for severe obsessive-compulsive disorder (OCD) resistant to other therapies. The number of implants worldwide is slowly increasing. Therefore, it is of importance to explore knowledge and concerns of this novel treatment among patients and their psychiatric healthcare contacts. This information is relevant for scientific professionals working with clinical studies for DBS for this indication. Especially, for future study designs and the creation of information targeting healthcare professionals and patients. The aim of this study was to explore the knowledge and concerns toward DBS among patients with OCD, psychiatrists, and cognitive behavioral therapists.Methods:The study was conducted through web-based surveys for the aimed target groups –psychiatrist, patients, and cognitive behavioral therapists. The surveys contained questions regarding previous knowledge of DBS, source of knowledge, attitudes, and concerns towards the therapy.Results:The main source of information was from scientific sources among psychiatrists and psychotherapists. The patient's main source of information was the media. Common concerns among the groups included complications from surgery, anesthesia, stimulation side effects, and the novelty of the treatment. Specific concerns for the groups included; personality changes mentioned by patients and psychotherapists, and ethical concerns among psychiatrists.Conclusion:There are challenges for DBS in OCD as identified by the participants of this study; source and quality of information, efficacy, potential adverse effects, and eligibility. In all of which the current evidence base still is limited. A broad research agenda is needed for studies going forward.
Highlights
Obsessive‐compulsive disorder (OCD) is a chronic disorder affecting approximately 2% of the population
Three web‐based surveys were constructed for psychiatrist, therapists with experience of cognitive behavioral therapy (CBT), and obsessive‐compulsive disorder (OCD) patients, respectively
With the FDA approval for a “humanitarian device exemption” and the expected increase in number of worldwide implantations, Deep brain stimulation (DBS) for OCD may be moving from experimental to limited clinical use, increasing the number of potential patients that will be in need of ongoing follow‐up care by professionals in mental healthcare.[1,21]
Summary
Obsessive‐compulsive disorder (OCD) is a chronic disorder affecting approximately 2% of the population. DBS is an established treatment for severe therapy‐refractory Parkinson’s disease, dystonia, and essential tremor and is currently evaluated for a number psychiatric disorders.[19] One of the most well‐studied psychiatric disorders is OCD. The question remains how come there are no more than about 100 patients reported to have undergone DBS for OCD in the literature, despite 17 years since the first publication, the debilitating symptoms in the severe form of the disorder, lack of therapeutic options, and promising results of DBS? It is of importance to explore knowledge and concerns of this novel treatment among patients and their psychiatric healthcare contacts. This information is relevant for scientific professionals working with clinical studies for DBS for this indication. The aim of this study was to explore the knowledge and concerns toward DBS among patients with OCD, psychiatrists, and cognitive behavioral therapists
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