Abstract
Over two decades ago, the first scientific publication on deep brain stimulation (DBS) in psychiatry was published. The evidence for effectiveness of DBS for several psychiatric disorders has been steadily accumulating since the first report of DBS for Obsessive Compulsive Disorder (OCD) in 1999. However, the number of psychiatric patients treated with DBS is lagging behind, particularly in comparison with neurology. The number of patients treated with DBS for psychiatric indications worldwide probably does not exceed 500, compared to almost 300,000 patients with neurological disorders that have been treated with DBS within the same period of 20 years. It is not the lack of patients, knowledge, technology, or efficacy of DBS that hinders its development and application in psychiatry. Here, we discuss the reasons for the gap between DBS in neurology and in psychiatry, which seemed to involve the scientific and social signature of psychiatry.
Highlights
It has been roughly two decadess since deep brain stimulation (DBS) was first applied in psychiatry
We discuss the reasons for the gap between DBS in neurology and in psychiatry, which seemed to involve the scientific and social signature of psychiatry
We hypothesize that lack of belief in the biology of psychiatric disorders, social stigma surrounding psychiatry, and ethical concerns hamper psychiatry in the development of DBS for severe and refractory disorders
Summary
It has been roughly two decadess since deep brain stimulation (DBS) was first applied in psychiatry. Based on the published studies and the number of research groups, we estimated that the number of DBS receiving patients with OCD worldwide probably does not exceed 300. These low numbers are especially poignant when compared to those in neurology. Why are there so few patients treated with DBS in psychiatry despite the number of severe therapy-refractory patients and the mental burden it incurred is no less than movement disorders?. Raising funds for DBS research is often hampered by reviewers who find it unethical to treat a psychiatric patient with electrodes, maybe partly due to the negative historical influence of the anti-psychiatry movement and the past experiences with psychosurgery. Should we still let the past cast its shadow over our clinical practice today?
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